Waterborne Elizabethkingia meningoseptica in Adult Critical Care |
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Authors: | Luke S.P. Moore Daniel S. Owens Annette Jepson Jane F. Turton Simon Ashworth Hugo Donaldson Alison H. Holmes |
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Affiliation: | Imperial College Healthcare NHS Trust, London, UK (L.S.P. Moore, A. Jepson, S. Ashworth, H. Donaldson, A.H. Holmes); ;Imperial College London, London. (L.S.P. Moore, A.H. Holmes); ;St. George’s Healthcare NHS Trust, London (D.S. Owens); ;Public Health England, London (J.F. Turton) |
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Abstract: | Elizabethkingia meningoseptica is an infrequent colonizer of the respiratory tract; its pathogenicity is uncertain. In the context of a 22-month outbreak of E. meningoseptica acquisition affecting 30 patients in a London, UK, critical care unit (3% attack rate) we derived a measure of attributable morbidity and determined whether E. meningoseptica is an emerging nosocomial pathogen. We found monomicrobial E. meningoseptica acquisition (n = 13) to have an attributable morbidity rate of 54% (systemic inflammatory response syndrome >2, rising C-reactive protein, new radiographic changes), suggesting that E. meningoseptica is a pathogen. Epidemiologic and molecular evidence showed acquisition was water-source–associated in critical care but identified numerous other E. meningoseptica strains, indicating more widespread distribution than previously considered. Analysis of changes in gram-negative speciation rates across a wider London hospital network suggests this outbreak, and possibly other recently reported outbreaks, might reflect improved diagnostics and that E. meningoseptica thus is a pseudo-emerging pathogen. |
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Keywords: | Matrix-assisted laser desorption/ionization time-of-flight intensive care antimicrobial drug resistance water Chryseobacterium meningosepticum Flavobacterium meningosepticum Elizabethkingia meningoseptica United Kingdom adults |
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