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Drug resistance linked to outbreak of E. meningoseptica in ICU

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Colonization of tap surfaces and use of broad-spectrum antibiotics contributed to an outbreak of Elizabethkingia meningoseptica in an adult ICU at an English hospital, according to data presented at the 2014 European Congress of Clinical Microbiology and Infectious Diseases.

After an increase in positive samples of E. meningoseptica among patients in the adult ICU at Addenbrooke’s Hospital in Cambridge, United Kingdom, during 2013, researchers sought to investigate the outbreak. Luke Bedford, PhD, of the Cambridge Public Health and Microbiology Laboratory, and colleagues analyzed clinical data for 25 patients who tested positive for at least one clinical isolate of E. meningoseptica from January to October 2013. Patients had a median age of 62 years. Environmental screening of the ICU was conducted as well.

Twenty-two patients had been in the ICU before the study period. Median stay in the ICU until first positive sample for E. meningoseptica was 17.5 days. Median length of stay in the ICU was 27.5 days. Twenty-one patients (84%) received antibiotics to which isolates were expected to be resistant, according to sensitivities before isolation.

Environmental screening indicated 10 positive samples. Analysis of 12 clinical isolates identified two related strains of E. meningoseptica, which were confirmed as resistant to meropenem and sensitive to piperacillin-tazobactam. Fourteen patients died during the study period.

“We describe an outbreak of E. meningoseptica in an adult ICU. A significant number of patients were affected through colonization and septic episodes. The outbreak appeared to be either related to the colonization of tap surfaces in clinical areas and selection pressure through use of broad-spectrum antibiotics,” the researchers concluded.

For more information:

Bedford LJ. Presented at: European Congress of Clinical Microbiology and Infectious Diseases; May 10-13, 2014; Barcelona, Spain.

Disclosure: Relevant financial disclosures could not be confirmed.