Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Two cases of Chryseobacterium meningosepticum infection in a neonatal intensive care unit

신생아 중환자실에서 발생한 Chryseobacterium meningosepticum 감염 2례

  • Yoon, Hye Sun (Department of Pediatrics, School of Medicine, Eulji University)
  • 윤혜선 (을지대학교 의과대학 을지병원 소아과)
  • Received : 2007.05.31
  • Accepted : 2007.06.22
  • Published : 2007.07.15
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Abstract

We report on two premature infants who developed nosocomial infection caused by Chryseobacterium meningosepticum in a neonatal intensive care unit (NICU). One premature infant developed sepsis, meningitis, and hydrocephalus, and was treated successfully with ciprofloxacin plus trimethoprim-sulfamethoxazole combination therapy for 4 weeks and with a ventriculoperitoneal shunt. The other premature infant, who was in a chronically debilitated state, had infection that had colonized only in the respiratory tract but had no clinical signs for 66 days. Extensive environmental surveillance demonstrated that the suction bottle apparatus was the source of infection. We prevented the spread of infection by closing the NICU temporarily, isolating the patients early in their infection, and eradicating the source of infection source.

Cryseobacterium meningosepticum은 흙, 병원, 수돗물을 포함한 물이 있는 환경에서 발견되는 그람 음성 막대균으로, 미숙아, 노인과 같이 면역성이 결여된 인체에 기회감염을 일으키고, 미숙아에서는 패혈증, 뇌수막염과 같은 중증 질환을 유발하여 사망률과 합병증 발생이 높다. 특히, 균주가 병원내 배수관, 기계장비등을 통해 오염되어 신생아실에서 폭발적 유행이 가능하다. 저자들은 미숙아에서 발생한 다항생제 내성 C. meningosepticum에 의한 패혈증, 뇌수막염을 ciprofloxacin으로 치료한 1례와 동기간에 무증상 보균상태를 보였던 1례와 성공적인 환경검사와 조절에 대해서 보고하는 바이다.

Keywords

References

  1. Powell DA, Marcon MJ. Flavobacteriaceae. In: Long SS editor. Principles and practice of pediatric infectious diseases. 2nd ed. Oxford, Churchill Livingstone 2003:851-2
  2. Chiu CH, Waddingdon M, Hsieh WS, Greenberg D, Schreckenberger PC, Carnahan AM. Atypical Chryseobacterium meningosepticum and meningitis and sepsis in newborns and the immunocompromised, Taiwan. Emerg Infect Dis 2000;6:481-6 https://doi.org/10.3201/eid0605.000506
  3. Hoque SN, Graham J, Kaufmann ME, Tabaqchali S. Chryseobacterium (Flavobacterium) meningosepticum outbreak associated with colonization of water taps in a neonatal intensive care unit. J Hosp Infection 2001;47:188-92 https://doi.org/10.1053/jhin.2000.0908
  4. Kirby JT, Sader HS, Walsh TR, Jones RN. Antimicrobial susceptibility and epidemiology of a worldwide collection of Chryseobacterium spp:report from th SENTRY antimicrobial surveillance program (1997-2001). J Clin Microbiol 2004;42:445-8 https://doi.org/10.1128/JCM.42.1.445-448.2004
  5. Gungor S, Ozen M, Akinci A, Durmaz R. A Chryseobacterium meningosepticum outbreak in a neonatal ward. Infect Control Hosp Epidemiol 2003;24:613-7 https://doi.org/10.1086/502261
  6. Bloch KC, Nadarajah R, Jacobs R. Chryseobacterium meningosepticum: an emerging pathogen among immunocompromised adults. Reports of 6 cases and literature review. Medicine 1997;76:30-41 https://doi.org/10.1097/00005792-199701000-00003
  7. Di Pentima MC, Mason EO Jr, Kaplan SL. In vitro antibiotic synergy against Flavobacterium meningosepticum: implications for therapeutic options. Clin Infect Dis 1998;26:1169-76 https://doi.org/10.1086/520309
  8. Lin PY, Chu C, Su LH, Huang CT, Chang WY, Chiu CH. Clinical and microbiological analysis of bloodstream infections caused by Chryseobacterium meningosepticum in nonneonatal patients. J Clin Microbiol 2004;42:3353-5 https://doi.org/10.1128/JCM.42.7.3353-3355.2004
  9. Kubin R. Safety and efficacy of ciprofloxacin in paediaric patients-review. Infection 1993;21:413-21 https://doi.org/10.1007/BF01728929
  10. van den Oever HL, Versteegh FG, Thewessen EA, van den Anker JN, Mouton JW, Neijens HJ. Ciprofloxacin in preterm neonates: case report and review of the literature. Eur J Pediatr 1998;157:843-5 https://doi.org/10.1007/s004310050949
  11. Tekerekoglu MS, Durmaz R, Ayan M, Cizmeci Z, Akinci A. Analysis of an outbreak due to Chryseobacterium meningosepticum in a neonatal intensive care unit. New Microbiol 2003;26:57-63