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Volume 22, Number 1—January 2016

Waterborne Elizabethkingia meningoseptica in Adult Critical Care1

Luke S.P. MooreComments to Author , Daniel S. Owens, Annette Jepson, Jane F. Turton, Simon Ashworth, Hugo Donaldson, and Alison H. Holmes
Author affiliations: 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)

Main Article

Table 1

Clinical and epidemiologic patient characteristics from an Elizabethkingia meningoseptica outbreak in an adult critical care unit, West London, UK, 2012–2013*

Patient no. Age, y/sex Admission category Date of E. m. acquisition Hospital day of acquisition Sample type† Antimicrobial therapy immediately before E. m. acquisition E. m. treatment regimen Clinical outcome PFGE designation
1 29/M Trauma 2012 Jan 12 35 Respiratory None None Discharged NA
2 45/F Medical 2012 Feb 27 9 Respiratory TZP None Discharged EZ1
3 58/M Medical 2012 Mar 2 22 Respiratory MEM + CAS None Discharged EZ1
4 34/M Trauma 2012 Mar 10 18 Respiratory TZP None Discharged NA
5‡ 28/M Trauma 2012 Mar 20 15 Screening MEM TGC Discharged EZ2
6 64/M Surgical 2012 Mar 22 4 Respiratory None None Discharged NA
7‡ 77/M Medical 2012 Mar 28 10 Screening MEM + MTZ None Discharged EZ1
8 69/M Trauma 2012 Apr 18 11 Screening MEM None Discharged NA
9‡ 35/F Trauma 2012 May 21 19 Screening TZP + AFG TMP/SXT Discharged EZ2
10ठ35/F Surgical 2012 Jul 16 14 Respiratory MEM TMP/SXT Discharged NA
11ठ60/F Medical 2012 Jul 21 22 Respiratory None None Died EZ1
12 55/M Surgical 2012 Jul 27 14 Respiratory TZP + VAN None Died EZ1
13 43/M Trauma 2012 Sep 13 6 Screening MEM + MTZ None Discharged NA
14 40/M Trauma 2012 Dec 27 13 Respiratory MEM + VAN None Discharged NA
15 40/F Medical 2013 Jan 3 31 Blood culture MEM + MTZ TGC Died NA
16‡ 23/M Trauma 2013 Jan 14 13 Respiratory None None Discharged EZ1
17 57/M Trauma 2013 Jan 14 13 Respiratory TZP + FCA None Discharged NA
18ठ19/M Trauma 2013 Mar 26 25 Respiratory TZP + MTZ None Discharged NA
19‡ 70/M Vascular 2013 Apr 8 11 Respiratory MEM + FCA TGC Discharged Unique
20ठ61/F Trauma 2013 Apr 27 11 Respiratory MEM TGC Died Unique
21ठ43/M Surgical 2013 May 1 12 Respiratory MEM +AFG None Discharged NA
22‡ 17/M Trauma 2013 May 22 28 Screening MEM + MTZ None Discharged EZ3
23§ 60/M Medical 2013 May 30 13 Respiratory TZP + FCA None Died NA
24ठ75/F Trauma 2013 Jun 21 13 Respiratory TZP TGC Discharged NA
25 75/M Trauma 2013 Jun 22 12 Respiratory MEM + VAN None Discharged NA
26 77/F Medical 2013 Aug 2 22 Respiratory TZP TMP/SXT Discharged EZ1
27 31/M Trauma 2013 Sep 15 26 Respiratory MEM + VAN TGC Discharged NA
28ठ83/M Surgical 2013 Sep 15 28 Respiratory TZP + FCA TMP/SXT Discharged NA
29ठ32/M Trauma 2013 Oct 10 11 Respiratory TZP + VAN TMP/SXT Discharged NA
30 48/M Trauma 2013 Oct 29 34 Respiratory TZP + VAN None Discharged NA
31¶ 34/F Trauma 2014 Apr 12 1 Screening None None Discharged Unique

*AFG, anidulofungin; CAS, caspofungin; Dis, discharged; E. m., E. meningoseptica; FCA, fluconazole; MEM, meropenem; MTZ, metronidazole; NA, isolate unrecoverable for PFGE analysis; PFGE, pulsed-field gel electrophoresis; TGC, tigecycline; TMP/SXT, trimethoprim/sulfamethoxazole; TZP, piperacillin/tazobactam; VAN, vancomycin; TGC, tigecycline; AFG, anidulofungin.
†Respiratory sample types included nondirected bronchoalveolar lavage or endotracheal suction. Cross-infection screens comprise throat, rectum, nose, and groin swab specimens.
‡Patients in whom no other pathogen was identified in the 7 days before or after isolation of E. meningoseptica.
§Patients in whom chest radiography demonstrated new-onset signs consistent with a pneumonic process in the 48 hours before and after E. meningoseptica isolation.
¶Postoutbreak infection.

Main Article

1Preliminary findings of this study were presented, in part, at the 27th European Society for Intensive Care Medicine conference, Barcelona, Spain, September 27– October 1, 2014.

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