title: A Chryseobacterium meningosepticum outbreak in a neonatal ward.
abstract: OBJECTIVE
  To report epidemiologic, bacteriologic, and clinical features of a Chryseobacterium meningosepticum outbreak.
  
  
  METHODS
  Outbreak investigation.
  
  
  METHODS
  A neonatal intensive care unit (NICU) of a referral teaching hospital.
  
  
  METHODS
  During 2 weeks in September 2001, four neonates in the NICU developed sepsis and underwent laboratory investigation. Multiple samples were obtained for cultures from endotracheal tubes, mechanical ventilators and humidifier boxes, infant incubators, parenteral and antiseptic solutions, feeding bottles, sinks, faucets, doors, and healthcare workers.
  
  
  RESULTS
  C. meningosepticum was isolated from the blood cultures of four patients. The first isolate was identified 5 days after the death of the index case. Although all isolates were ciprofloxacin susceptible in vitro, the remaining three patients did not respond to ciprofloxacin therapy given for 6 or 7 days. Therapy was switched to vancomycin and rifainpin and all three patients survived, with one having a complication (hydrocephalus). Environmental surveillance revealed C. meningosepticum in the stock lipid solution as the source of the epidemic. The outbreak was controlled after discontinuation of intravenous lipid solution, restriction of further neonatal admissions, and thorough disinfection of the unit and its equipment.
  
  
  CONCLUSIONS
  Early identification of an epidemic and its source is important in avoiding morbidity and mortality. A contaminated lipid stock bottle was the source of this outbreak associated with multiple cases and one death.
authors.affiliation: Department of Pediatrics, Turgut Ozal Research Center, Medical Faculty of Inönü University, Malatya, Turkey.
authors.forename: Serdal
authors.initials: S
authors.lastname: Güngör
authors.forename: Metehan
authors.initials: M
authors.lastname: Ozen
authors.forename: Aysehan
authors.initials: A
authors.lastname: Akinci
authors.forename: Riza
authors.initials: R
authors.lastname: Durmaz
mesh_terms: D045247:Chryseobacterium / Q000472:pathogenicity; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks / Q000517:prevention & control; D024881:Drug Resistance, Bacterial; D004784:Environmental Monitoring / Q000379:methods; D062665:Epidemiological Monitoring; D045826:Flavobacteriaceae Infections / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D018571:Sentinel Surveillance; D014421:Turkey / Q000453:epidemiology