title: An outbreak of Elizabethkingia meningoseptica neonatal meningitis in Mauritius.
abstract: BACKGROUND
  Elizabethkingia meningoseptica is a rare but well-recognised cause of neonatal meningitis. Reported outbreaks have involved very few cases. We describe the management and outcome of a relatively large outbreak of E.meningoseptica neonatal meningitis
  
  
  METHODS
  From August 2002 to December 2003, eight cases of meningitis caused by E. meningoseptica occurred among babies admitted to the neonatal ward of Jawarhlal Nehru hospital, Mauritius. In all cases, the organism was isolated from the cerebrospinal fluid. Infection control measures were re-emphasized after each case and environmental swabs were cultured on several occasions.
  
  
  RESULTS
  The affected babies were aged 6 to 20 days (mean age of 10 days). Seven of the babies weighed < 2,500 g. All CSF isolates had the same antibiotic susceptibility pattern. Apart from one baby who died shortly after admission, all cases responded to treatment with intravenous piperacillin and oral rifampicin for three weeks. Hydrocephalus developed in two babies and was subsequently fatal in one case. At follow-up of the other cases, one baby had severe neurological sequelae but a full recovery was observed in the other four cases. The source of the outbreak could not be established conclusively.
  
  
  CONCLUSIONS
  The outcome was better than what has been reported in the medical literature. Prompt identification of the causative organism and initiation of appropriate antimicrobial therapy is essential. The combination of piperacillin and rifampicin should be considered an option for the treatment of E. meningoseptica neonatal meningitis if supported by properly performed antibiotic susceptibility test results.
authors.affiliation: Central Health Laboratory, Victoria Hospital, Candos, Mauritius. missack@intnet.mu
authors.forename: Mohammad I
authors.initials: MI
authors.lastname: Issack
authors.forename: Yaseen
authors.initials: Y
authors.lastname: Neetoo
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002555:Cerebrospinal Fluid / Q000382:microbiology; D004196:Disease Outbreaks; D004783:Environmental Microbiology; D005260:Female; D041965:Flavobacteriaceae / Q000302:isolation & purification*; D045826:Flavobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D006849:Hydrocephalus / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D007231:Infant, Newborn; D008297:Male; D008436:Mauritius / Q000453:epidemiology; D016920:Meningitis, Bacterial / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D008826:Microbial Sensitivity Tests; D010878:Piperacillin / Q000008:administration & dosage; D012293:Rifampin / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D012293:Rifampin; D010878:Piperacillin