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Waterborne Elizabethkingia meningoseptica in Adult Critical Care(1)

OPEN Emerging infectious diseases | 23 Dec 2015

LS Moore, DS Owens, A Jepson, JF Turton, S Ashworth, H Donaldson and AH Holmes
Abstract
Elizabethkingia meningoseptica is an infrequent colonizer of the respiratory tract; its pathogenicity is uncertain. In the context of a 22-month outbreak of E. meningoseptica acquisition affecting 30 patients in a London, UK, critical care unit (3% attack rate) we derived a measure of attributable morbidity and determined whether E. meningoseptica is an emerging nosocomial pathogen. We found monomicrobial E. meningoseptica acquisition (n = 13) to have an attributable morbidity rate of 54% (systemic inflammatory response syndrome >2, rising C-reactive protein, new radiographic changes), suggesting that E. meningoseptica is a pathogen. Epidemiologic and molecular evidence showed acquisition was water-source-associated in critical care but identified numerous other E. meningoseptica strains, indicating more widespread distribution than previously considered. Analysis of changes in gram-negative speciation rates across a wider London hospital network suggests this outbreak, and possibly other recently reported outbreaks, might reflect improved diagnostics and that E. meningoseptica thus is a pseudo-emerging pathogen.
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Concepts
Linguistics, Pneumonia, Measurement, Systemic inflammatory response syndrome, Outbreak, C-reactive protein, Inflammation, Epidemiology
MeSH headings
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