Ratnamani M S, Rao Ratna
Department of Microbiology, Apollo Hospitals, Hyderabad, Andhra Pradesh, India.
Indian J Crit Care Med. 2013 Sep;17(5):304-7. doi: 10.4103/0972-5229.120323.
Elizabethkingia meningoseptica, a ubiquitous gram-negative aerobic bacillus, is an emerging hospital acquired pathogen in patients on dialysis. It has been isolated in the hospital environment in water supplies, disinfectants, and medical devices. We present here an analysis of eight healthcare-acquired infections with this organism in adults. To the best of our our knowledge, this is the first report of infections with this organism in patients on hemodialysis.
Over a 6-month period, eight patients were infected with E. meningoseptica in our hospital. These patients had bacteremia and lower respiratory tract infection. All these patients were on on mechanical ventilation and undergoing bedside hemodialysis in the intensive care unit (ICU). Environmental surveillance was done to detect the possible source.
These patients had a common denominator of bedside hemodialysis, and use of broad-spectrum antibiotics. E. meningoseptica was isolated from the water and sink of the ICU.
E. meningoseptica is emerging as a nosocomial pathogen among patients on hemodialysis. Its unusual resistance pattern coupled with inherent resistance to colistin makes this organism difficult to treat unless susceptibility patterns are available. Isolation of this organism in handwash sink and water is a significant finding as they have been reported to survive in chlorinated water. Disinfecting the sinks and using filtered water for hand washing in critical areas may help in preventing infections with this organism.
脑膜败血伊丽莎白金菌是一种普遍存在的革兰氏阴性需氧杆菌,是透析患者中一种新出现的医院获得性病原体。它已在医院环境中的供水系统、消毒剂和医疗设备中被分离出来。我们在此呈现对8例成人该病原体医院获得性感染的分析。据我们所知,这是关于血液透析患者感染该病原体的首例报告。
在6个月期间,我院有8例患者感染脑膜败血伊丽莎白金菌。这些患者患有菌血症和下呼吸道感染。所有这些患者均在重症监护病房(ICU)接受机械通气并进行床边血液透析。进行了环境监测以检测可能的来源。
这些患者的共同特征是床边血液透析以及使用广谱抗生素。脑膜败血伊丽莎白金菌从ICU的水和水槽中分离出来。
脑膜败血伊丽莎白金菌正成为血液透析患者中的一种医院病原体。其不同寻常的耐药模式以及对黏菌素的固有耐药性使得该病原体难以治疗,除非有药敏结果。在洗手水槽和水中分离出该病原体是一个重要发现,因为据报道它能在含氯水中存活。对水槽进行消毒并在关键区域使用过滤水洗手可能有助于预防该病原体感染。