LATE-ONSET NEONATAL SEPSIS DUE TO ELIZABETHKINGIA MENINGOSEPTICA
Keywords:
bacterial sepsis, infection, neonatal period, primary health careAbstract
Inroduction Elizabethkingia meningoseptica is well distributed in hospitals but also in community environments. It rarely causes infections in an immunocompetent host or in hosts who haven’t had a prolonged hospital stay. Premature birth is the major risk factor for neonates. Our objective is to report two cases of late-onset neonatal sepsis from Primary-care pediatrician’s perspective, as well as to point out E.meningoseptica as the causative agent.
Case report We report cases of two neonates who were patients of the same pediatrician practice at the Primary Health Care Center and were born in the same maternity hospital within five days. They were not on a prolonged hospital stay. One was a preterm neonate, who was ventilated and on 5-day antibiotic treatment and negative infection markers when discharged. He was at home for 8 days, and the other one was a term neonate who was at home for 14 days from the maternity hospital having been discharged until the beginning of symptoms. In that time the term neonate had brief contact with health care services for twice, but portal of entry was not confirmed by laboratory tests.
Conclusion Primary care pediatricians should always take a careful history (maternal and infant risk factors) and observe a febrile neonate as a possible case of sepsis. Early recognition is the most important factor in decreasing the morbidity and mortality from neonatal sepsis.
References
Ershad M, Mostafa A, Dela Cruz M, Vearrier D. Neonatal Sepsis. Curr Emerg Hosp Med Rep. 2019; 7(3):83-90.
Güngör S, Ozen M, Akinci A, Durmaz R (2003) A Chryseobacterium meningosepticum outbreak in a neonatal ward. Infect Control Hosp Epidemiol 24:613–17.
Chan JC, Chong CY, Thoon KC, Tee NWS, Maiwald M, Lam JCM et al. Invasive paediatric Elizabethkingia meningoseptica infections are best treated with a combination of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or fluoroquinolone. J Med Microbiol. 2019; 68(8):1167-72.
Ceyhan M, Celik M. Elizabethkingia meningosepticum (Chryseobacterium meningosepticum) Infections in Children. Int J Pediatr. 2011; 2011:215237.
Dong Y, Speer CP. Late-onset neonatal sepsis: recent developments. Arch Dis Child Fetal Neonatal Ed. 2015; 100(3): F257-63.
Iroh Tam PY, Bendel CM. Diagnostics for neonatal sepsis: current approaches and future directions. Pediatr Res. 2017; 82(4): 574–83.
Avva U, Mueller M. Fever In A Neonate. [Updated 2021 August 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482196/
Choi MH, Kim M, Jeong SJ, Choi JY, Lee IY, Yong TS, et al. Risk Factors for Elizabethkingia Acquisition and Clinical Characteristics of Patients, South Korea. Emerg Infect Dis. 2019; 25(1): 42-51.
Güngör S, Ozen M, Akinci A, Durmaz R. A Chryseobacterium meningosepticum outbreak in a neonatal ward. Infect Control Hosp Epidemiol. 2003; 24(8):613-7.
Lin JN, Lai CH, Yang CH, Huang YH. Elizabethkingia Infections in Humans: From Genomics to Clinics. Microorganisms. 2019; 7(9):295.
Bennett JE, Dolin R, Blaser MJ. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases 8th Edition. Elsevier Health Sciences. 2014; 293.
Tai IC, Liu TP, Chen YJ, Lien RI, Lee CY, Huang YC. Outbreak of Elizabethkingia meningoseptica sepsis with meningitis in a well-baby nursery. J Hosp Infect. 2017; 96(2):168-71.
Jean SS, Lee WS, Chen FL, Ou TY, Hsueh PR. Elizabethkingia meningoseptica: an important emerging pathogen causing healthcare-associated infections. J Hosp Infect. 2014; 86:244–9.
Barnawi AI, Kordy FN, Almuwallad OK, Kassarah KA. Early neonatal sepsis and meningitis caused by Elizabethkingia meningoseptica in Saudi Arabia. Saudi Med J. 2020; 41(7):753-6.
Maraki S, Scoulica E, Manoura A, Papageorgiou N, Giannakopoulou C, Galanakis E. A Chryseobacterium meningosepticum colonization outbreak in a neonatal intensive care unit. Eur J Clin Microbiol Infect Dis. 2009; 28(12):1415-9.
