Waterborne Elizabethkingia meningoseptica in Adult Critical Care.
Waterborne Elizabethkingia meningoseptica in Adult Critical Care.
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DOI：
10.3201/eid2201.150139
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发表时间：
2016-01
影响因子：
11.8
通讯作者：
Holmes AH
中科院分区：
文献类型：
--
作者：
Moore LS;Owens DS;Jepson A;Turton JF;Ashworth S;Donaldson H;Holmes AH
这次爆发可能反映了诊断测试的改进，表明E。脑膜炎败血症是一种假新兴病原体。脑膜炎败血症嗜酸菌是一种罕见的呼吸道定植者;其致病性尚不确定。在E.我们对英国伦敦重症监护病房的30例脑膜炎败血症患者（发病率为3%）进行了归因发病率的测定，并确定了E.脑膜炎败血症是一种新出现的医院感染病原体。我们发现了单菌E. 13例脑膜炎败血症患者的归因发病率为54%（全身炎症反应综合征>2分、C反应蛋白升高、新的影像学改变），提示脑膜炎败血症可能与E.脑膜炎败血症是一种病原体流行病学和分子证据表明，在重症监护中，感染与水源有关，但也发现了许多其他E。脑膜炎败血症菌株，表明更广泛的分布比以前认为的。对整个伦敦医院网络中革兰氏阴性菌物种形成率变化的分析表明，这次疫情以及最近报道的其他疫情可能反映了诊断方法的改进，因此，脑膜炎败血症是一种假新兴病原体。
This outbreak might reflect improved diagnostic testing, indicating that E. meningoseptica is a pseudo-emerging pathogen. 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.