Epidemic meningitis of the newborn caused by Flavobacteria. I. Epidemiology and bacteriology

Cabrera, Hugo Álvarez-Argüelles; Davis, Galen H.

doi:10.1097/00006199-196201120-00031

Cited by 14 publications

(23 citation statements)

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“…Biochemical characteristics are summarised in the Table. The organism was found to belong to serotype C and was sensitive to erythromycin (15 ,ug/l), nalidixic acid (30 ,ug/l), lincomycin (2 ,ug/l), and novobiocin (5 ,ug/l). (Cabrera and Davis, 1961;Sugathadasa and Arseculeratne, 1963;Agarwal and Ray, 1971). In healthy adults without prior debilitating illness, infections by this organism have responded promptly to treatment with appropriate antibiotics (Werthamer and Weiner, 1972;Bagley et al, 1976).…”

Section: Resultsmentioning

confidence: 99%

Flavobacterium meningosepticum as an opportunist.

Mani¹,

Kuruvila²,

Batliwala³

et al. 1978

J Clin Pathol

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Section: Resultsmentioning

confidence: 99%

Flavobacterium meningosepticum as an opportunist.

Mani¹,

Kuruvila²,

Batliwala³

et al. 1978

J Clin Pathol

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“…In some of the previous studies, F. meningosepticum was traced to environmental sources. 7,16 The organism was known to inhabit watery environments and even to resist a chlorine level of 100 mg/kg higher than that used in chlorination of municipal water supplies. 13 Although F. meningosepticum was frequently isolated from the hospital environment, 10,11 our previous routine and environmental screening for hospital-acquired infections since 1982 did not reveal this organism in our hospital environment.…”

Section: Discussionmentioning

confidence: 99%

“…3 Flavobacterium meningosepticum is the species most often associated with human disease, and it was initially recognized and named by King in 1959. 4 Besides causing meningitis in premature infants, [5][6][7] the organism has previously been reported as a cause of many hospital-acquired infections, including endocarditis, 8 postoperative bacteremia, 9 burn and soft tissue infections, 10 as well as pneumonia in patients in intensive care units. 11,12 Some of these infections were linked to environmental sources.…”

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confidence: 99%

Flavobacterium Meningosepticumin Intensive Care Units of a Teaching Hospital in Riyadh, Saudi Arabia

et al. 1997

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“…meningosepticum have been reported extensively by others (4,6,10). The antibiotic susceptibility pattern is unique and identifying; for example, it is highly resistant to all aminoglycosides, cephalosporins, polymyxins, and penicillins, and it is almost always susceptible to erythromycin, clindamycin, rifamycin, and vancomycin.…”

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confidence: 98%

“…Subsequent development of resistance to erythromycin prompted the use of intravenous and intraventricular rifamycin, which eventually resulted in cure. Diagnosis of F. meningosepticum meningitis in the second patient was delayed, and appropriate therapy was not administered until 4 days prior to the patient's death. Of 82 previously published cases, only 4 occurred in adults.…”

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Flavobacterium meningosepticum Meningitis: Report of Selected Aspects

Rios

Klimek

Maderazo

et al. 1978

Antimicrob Agents Chemother

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Two patients developed meningitis due to Flavobacterium meningosepticum. Because of resistance to most available antimicrobial agents, intravenous and intraventricular erythromycin was administered to one patient. Subsequent development of resistance to erythromycin prompted the use of intravenous and intraventricular rifamycin, which eventually resulted in cure. Diagnosis of F. meningosepticum meningitis in the second patient was delayed, and appropriate therapy was not administered until 4 days prior to the patient's death. Of 82 previously published cases, only 4 occurred in adults. Therapy of meningitis due to this organism has been a difficult problem, and we suggest possible modes of therapy, based on our experience and a review of the literature.Although Flavobacterium meningosepticum is not commonly considered a pathogen in humans, this organism has been reported to produce meningitis (1-5, 7-14, 16-20, 22), postoperative bacteremia (15), and endocarditis (21). Of these infections, meningitis has gained greatest attention because of its tendency to occur in local outbreaks, to involve neonates, and to result in high mortality. Difficulty in the eradication of infection in neonates may be explained by the impaired host defenses of newborns, the use of inappropriate antibiotic therapy, or the peculiar antibiotic susceptibility pattern of this organism.In this communication, we describe two additional cases of meningitis due to this organism and review the literature of previous case reports with special emphasis on the antimicrobial susceptibility patterns and therapy.CASE REPORTS Case no. 1. A 16-day-old boy was admitted to Hartford Hospital with a history of fever and increasing irritability of 4-day duration. He was delivered by Caesarian section because of uterine bleeding after 40 weeks of gestation and weighed 2.8 kg.On admission he was irritable and refused feedings. The temperature was 101°F (ca. 38.3°C) by rectum. The anterior fontanelle was not tense, arid there were no localizing neurological signs. A chest roentgenogram showed a right middle lobe infiltrate. Lumbar puncture was perforned and yielded cerebrospinal fluid (CSF) with 784 erythrocytes per mm3 and 11 white blood cells per mm3 with 8 polymorphonuclear cells and 3 lymphocytes; the sugar was 53 mg/100 ml with a simultaneous blood sugar of 130 mg/100 ml, and the protein was 90%. Gram stain did not reveal any microorganism. A presumptive diagnosis of meningitis was made, and the patient was begun on ampicillin (200 mg/kg per day) and gentamicin (7.5 mg/kg per day), both intravenously.On hospital day 2, he developed apneic episodes. Lumbar puncture was repeated, and CSF examination now revealed 7,500 erythrocytes per mm3 and 290 white blood cells per mm3 with 78% polymorphonuclear cells and 22% lymphocytes. The sugar was 3 mg/100 ml, and protein was 310 mg/100 ml.On hospital day 3, chloramphenicol (50 mg/kg per day intravenously) was started and ampicillin and gentamicin were discontinued due to no apparent clinical improvement while on th...

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Epidemic meningitis of the newborn caused by Flavobacteria. I. Epidemiology and bacteriology

Cited by 14 publications

References 0 publications

Flavobacterium meningosepticum as an opportunist.

Flavobacterium meningosepticum as an opportunist.

Flavobacterium Meningosepticumin Intensive Care Units of a Teaching Hospital in Riyadh, Saudi Arabia

Flavobacterium meningosepticum Meningitis: Report of Selected Aspects

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