Two outbreaks of Flavobacterium meningosepticum type E in a neonatal intensive care unit

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Abstract
Two separate outbreaks due to F. meningosepticum type E occurred in a neonatal intensive care unit in March-April and July 1975. The 1st outbreak involved 4 infants in the unit. Two infants developed meningitis, 1 had bacteremia and 2 were colonized. During the 2nd outbreak, 5 of 7 infants were colonized but none developed disease. The upper respiratory tract was colonized first in most instances, and the organism persisted at this site for a mean of 17.3 days. Duration of colonization was more prolonged in infants receiving antibiotics than in untreated infants. Extensive environmental surveillance failed to demonstrate a reservoir, but F. meningosepticum was recovered from 3 nasoendotracheal tubes and from an aerosol tube before colonization of 4 infants. The organism was resistant to most antimicrobial agents tested and developed resistance to others during the treatment course of 1 infant. Although F. meningosepticum was not recovered from cultures of transport vehicles, several other gram-negative bacteria were isolated and were also resistant to multiple antibiotics.