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Abstract O-17: INFECTIOUS DISEASES

Yung, C.F.1; Maiwald, M.2; Loo, L.H.2; Soong, H.Y.2; Thoon, K.C.1; Chan, Y.H.3

Pediatric Critical Care Medicine: June 2018 - Volume 19 - Issue 6S - p 10
doi: 10.1097/01.pcc.0000537359.95903.3c
Oral Abstracts
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1K K Women’s and Children’s Hospital - Singapore, Infectious Disease Service, Singapore, Singapore

2K K Women’s and Children’s Hospital - Singapore, Department of Pathology and Laboratory Medicine, Singapore, Singapore

3K K Women’s and Children’s Hospital - Singapore, Critical Intensive Care Unit, Singapore, Singapore

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Aims & Objectives:

Elizabethkingia anophelis (E. anophelis) is an emergent pathogen first described from mid-gut specimens of the Anopheles gambiae mosquito. We report the first confirmed E. anophelis case cluster in a paediatric critical care unit (CCU).

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Methods

A clinical and molecular epidemiological investigation to decipher the clinical manifestation, effective outbreak interventions as well as transmission route of E.anophelis in CCU. All samples were tested using 16S rDNA PCR to identify E.anophelis.

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Results

The cluster was composed of 3 patients positive for Elizabethkingia species from blind bronchial samples detected within a 13 day period. The patients’ age ranged from 2.8 months-4.8 years old and all had significant comorbidity. All case patients’ rooms or cubicles were confirmed positive for E. anophelis from their respective tap outlets. Removal of tap aerators was effective in eliminating E. anophelis from tap water sources. Of the two healthcare staff included in the transmission study, one acquired E. anophelis on her hands following hand washing with contaminated water. After hand hygiene using alcohol based hand rub (ABHR), there was no detectable E. anophelis growth on her hands. Phylogenetic data confirmed the association between tap outlet and patient sample.

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Conclusions

E. anophelis is a nosocomial pathogen with outbreak potential in paediatric CCUs. Hand washing, despite using chlorhexidine soap, is a possible vehicle of transmission for E. anophelis. Effective outbreak control measures should include removal of aerators from tap outlets and the use of ABHR as the primary hand hygiene method of choice.

©2018The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies