Chryseobacterium meningosepticum infections in a dialysis unit.

BACKGROUND Chryseobacterium species are Gram-negative bacteria with an unusual antibiotic profile. Chryseobacterium meningosepticum is the species most commonly encountered as a human pathogen. OBJECTIVES To study the microbiological, clinical and therapeutic features of C. meningosepticum infections in patients on dialysis, at Sri Jayewardenepura General Hospital (Teaching) (SJGH), and to trace the source of infections. DESIGN A retrospective descriptive study. SETTING Dialysis unit of SJGH. PATIENT population Patients who underwent long term haemodialysis (HD) and manual intermittent peritoneal dialysis (IPD) in the dialysis unit. METHODS Clinical and microbiological records of patients with C. meningosepticum infections over a period of 2 years were reviewed retrospectively. Environmental screening was carried out to detect a possible source of infection. RESULTS Thirty five episodes of infection due to C. meningosepticum in 33 patients on HD and IPD were detected. There were 30 episodes of peritonitis, four of bacteraemia and one of asymptomatic colonization of a PD catheter. Isolates were resistant to aminoglycosides, chephalosporins and aztreonam, and sensitive to cotrimoxazole, vancomycin and rifampicin. They showed variable sensitivity to imipenem and ciprofloxacin. All except one patient had a favourable outcome. C. meningosepticum was cultured from a sink in the dialysis unit, but the original source of the organism was not known. CONCLUSION C. meningosepticum could be an important pathogen in a dialysis unit, and fluoroquinolones and vancomycin are effective as empiric therapy.