Infection Control in the NICU: Addressing the Threat of Elizabethkingia meningoseptica and Multidrug-Resistant Organisms

Background: Elizabethkingia meningoseptica is an opportunistic, intrinsically multidrug-resistant gram-negative bacillus increasingly implicated in neonatal intensive care unit (NICU) outbreaks.Methods: This retrospective case series with environmental surveillance describes two NICU outbreaks (September 2023 and February – March 2024) involving four neonates in a tertiary care hospital. Environmental samples were collected from various sites within the NICU on two occasions following the outbreaks. Cultures and antimicrobial susceptibility testing (AST) were done as per standard protocols to isolate the pathogen and to report its AST profile.Results: Elizabethkingia meningoseptica was isolated from blood and cerebrospinal fluid of affected neonates and from NICU water-associated sites confirming its role in the outbreaks. Targeted infection control interventions resulted in complete containment of the outbreak.Conclusion: This study documents a NICU outbreak of Elizabethkingia meningoseptica linked to environmental water sources. Early environmental surveillance and prompt multidisciplinary infection control interventions successfully terminated the outbreak. Sustained environmental surveillance of NICU is essential to prevent recurrence.