Flavobacterium meningosepticum

Flavobacterium meningosepticum. Black pigment ink on on white 6"x6" Bristol Board, inverted colors.

The Wall Street Journal Weekend edition dated June 30, 2012 has a very good article by Matt Ridley (Mind & Matter) about microbes, worms and our bodies and I quote "...there are at least 10 times as many bacterial cells (belonging to up to 1,000 species) in your gut as there are human cells in your entire body: that "you" are actually an entire microbial zoo as well as a person. You are 90% microbes by cell count, though not by volume - a handy reminder of just how small bacteria are."

For the past three years I have been involved with a project for our infection control department that at times consumed my waking hours and disrupted my sleep. I was asked to write a rule program to identify MDRO or multiple drug resistant organism microbiology results and automate desired actions that will facilitate the monitoring process for our clinicians to enhance care for our patients and the prevention of nosocomial infections. Whew! That was a long sentence! I loved and dreaded the project. It was a complete mental burden since I was the primary and lone rule writer for this project. We worked as a team but still it was my responsibility to write and make the rule work. The rule module is so long it prints on 40 to 50 letter sized pages in size 10 font. Imagine troubleshooting a programming line. That is why I wear glasses. Below is a drawing I did three years ago to describe my enthusiasm and dread for the overwhelming responsibility. By the way, the project is still going on and this month we are upgrading the code.

In 2009 it was an ambitious attempt to install a timely notification process for our infection control specialists. We were pioneers in this field having started as early as 2004 to computerize some form of notification and automate desired actions and procedures. This year, we finally implemented a software module from our vendor but it fell short in performing the most important process – identify MDRO or multiple drug resistant organisms through a clinical algorithm. You see, this process is quite complicated with formulas and clinical requirements associated with cultures and sensitivities. We were successful in doing so with scripts and rules that we developed. However, this was not without pain as throughout the past three years we improved upon the process in collaboration with our infection control practitioners. The vendor took our rule and script and enhanced it to make the new module perform what we now consider as one of the core functions.

One of the organism genus evaluated by this rule is Flavobacterium, meaning “yellow bacteria” described by the yellow pigment often associated with these organisms.

Flavobacterium meningosepticum* is a gram negative, slender, non encapsulated rod. Short and rounded forms may also be present. It is a saprophyte (living on dead organic matter) in water, soil and hospital environments. It is widely distributed in nature such as lakes, ponds, streams, rivers, seas and soil. Want to go swimming now?  They are ubiquitous colonizers of the hospital environment due to their ability to grow in non-nutrient fluids. They have been isolated from intravenous fluid vials, ice machines, nebulizers, topical hand sanitizers and the hands of hospital personnel. The organism does not easily colonize an adult with intact host defenses but have been recovered from nasoendotracheal tubes and throat cultures of healthy infants in outbreaks of meningitis in nurseries. The outbreaks of neonatal meningitis usually have high mortality and serious neurological sequelae.

The term Flavobacterium meningosepticum was proposed by Elizabeth King in her 1959 study of previously unclassified bacteria associated with meningitis.

* Flavobacterium meningosepticum. Hilda Ratner. Infection Control. Vol.5, No,5 (May, 1984). Pp 237-239 Published by The University of Chicago press