Oral Presentation New Zealand Association of Plastic Surgeons ASM & AGM

The Crazy Microbiology of the White Island Burns Victims - Chryseobacterium indologenes  (1279)

Febe Minogue 1 , Orazio DiBartolo 1 , Richard Wong She 1 , Paul Baker 1 , Amber Moazzam 1 , Susan Morpeth 1
  1. Middlemore Hospital, Auckland, AUCKLAND, New Zealand

White Island, an active volcano 50km offshore from a small town in New Zealand called Whakatane, is an isolated destination, with old mining equipment and a steaming crater that draw tourists. There were 47 souls on the island on the 9th of December 2019 when it suddenly erupted.  The survivors were a mixture of some who hid behind rocks or jumped into the ocean, prior to getting onto a boat or helicopter to escape back to Whakatane. Some were cooled with fresh water on board the rescuing boats.  

Among the 31 patients that were hospitalized after the White Island eruption, three of those that were treated in the National Burn Unit at Middlemore Hospital had Chryseobacterium indologenes isolated from tissue cultures, and two of these also isolated Elizabethkingia miricola.  Chryseobacterium and Elizabethkingia are related organisms, and are intrinsically multi-resistant, including to carbapenems. 

These are both uncommon human pathogens, and are opportunistic organisms of low virulence that on the rare occasion can be involved in severe infection. Infection is usually from an environmental source such as the water initially used to cool the patients, although they are typically found in catheter-related bacteraemia, in severely immunosuppressed patients1.

Prior to this paper, the largest case series of Chryseobacterium seen in burns patients was a series of three observed over a period of two years, by The Royal Brisbane2. 

We present these new cases with Chryseobacterium from the White Island burns injuries, and go through the difficulties of these unusual bacteria, as well as recommendation of management.

  1. Booth, S. J. (2014). Chryseobacterium Related Genera Infections☆. Reference Module in Biomedical Sciences. Elsevier Inc. https://doi.org/10.1016/b978-0-12-801238-3.04922-9
  2. Kienzle, N., Muller, M., & Pegg, S. (2001). Chryseobacterium in burn wounds. Burns, 27(2), 179–182. https://doi.org/10.1016/S0305-4179(00)00087-5