Biliary Tract Infection or Colonization with Elizabethkingia meningoseptica after Endoscopic Procedures Involving the Biliary Tract

Abstract

Objective This study was performed to investigate the clinical significance of detecting Elizabethkingia meningoseptica in the bile. Methods We herein report a case series of biliary colonization or infection with E. meningoseptica. Twenty patients with E. meningoseptica recovered from the bile were treated at a 4,300-bed teaching hospital in China between January 2009 and December 2012. The clinical information for the cases of E. meningoseptica recovered from the bile and the microbiological data of the E. meningoseptica isolates were examined. Results Most of the 20 patients were not immunocompromised, although they had cholelithiasis and had recently received antimicrobial agents. All cases were treated with indwelling nasobiliary tubes and endoscopic retrograde cholangiopancreatography and/or endoscopic sphincterotomy prior to the detection of E. meningoseptica in the bile. The average time between the placement of the nasobiliary tube and the detection of E. meningoseptica in the bile was 6.6 days. E. meningoseptica caused cholangitis in five cases, one of which also involved secondary septicemia, and colonized the nasobiliary tubes or biliary tract in the remaining 15 cases. All but two patients recovered and were discharged. Two patients died of septicemia; E. meningoseptica and Escherichia coli were the causative pathogens in one case and other organisms were the causative pathogens in the other. Conclusion E. meningoseptica is an unusual causative pathogen of healthcare-associated cholangitis. Cholangitis resulting from this bacterium is generally associated with good outcomes, although secondary septicemia can be life-threatening.

Epidemiological Study and Analysis of Risk Factors for Elizabethkingia Meningoseptica Infection in a Large General Hospital in China

“…The literature showed that E. meningoseptica was detected in six species (humans, pigs, dogs, birds, insects, and corn) and was reported on ve continents (Asia, Europe, America, Africa, and Oceania), of which Asia had the most reports, followed by Europe and America (Table 1). There were 32 epidemiological investigation reports related to E. meningoseptica infection, which included 366 infected people; the overall mortality rate of patients with E. meningoseptica infection was > 20%, and the highest mortality rate was 63.20% (Table 2) [5][6][7][8][9][10][11][12][13][14][15][16][17][18]. proportion, with 48 cases (52%) in total, followed by elderly patients (aged > 65 years), with 28 cases (30%) (Fig.…”

Fatal Elizabethkingia Meningosepticacholangitis Following Biliary Stent Placement

“…Although it rarely causes biliary tract infection, cholangitis due to E. meningoseptica is generally associated with a favourable prognosis. 3 Here, we report the case of an elderly lady who developed cholangitis due to E. meningoseptica following biliary stent placement and died subsequently because of septic shock.…”

Probability of outbreaks and cross-border dissemination of the emerging pathogen: a genomic survey of Elizabethkingia meningoseptica

“…While healthy individuals rarely contract E. meningoseptica infections or diseases, there has been an increasing number of reports linking this bacterium to life-threatening infections in immunocompromised individuals. It has been associated with severe meningitis (particularly neonatal meningitis) ( 5 – 11 ), bacteremia ( 12 – 17 ), respiratory infection ( 18 , 19 ), urinary tract infection ( 20 ), sepsis ( 21 , 22 ), eye infections ( 23 – 26 ), biliary tract infections ( 27 , 28 ) and has emerged as a significant public health concern. Furthermore, recent studies have described nosocomial outbreaks associated with E. meningoseptica ( 5 , 6 , 21 , 29 – 31 ).…”