Comparative Genomics and Antimicrobial Resistance Profiling of Elizabethkingia Isolates Reveal Nosocomial Transmission and In Vitro Susceptibility to Fluoroquinolones, Tetracyclines, and Trimethoprim-Sulfamethoxazole

Abstract

The Elizabethkingia genus has gained global attention in recent years as a sporadic, worldwide, nosocomial pathogen. Elizabethkingia spp. are intrinsically multidrug resistant, primarily infect immunocompromised individuals, and are associated with high mortality (∼20-40%). Yet, gaps remain in our understanding of transmission, global strain relatedness, antimicrobial resistance and effective therapy. Over a 16-year period 22 clinical and six hospital environmental isolates were collected from Queensland, Australia. Identification using the MALDI-TOF MS (VITEK® MS) and whole-genome sequencing was compared with a global strain dataset. Phylogenomic reconstruction robustly identified 22 E. anophelis, three E. miricola, two E. meningoseptica and one E. bruuniana, most of which branched as unique lineages. Global analysisrevealed some Australian E. anophelis isolates are genetically closely related to strains identified from the USA, England and Asia. Comparative genomics of clinical and environmental strains identified evidence of nosocomial transmission in patients, indicating probable infection from a hospital reservoir. Furthermore, broth microdilution against 39 antimicrobials revealed almost ubiquitous resistance to aminoglycosides, carbapenems, cephalosporins and penicillins. Like other international strains, our isolates expressed susceptibility to minocycline and levofloxacin and the less common trimethoprim/sulfamethoxazole. Our study demonstrates important new insights into the genetic diversity, environmental persistence, transmission of and potential effective therapy for Australian Elizabethkingia species.

Single Cell Raman-Deuterium Isotope Probing for Drug Resistance of Elizabethkingia spp

“…were responded high sensitivity to minocycline and levofloxacin confirmed by 4-hour single cell Raman-DIP procedure. It was consistent with previous reports (30,35,(42)(43)(44). Our study on Elizabethkingia spp.…”

“…Elizabethkingia spp. is a group of Gram-negative, none-ferment pathogens, responsible for a panel of diseases, including meningitis, sepsis, bacteremia, pneumonia, and neutropenic fever (30)(31)(32)(33).…”

A Unique Case of Elizabethkingia Associated Cardiac Device Infection

“…This opportunistic infection, generally found in water and soil, has been associated with high morbidity and mortality rates in critically ill intensive care unit (ICU) patients on hemodialysis. Mortality has been reported to be between 23-41% due to a lack of effective therapeutic regimens and intrinsic antibiotic resistance [ 4 , 5 ]. In our case, a high-risk individual developed sepsis post-prostatectomy.…”

What happened to microbiological diagnosis in 2020 beyond COVID-19?

“…Among them, the intrinsically multidrug resistant Elizabethkingia genus is one example of a worldwide pathogen, primarily infecting immunocompromised individuals and associated with high mortality (20%-40%). Burnard et al [ 15 ] describe a series of 22 clinical and 6 hospital environmental Elizabethkingia spp. isolates obtained in a hospital in Australia over a 16-year period.…”