Elizabethkingia meningosepticum: An Emerging Cause of Septicemia in Critically Ill Patients

Sarma, Satyam; Kumar, Navin; Jha, A. K.; Baveja, U K; Sharma, Sunil

doi:10.4103/0974-2727.78575

Cited by 12 publications

(16 citation statements)

References 5 publications

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“…Literatürdeki E.meningosepticum olgularının çoğu immün süpresif hastalar ile yenidoğanlarda rapor edilen hastane kaynaklı enfeksiyonlardır [5][6][7][8][9][10][11][12][13] . Ülkemizden bildirilen olgular E.meningosepticum kaynaklı posttravmatik keratit ve hastane kaynaklı yenidoğan E.meningosepticum enfeksiyonlarıdır [5][6][7][8] .…”

Section: Discussionunclassified

Elizabethkingia meningosepticum Bacteremia in a Patient with Bardet-Biedl Syndrome and Chronic Renal Failure

Bayrak¹,

Fincanci²,

Bınay³

et al. 2014

Mikrobiyol Bul

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ÖZETElizabethkingia meningosepticum, özellikle yenidoğanlar ve immün süpresif hastalarda hayatı tehdit eden hastane kaynaklı enfeksiyonlara yol açabilen gram-negatif bir fırsatçı patojendir. Değişik bir antibiyotik duyarlılık paternine sahip olan E.meningosepticum, gram-negatif bakterilerin duyarlı olduğu birçok antibiyotiğe dirençli olup, vankomisin ve kotrimoksazol (SXT) gibi gram-pozitif bakterilere etkili olan antibiyotiklere duyarlılık gösterir. Bu nedenle E.meningosepticum enfeksiyonlarında tedavinin başarısı, etkenin doğru tanımlanmasına bağlıdır. Bu raporda, birçok organı etkileyen genetik bir bozukluk olan Bardet-Biedl sendromuna bağlı kronik böbrek yetmezliği gelişen ve diyaliz kateteri bulunan bir hastada görülen kateter ile ilişkili E.meningosepticum bakteriyemisi sunulmaktadır. Bardet-Biedl sendromlu femoral kateteri olan 25 yaşında erkek hasta acil servise bir gündür var olan yüksek ateş ve titreme şikayetleriyle başvurmuştur. Başvuru sırasında alınan kan kültürlerinin her ikisi, iki gün sonra pozitif sinyal vermiş; kanlı agar besiyerine yapılan pasajda 37°C'de 16 saatlik inkübasyon sonunda gram-negatif bakteri kolonilerine benzeyen düzgün kenarlı, iri, gri koloniler ürerken, MacConkey agara yapılan pasajda beş gün sonunda üreme olmamıştır. Bakteri kolonileri KOH, oksidaz, katalaz, üreaz, eskülin, MOI (Motility Indole Ornithine) testleriyle pozitif; sitratla negatif sonuç vermiş; Gram boyamada zayıf boyanan, gram-negatif, ince basiller izlenmiştir. İzolat, Vitek ® 2 sistemi (bioMérieux, ABD) ile E.meningosepticum olarak tanımlanmış ve tanı PCR ile 16S RNA gen bölgesinin amplifikasyonu ve dizi analizi yapılarak doğrulanmıştır. İzolatın antibiyotik duyarlılığı Vitek 2 sistemiyle belirlenmiş, vankomisin duyarlılığı ise Kirby-Bauer disk difüzyon testiyle değerlendirilmiştir. İzolatın, ampisilin/sulbaktam piperasilin/tazobaktam, seftazidim, sefepim, meropenem, imipenem, amikasin, gentamisin, netilmisin, levofloksasin, tetrasiklin, kolistin ve rifampisine dirençli; tigesiklin ve tetrasikline orta duyarlı; sefoperazon/sulbaktam, siprofloksasin, levofloksasin, SXT Geliş Tarihi

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Section: Discussionunclassified

Elizabethkingia meningosepticum Bacteremia in a Patient with Bardet-Biedl Syndrome and Chronic Renal Failure

Bayrak¹,

Fincanci²,

Bınay³

et al. 2014

Mikrobiyol Bul

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Section: Introductionmentioning

confidence: 99%

“…meningosepticum has a characteristic resistance to most antibiotics useful against Gram-negative bacteria (aminoglycosides, beta-lactams, cloramphenicols, but it is susceptible to vancomycin, ciprofloxacin, levofloxacin, etc.. Due to the natural resistance to multiple antimicrobials N o n -c o m m e r c i a l u s e o n l y it can colonize different hospital environments and medical equipment (such as incubation tubes, saline solution, syringes, medical devices, incubators, etc.) as an opportunistic nosocomial pathogen (6,14) and can generate disease in favouring hospital and individual conditions. Most cases of the disease concern neonatal meningitis with a degree of mortality of 57% (5,12,15,13), although it may also represent a rare cause of pneumonia, endocarditis, postsurgical bacteraemia, cellulite and abdominal infections in immunosuppressed patients (1)(2)(3)14).…”

Section: Introductionmentioning

confidence: 99%

“…as an opportunistic nosocomial pathogen (6,14) and can generate disease in favouring hospital and individual conditions. Most cases of the disease concern neonatal meningitis with a degree of mortality of 57% (5,12,15,13), although it may also represent a rare cause of pneumonia, endocarditis, postsurgical bacteraemia, cellulite and abdominal infections in immunosuppressed patients (1)(2)(3)14). Therefore, immunosuppression, particular treatment and/or invasive surgical procedures, long-term care, use of a central venous catheter and prolonged and untargeted antibiotic prophylaxis are considered among the main risk factors (12,16).…”

Section: Introductionmentioning

confidence: 99%

“…The grey colour of the colonies on blood agar is due to protease and gelatinase production. They grow poorly on MacConkey agar and are unable to grow on colistin-nalidixic acid (CNA) agar due to the susceptibility to quinolones such as nalidixic acid (6,10,14).E. meningosepticum has a characteristic resistance to most antibiotics useful against Gram-negative bacteria (aminoglycosides, beta-lactams, cloramphenicols, but it is susceptible to vancomycin, ciprofloxacin, levofloxacin, etc.. Due to the natural resistance to multiple antimicrobials Correspondence: Vittorio Panetta,…”

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confidence: 99%

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Elizabethkingia meningosepticum: an emerging nosocomial pathogen in a critical patient with septicaemia

Panetta¹,

Greco²,

Costanzo

et al. 2017

Microbiol Med

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SummaryWe describe a case of sepsis due to the non-fermenter Gram-negative bacillus Elizabethkingia meningosepticum in a patient (M, 23 y.o.) hospitalized at the Intensive Care and Critical Care Medicine suffering of a severe neurological disease and acute surgical abdomen, caused by suppurative peritonitis secondary to PEG removal. Two sets of blood cultures were collected at the time of persistent fever. The culture on chocolate and blood agar showed the presence of colonies with characteristic grey-shiny appearance and 1-2 mm in diameter. No growth was instead evident on Mac-Conkey agar. The Gram stain was performed, but the final identification of the isolate as E. meningosepticum was obtained by Vitek2 System, on the basis of growth characteristics, biochemical reaction results, and the peculiar antibiotic susceptibility profile. The identification was also confirmed by Vitek MS MALDI-TOF mass spectrometry instrument (bioMérieux, Marcy-l'Étoile, France). Results of susceptibility testing highlighted the resistance to most antibiotics useful against Gram-negative bacteria and a paradoxical susceptibility to those targeting mainly Gram-positives. The vancomycin and ciprofloxacin combined therapy improved the patient's conditions, with a complete resolution of the E. meningosepticum bacteraemia. Unfortunately, due to the onset of important clinical and surgical complications, the patient died as a result of a septic shock caused by a MDR Acinetobacter baummannii. The present work underline the importance of correct species identification in the case of E. meningosepticum, a rare bacterium whose unique antimicrobial susceptibility pattern, require an ad hoc therapeutic approach. IntroductionElizabethkingia meningosepticum is a non-fermenter Gram-negative bacillus isolated for the first time in 1959 by the American bacteriologist Elizabeth King, who studied nonclassified bacilli related to childhood meningitis. The bacterium, initially classified as Flavobacterium meningosepticum, was re-classified as Cryseobacterium meningosepticum in 1994 and subsequently, after phylogenetic studies, definitely categorized as E. meningosepticum in 2005 (3, 9, 8).Widespread in nature (fresh water, salt water, or soil), is an aerobic, non-fermenter, non-spore-forming and non-mobile, saprophiticus ubiquitous bacillus. Unlike many other non-fermenter bacteria (Flavobacterium and Cryseobacterium), E. meningosepticum grows well at 37°C on blood agar and chocolate agar (4, 7). The colonies appear very pale yellow or more often not pigmented (dissimilarly to all Chryseobacterium species, that produce a not diffusible yellow-orange pigment); their growth is not easily appreciable after 24 hours of incubation (1). The grey colour of the colonies on blood agar is due to protease and gelatinase production. They grow poorly on MacConkey agar and are unable to grow on colistin-nalidixic acid (CNA) agar due to the susceptibility to quinolones such as nalidixic acid (6,10,14).E. meningosepticum has a characteristic resistance to most antibio...

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Genomic analysis of Elizabethkingia species from aquatic environments: Evidence for potential clinical transmission

Hem

Jarocki

Baker

et al. 2022

Current Research in Microbial Sciences

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Highlights Identification of closely related (< 50 SNV) clinical and environmental aquatic Elizabethkingia anophelis isolates. Identification of a provisional novel species Elizabethkingia umaracha . Novel bla GOB and bla B carbapenemases and extended spectrum β-lactamase bla CME alleles identified in Elizabethkingia spp. Analysis of the global phylogeny and pangenome of Elizabethkingia spp. Identification of novel ICE elements carrying uncharacterised genetic cargo in 67 / 94 (71.3%) of the aquatic environments Elizabethkingia spp.

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Elizabethkingia meningosepticum: An Emerging Cause of Septicemia in Critically Ill Patients

Cited by 12 publications

References 5 publications

Elizabethkingia meningosepticum Bacteremia in a Patient with Bardet-Biedl Syndrome and Chronic Renal Failure

Elizabethkingia meningosepticum Bacteremia in a Patient with Bardet-Biedl Syndrome and Chronic Renal Failure

Elizabethkingia meningosepticum: an emerging nosocomial pathogen in a critical patient with septicaemia

Genomic analysis of Elizabethkingia species from aquatic environments: Evidence for potential clinical transmission

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