Elizabethkingia anophelis and Association with Tap Water and Handwashing, Singapore

Yung, Chee-Fu; Maiwald, Matthias; Loo, Liat Hui; Soong, Han Yang; Tan, Chin B.; Lim, Phaik Kooi; Ling, Li; Tan, Natalie Wh; Chong, Chia-Yin; Tee, Nancy Wen Sim; Thoon, Koh Cheng; Chan, Yoke Hwee

doi:10.3201/eid2409.171843

Cited by 34 publications

(33 citation statements)

References 9 publications

(9 reference statements)

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“…33 Clonal dissemination could be mediated by the hands of hospital staff or patients. 34 Therefore, it is necessary to reinforce hand hygiene and environmental cleaning when this genus is detected in the hospital.…”

Section: Discussionmentioning

confidence: 99%

Molecular Characteristics and Antimicrobial Susceptibility Profiles of Elizabethkingia Clinical Isolates in Shanghai, China

Wang¹,

Zhang²,

Li³

et al. 2020

IDR

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Purpose: To investigate molecular characteristics and antimicrobial susceptibility profiles of clinical isolates of Elizabethkingia in Shanghai, China. Methods: Elizabethkingia isolates were collected in a university-affiliated hospital in 2012-2015 and 2017-2018. They were re-identified to species level by 16S rRNA gene and species-specific gene sequencing. Antimicrobial susceptibility testing, screening for metallo-beta-lactamase production, identification of antimicrobial resistance genes and pulsed-field gel electrophoresis (PFGE) were performed. Results: Among 52 Elizabethkingia isolates, E. anophelis was the most prevalent species (67.3%), followed by E. meningoseptica (26.9%). High carriage rates of bla CME , bla BlaB and bla GOB genes were consistent with the poor in vitro activity of most β-lactams including carbapenems. Nevertheless, β-lactamase inhibitors increased susceptibility rates significantly for cefoperazone and piperacillin. Susceptibility rates for minocycline, tigecycline, rifampin and levofloxacin were 100%, 78.8%, 76.9% and 71.2%, respectively. Ser83Ile or Ser83Arg substitution in the DNA gyrase A unit was associated with resistance to fluoroquinolones. MIC 50 /MIC 90 values of vancomycin and linezolid were 16/16 mg/L and 16/32 mg/L, respectively. Molecular typing showed twenty-one different types of PFGE and more than one indistinguishable isolates were observed in each of the eight subtypes. Conclusion: Tetracyclines, tigecycline, β-lactam/β-lactamase inhibitor combinations, rifampin and fluoroquinolones demonstrated high rates of in vitro activity against clinical isolates of Elizabethkingia. Both genetic diversity and clonality were observed from this health-care facility. Our report provides potential alternative treatment options for Elizabethkingia infections.

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Section: Discussionmentioning

confidence: 99%

Molecular Characteristics and Antimicrobial Susceptibility Profiles of Elizabethkingia Clinical Isolates in Shanghai, China

Wang¹,

Zhang²,

Li³

et al. 2020

IDR

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“…Perinatal vertical transmission from mother to infant has been established in Hong Kong through a whole-genome analysis of the offending strains [65]. In addition, an epidemiologic investigation of outbreaks in Singapore revealed E. anophelis in the tap water aerators of the hospital [10,11]. E. anophelis was suggested to be transmitted from the hands of health care workers, who acquired this bacterium during handwashing, to patients.…”

Section: Epidemiology Clinical Characteristics and Outcomesmentioning

confidence: 99%

“…Microorganisms in the genus Elizabethkingia are Gram-negative, aerobic, pale yellow-pigmented, nonmotile, glucose-non-fermenting, non-spore-forming, oxidase-positive, weakly indole-positive, and nitrate-negative bacilli (Figure 1) [1,2]. These bacteria are ubiquitously distributed in natural environments such as water, soils, fish, frogs, and insects [3,4,5,6,7,8], as well as in the tap water of hospitals [9,10,11]. Since its first identification in 1959 [12], Elizabethkingia has been occasionally reported to cause human infections.…”

Section: Introductionmentioning

confidence: 99%

Elizabethkingia Infections in Humans: From Genomics to Clinics

et al. 2019

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The genus Elizabethkingia has recently emerged as a cause of life-threatening infections in humans, particularly in immunocompromised patients. Several new species in the genus Elizabethkingia have been proposed in the last decade. Numerous studies have indicated that Elizabethkingia anophelis, rather than Elizabethkingia meningoseptica, is the most prevalent pathogen in this genus. Matrix-assisted laser desorption/ionization–time of flight mass spectrometry systems with an extended spectrum database could reliably identify E. anophelis and E. meningoseptica, but they are unable to distinguish the remaining species. Precise species identification relies on molecular techniques, such as housekeeping gene sequencing and whole-genome sequencing. These microorganisms are usually susceptible to minocycline but resistant to most β-lactams, β-lactam/β-lactam inhibitors, carbapenems, and aminoglycosides. They often exhibit variable susceptibility to piperacillin, piperacillin-tazobactam, fluoroquinolones, and trimethoprim-sulfamethoxazole. Accordingly, treatment should be guided by antimicrobial susceptibility testing. Target gene mutations are markedly associated with fluoroquinolone resistance. Knowledge on the genomic characteristics provides valuable insights into in these emerging pathogens.

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“…Since 2004, there has been an increased incidence among hospitalized patients, an emerging pathogen. 26,27 The species of concern for this discussion is E anopheles, which is known to cause respiratory tract illness in humans. 27 Although the bacteria have been isolated from Anopheles mosquitoes, their role in transmission is unclear.…”

Section: Elizabethkingia Anophelesmentioning

confidence: 99%

Emerging Infectious Diseases

McArthur

2019

Nursing Clinics of North America

124

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KEYWORDSEmerging infections Zoonotic diseases Vector-borne diseases Candida auris Elizabethkingia anopheles Avian influenza mcr-1 KEY POINTSMost emerging infectious diseases (EID) are caused by zoonotic pathogens.Vector-borne diseases are a major public health problem in the United States.Factors contributing to EID include population growth, spread in health care facilities, aging population, global travel, and changing vector habitats related to climate change.

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Elizabethkingia anophelis and Association with Tap Water and Handwashing, Singapore

Cited by 34 publications

References 9 publications

<p>Molecular Characteristics and Antimicrobial Susceptibility Profiles of <em>Elizabethkingia</em> Clinical Isolates in Shanghai, China</p>

<p>Molecular Characteristics and Antimicrobial Susceptibility Profiles of <em>Elizabethkingia</em> Clinical Isolates in Shanghai, China</p>

Elizabethkingia Infections in Humans: From Genomics to Clinics

Emerging Infectious Diseases

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