Evidence for Elizabethkingia anophelis Transmission from Mother to Infant,Hong Kong

Elizabethkingia anophelis, recently discovered from mosquito gut, is an emerging bacterium associated with neonatal meningitis and nosocomial outbreaks. However, its transmission route remains unknown. We use rapid genome sequencing to investigate 3 cases of E. anophelis sepsis involving 2 neonates who had meningitis and 1 neonate’s mother who had chorioamnionitis. Comparative genomics revealed evidence for perinatal vertical transmission from a mother to her neonate; the 2 isolates from these patients, HKU37 and HKU38, shared essentially identical genome sequences. In contrast, the strain from another neonate (HKU36) was genetically divergent, showing only 78.6% genome sequence identity to HKU37 and HKU38, thus excluding a clonal outbreak. Comparison to genomes from mosquito strains revealed potential metabolic adaptations in E. anophelis under different environments. Maternal infection, not mosquitoes, is most likely the source of neonatal E. anophelis infections. Our findings highlight the power of genome sequencing in gaining rapid insights on transmission and pathogenesis of emerging pathogens.     

Waterborne Elizabethkingia meningoseptica in Adult Critical Care

Elizabethkingia meningoseptica is an infrequent colonizer of the respiratory tract; its pathogenicity is uncertain. In the context of a 22-month outbreak of E. meningoseptica acquisition affecting 30 patients in a London, UK, critical care unit (3% attack rate) we derived a measure of attributable morbidity and determined whether E. meningoseptica is an emerging nosocomial pathogen. We found monomicrobial E. meningoseptica acquisition (n = 13) to have an attributable morbidity rate of 54% (systemic inflammatory response syndrome >2, rising C-reactive protein, new radiographic changes), suggesting that E. meningoseptica is a pathogen. Epidemiologic and molecular evidence showed acquisition was water-source–associated in critical care but identified numerous other E. meningoseptica strains, indicating more widespread distribution than previously considered. Analysis of changes in gram-negative speciation rates across a wider London hospital network suggests this outbreak, and possibly other recently reported outbreaks, might reflect improved diagnostics and that E. meningoseptica thus is a pseudo-emerging pathogen.     

Elizabethkingia meningoseptica: Emergent bacteria causing pneumonia in a critically ill child

Elizabethkingia meningoseptica is an unusual, highly resistant, gram‐ negative bacillus. While E. meningoseptica–associated meningitis outbreaks have been well‐documented in hospital neonatal wards and among immunocompromised adults, reports describing this microorganism in critically ill children are scarce. The purpose of this report was to describe a case of a 3 year‐old girl who developed pneumonia caused by E. meningoseptica in the setting of previous use of broad‐spectrum antibiotics and to review the pediatric literature regarding this pathogen.     

脑膜败血伊丽莎白菌感染致足月新生儿脑膜炎一例并文献复习

<正>脑膜败血伊丽莎白菌(Elizabethkingia meningoseptica, E. meningoseptica)广泛存在于水、土壤及医院等各种环境中,是重要的条件致病菌,可引起心内膜炎、败血症、脑膜炎等多种疾病^[1]。国内对新生儿感染脑膜败血伊丽莎白菌的病例报道极少,尤其罕见足月新生儿感染,本文就浙江省嘉兴市妇幼保健院收治的1例脑膜败血伊丽莎白菌感染致足月新生儿脑膜炎病例的诊疗过程进行分析回顾,并结合国内外文献复习,对该病的临床特点、诊治进行总结探讨,以期提高对该病的诊疗水平。     

Elizabethkingia miricola infection in Chinese spiny frog (Quasipaa spinosa)

Elizabethkingia miricola is a Gram‐negative rod which has been incriminated in severe infections in humans. Recently, a serious infectious disease was identified in Chinese spiny frogs (Quasipaa spinosa), in the Sichuan Province of China; the disease was characterized by corneal opacity, the presence of ascites and neurological symptoms. A Gram‐negative bacillus was isolated from the liver, spleen and kidney of the diseased frogs. Experimental infection test revealed that the bacillus could infect the frogs Q. spinosa and the LD₅₀ value was 1.19 × 10⁶ cfu per frog. The isolated Gram‐negative bacillus was identified as E. miricola according to phenotypic characteristics, 16S rRNA and gyrB gene sequence analysis. The isolated strain was only susceptible to florfenicol among all investigated chemotherapeutic agents. Histological examination revealed that E. miricola infection caused pathological lesions to multiple organs and tissues, especially in the liver, brain, kidney. These results confirmed that E. miricola is an emerging pathogen of Chinese spiny frogs.     

Keratitis with Elizabethkingia meningoseptica Occurring after Contact Lens Wear: A Case Report

To report keratitis with Elizabethkingia meningoseptica, which occurred in a healthy patient after wearing contact lenses for 6 months. A 24-year-old male patient visited our hospital with ocular pain. This patient had a history of wearing soft contact lenses for 6 months, about 10 hours per day. At initial presentation, slit lamp examination showed corneal stromal infiltrations and small epithelial defect. Microbiological examinations were performed from corneal scrapings, contact lenses, and the contact lens case and solution. The culture results from contact lenses, contact lens case and solution were all positive for Elizabethkingia meningoseptica. Thus, we could confirm that the direct cause of keratitis was contamination of the contact lenses. The patient was treated with 0.3% gatifloxacin. After treatment, the corneal epithelial defect was completely healed, and a slight residual subepithelial corneal opacity was observed. We diagnosed keratitis with Elizabethkingia meningoseptica in a healthy young male wearing soft contact lenses. We conclude that Elizabethkingia meningoseptica should be considered as a rare but potential pathogen for lens-related keratitis in a healthy host.     

1例脑室外引流术后颅内感染脑膜败血伊丽莎白菌的治疗分析

脑膜败血伊丽莎白菌是一种条件性致病菌,临床上院内获得性颅内感染病例少见。现回顾性分析1例由我院临床药师会诊并持续监护的罕见脑膜败血伊丽莎白菌颅内感染患者的药物治疗经过。临床药师通过用药分析,确保抗菌药物正确应用,提高合理用药水平。     

脑膜败血伊丽莎白金菌引发成年患者下呼吸道感染的危险因素及耐药性分析

目的 了解医院住院患者下呼吸道感染脑膜败血伊丽莎白金菌的危险因素及其耐药性,为临床合理用药及预防感染提供参考数据.方法 采用回顾性调查方法收集医院2010年2月-2012年2月下呼吸道感染脑膜败血伊丽莎白金菌的成年患者.结果 共调查60例,其中男性51例,女性9例,平均年龄(65.08±17.7)岁,检出脑膜败血伊丽莎白金菌28 d的死亡率为41.67％;感染患者均有严重的基础疾病、长期住院史[(44.8±62.85)d]和使用抗菌药物史(76.67％);危险因素单因素分析显示患者在人住ICU时间、气管切开、中央静脉插管、血液透析、有无近期手术、有无糖尿病6个因素中28 d死亡率差异均有统计学意义(P＜0.05);进一步进行多因素分析显示,静脉插管、血液透析、使用免疫抑制药物以及有糖尿病4个因素是致死亡率的危险因素;60株脑膜败血伊丽莎白金菌耐药性均较高,仅对环丙沙星等少数药物敏感.结论 脑膜败血伊丽莎白金菌引发的医院感染已日益严重,研究证明感染该菌的患者预后不良,临床医务人员应加强无菌操作规范,严格消毒隔离,做好手卫生,合理用药,减少医院感染的发生.     

Chryseobacterium/Elizabethkingia species infections in Saudi Arabia

Objectives:To describe the epidemiological, clinical, and outcome data of patients infected or colonized with Chryseobacterium/Elizabethkingia spp including antibiotic susceptibility patterns.Methods:This retrospective study was conducted at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. All patients infected or colonized by Chryseobacterium /Elizabethkingia spp who were admitted between June 2013 and May 2019 were included. Data were extracted from patient electronic medical records.Results:We enrolled 27 patients (13 males and 14 females) with a mean age of 35.6 years. Chryseobacterium/Elizabethkingia spp were isolated from blood cultures (n=13, 48%) and tracheal aspirations (n=11, 41%). The most frequent species isolated was Elizabethkingia meningoseptica (n=22). Although 6 patients were considered colonized, the remaining 21 patients presented with ventilator associated pneumonia (n=9), central line associated bloodstream infection (n=4), septic shock (n=4), or isolated bacteremia (n=4). In 25 cases the infections were health-care related. Three patients (11%) died within 28 days. Twenty-six isolates (96.5%) were resistant to carbapenems. Moxifloxacin and cotrimoxazole were the most active antibiotics.Conclusion:Chryseobacterium/Elizabethkingia spp infection is rare, but can be responsible for severe hospital acquired infections. Cotrimoxazole and fluoroquinolone are the most effective antibiotic treatments.