Clinical Profile and Susceptibility Patterns of Infections by Elizabethkingia Species in a Tertiary Care Hospital, Bhubaneswar, Odisha (original) (raw)
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Journal of Pure and Applied Microbiology
Elizabethkingia meningoseptica a rare pathogen in earlier times has been accused to infect the immunocompromised, preterm neonates, the patients exposed to longterm antibiotics and intensive care units. The apparent resistance of the multidrug Elizabethkingia meningoseptica affects the selection of appropriate antibacterial agents against it. The current study attempts to determine the prevalence of E. meningoseptica infections and consider the sensitivity pattern in a tertiary care hospital. A prospective study of prevalence of E. meningoseptica in a tertiary care hospital from March 2020 to March 2021 i.e over a period of 1 year. Patient clinical data as well as ABST patterns were collected and analyzed. Out of total 1813 patient’s samples E. meningoseptica was isolates from 21 cases (1.15%). Average age was 61.42 years, with males most likely to be infected (52.38%). All the adult patients had underlying diseases, obstructive gall bladder diseases (n=7, 33.33%) which included cho...
International Journal of Infection Control, 2018
Elizabethkingia meningoseptica has been found to be associated with a broad range of infectious etiologies, most notably outbreaks of neonatal meningitis. In adults, it can also cause pneumonia, endocarditis, bacteremia, meningitis and even skin and soft tissue infections, primarily in immunocompromised individuals. We report a cluster of 3 cases with E. meningoseptica infection in an adult neurology critical care unit of a 400-bedded tertiary care hospital situated in Gurugram (Delhi-National Capital Region), India. Two patients were diagnosed with ventilator-associated-pneumonia (VAP) and one was a patient in whom the organism was isolated from a cerebrospinal fluid (CSF) sample. Clinical details were studied and outbreak investigation was carried out. We found the following common risk factors for infection: Prolonged ICU stay, exposure to multiple antibiotics, presence of underlying co-morbidities and insertion of multiple invasive medical devices. E. meningoseptica was isolated...
Intractable & Rare Diseases Research
Elizabethkingia species are gram negative bacilli which are aerobic, oxidase positive, indole positive, nonmotile bacilli and does not ferment glucose. They can be found commonly in freshwater, saltwater, soil and in hospital environments (1). They do not normally exists in the human body, but have been reported to cause various invasive infections like meningitis, pneumonia, endocarditis, and bacteremia in adults and neonates in association with severe underlying illness (2). The risk factors associated with acquisition of this infection include immunosuppression, underlying medical diseases, prolonged hospital stay, prior use of higher antibiotics, indwelling central venous catheter and other invasive devices (3). This organism is resistant to many antibiotics like beta-lactam antibiotics, aminoglycosides, tetracyclines, and chloramphenicol, However, it is susceptible to some agents used to treat Gram-positive bacteria like erythromycin, clindamycin, rifampicin, trimethoprim-sulfamethoxazole, quinolones and vancomycin (4). Selecting appropriate antimicrobial agents for patients infected with E. meningoseptica is difficult due to lack of data on clinical response to different treatments and also due to multiple drug resistance. In this report, we describe a series of four cases with E. meningoseptica bacteraemia and septic shock admitted to the ICUs of our level 1 Trauma Centre. 2. Patients and Methods This is a retrospective study conducted over a two Summary Elizabethkingia meningoseptica (E. meningoseptica) is a non-fermenting gram negative organism that is commonly detected in the soil and water but is rarely reported to cause human infection. However it is emerging as a nosocomial pathogen in patients admitted in intensive care units (ICUs). Infections caused by this organism have a high mortality rate due to lack of effective therapeutic regimens and its intrinsic resistance to multiple antibiotics. We report our experience in managing Elizabethkingia meningoseptica (E. meningoseptica) septicemia in our ICU patients with septic shock during prolonged intensive care management. Over a two year period four cases were admitted into the polytrauma ICU developed sepsis due to E. meningoseptica. All these patients were on mechanical ventilation, had central venous catheter (CVC) and were exposed to various broad spectrum antibiotics. Of the four patients, three died and one recovered. E. meningoseptica infection should be considered as a possible etiological agent of sepsis in patients who do not respond to empirical therapy, as this results in an inappropriate choice of antimicrobial therapy, leading to increased morbidity and mortality of patients. Its unusual resistance pattern along with inherent resistance to colistin makes this organism difficult to treat unless susceptibility patterns are available.
A Retrospective Study on Elizabethkingia Meningoseptica -An Emerging Pathogen
Elizabethkingia meningoseptica is a ubiquitous Gram negative bacilli and is an emerging pathogen for hospital acquired infection.. The mortality rate is high and thus timely diagnosis is essential. Even more so because it is inherently resistant to a lot of antibiotics. In this retrospective study carried out over a period of 3 months at our tertiary care hospital, 12 patients were detected with Elizabethkingia meningoseptica predominantly from Endo-Tracheal tube aspirate.In 83.33% instances they caused nosocomial infection in COVID 19 patients.Mechanical ventilation, ECMO and prolonged exposure to carbapenems were significant risk factors associated with the infection. Cotrimoxazole was most sensitive among the antibiotics tested, followed by vancomycin and levofloxacin. Most of the other antibiotics active against Gram negative bacilli showed very high resistance including recent antibiotics like meropenem EDTA, ceftazidime-avibactam and ELORES (ceftriaxone+ sulbactum + EDTA). The outcome was not favourable in most cases
South Asian journal of cancer, 2013
Although Elizabethkingia meningoseptica (Chryseobacterium meningosepticum) infections in immunocompromised hosts have been recognised, clinical data detailing these infections remain limited, especially from India. Antimicrobial susceptibility data on E. meningoseptica remain very limited, with no established breakpoints by Clinical and Laboratory Standards Institute (CLSI). The organism is usually multidrug resistant to antibiotics usually prescribed for treating Gram-negative bacterial infections, a serious challenge to the patient and the treating clinicians. The analysis was done in a tertiary care oncology and stem cell transplant center. Susceptibility testing and identification of E. meningoseptica was done using Vitek auto analyzer. Records of immunocompromised patients with E. meningoseptica bacteremia were analysed from January 2009 to March 2012. A total of 29 E. meningoseptica bacteremia cases were documented between 2009 and 2012. Eleven patients were immunocompromised....
2018
Elizabethkingia meningoseptica has been found to be associated with a broad range of infections, most notably outbreaks of neonatal meningitis. In adults, it can also cause pneumonia, endocarditis, bacteremia, meningitis and even skin and soft tissue infections, primarily in immunocompromised individuals. We report a cluster of 3 cases with E. meningoseptica infection in an adult neurology critical care unit of a 400-bedded tertiary care hospital situated in Gurugram (Delhi-National Capital Region), India. Two patients were diagnosed with ventilator-associated-pneumonia (VAP) and one was a patient in whom the organism was isolated from a cerebrospinal fluid (CSF) sample. Clinical details were studied and outbreak investigation was carried out. We found the following common risk factors for infection: prolonged ICU stay, exposure to multiple antibiotics, presence of underlying co-morbidities and insertion of multiple invasive medical devices. E. meningoseptica was isolated from the c...
International Journal Of Community Medicine And Public Health, 2018
Background: Elizabethkingia meningoseptica is frequently found in hospital environments and usually associated with healthcare-associated infections (HAIs), particularly in patients in the intensive care units (ICU). The current study report an outbreak of E. meningoseptica infection/colonization in the pediatric intensive care unit, highlighted the infection control methods used to stem the spread.Methods: During a period of 7 months, May-November 2015, 4 patients were infected/ colonized by E. meningoseptica. Infection control measures were re-emphasized after each case and environmental swabs were cultured to detect possible source. Follow up for 25 months to ensure eradication of the pathogen.Results: Four patients were colonized/ infected with E. meningoseptica, their mean age 22 months. The average time patients spent in ICU between admission and isolation of E. meningoseptica was 27.5±19.2 days. All patients were mechanically ventilated. 25% E. meningoseptica isolated from bl...
Journal of Hospital Infection, 2016
Elizabethkingia meningoseptica is an infrequent cause of hospital-acquired infections. The clinical and microbiological profiles of infections due to E. meningoseptica over a seven-year period at a Level I trauma centre are reported in this study. Medical records of patients from whose clinical samples E. meningoseptica was isolated on at least two occasions were reviewed. A total of 21 cases were observed during the study, 16 (76.2%) of which exhibited multidrug resistance. The observed in-hospital mortality rate was 47.6%. A high index of clinical suspicion and effective detection of E. meningoseptica in clinical samples are requisite for improved clinical outcome.
Journal of research in clinical medicine, 2022
Elizabethkingia meningoseptica is a rare, gram-negative bacterium, which is known as the causing agent for hospital-acquired infections, especially in immunocompromised patients and those with indwelling devices. E. meningoseptica is resistant to the most of the antibiotics making the treatment procedure a difficult task, because of which this bacterium is considered as an emerging cause of high mortality in critically ill patients. Herein, we describe a case of E. meningoseptica causing bacteremia in a young chronic kidney disease (CKD) patient who was successfully managed with an appropriate use of suitable antimicrobials. The case highlights the importance of constant and active interaction between the clinician and the microbiologist to handle such novel organisms.