Elizabethkingia meningoseptica: Waiting to Strike

Introduction: The prevalence of nosocomial infection by Elizabethkingia meningoseptica (E. meningoseptica) has increased. It has been found to be associated with outbreaks of neonatal, adult and device related infections with mortality rates as high as 50%. Conventional empirical antibiotics against Gram-Negative Bacteria (GNB) are not effective against E. meningoseptica and interpretive Minimum Inhibitory Concentration (MIC) breakpoints are not available yet, making the treatment tricky. Hence, early detection is essential to prevent morbidity and mortality associated with E. meningoseptica. Aim: To know the incidence, clinical profile, associated risk factors and antibiotic susceptibility of E. meningoseptica isolates from suspected patients. Materials and Methods: This prospective study was done on patients admitted from January 2017-December 2018 to a tertiary care Hepatobilliary center in India. Clinical details, demographic details, associated risk factors and antibiotic sensitivity pattern of E. meningoseptica isolates obtained from various clinical samples during the study period were analysed. Analysis was done using SPSS software version 22. The categorical data was represented in frequency (%) and continuous data in mean. Results: A total of 32 isolates from 20 patients were included. Out of the 20 patients, 15 (75%) were males with a mean age of 43.05 years (range, 2-71 years). E. meningoseptica was most frequently isolated from respiratory samples (87.5%). Risk factors were chronic liver disease (75%), diabetes mellitus (50%), prolonged hospital admission (55%), prior ICU stay (100%), invasive procedures like insertion of Central Venous Catheter (CVC) (100%), need for life supports like prolonged ventilation (70%) and haemodialysis (55%). Minocycline was the most susceptible drug with 100% sensitivity followed by cotrimoxazole (65.6%). Conclusion: Patients with E. meningoseptica infection have significant morbidity and mortality. Hence awareness about the organism, active surveillance and investigation for the source of the organism will help in implementation of appropriate infection control measures and prevent outbreaks or recurrence.