Elizabethkingia meningoseptica: An important emerging pathogen causing healthcare-associated infections

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Abstract

Elizabethkingia meningoseptica has been deemed a potentially important threat to patients in critical care areas because of its multidrug-resistant phenotype and its ability to adapt to various environments. This review considers the incidence, factors which predispose to, and clinical features of, E.meningoseptica sepsis, along with antimicrobial susceptibility patterns of clinical E.meningoseptica isolates and reportedly successful measures for the prevention and control of infections caused by this bacterium. The English-language literature from the PubMed database was reviewed. The incidence of E.meningoseptica bacteraemia has increased over the last decade. Patients at high risk of E.meningoseptica infection include preterm children, the immunocompromised and those exposed to antibiotics in critical care units. Vancomycin, rifampicin, newer fluoroquinolones, piperacillin-tazobactam, minocycline and possibly tigecycline are preferred empirical choices for E.meningoseptica infection according to in-vitro susceptibility data. Combination therapy has been used for infections not responding to single agents. Saline, lipid, and chlorhexidine gluconate solutions as well as contaminated sinks have been implicated as sources of infection following outbreak investigations. In addition to reinforcement of standard infection control measures, actions that have successfully terminated E.meningoseptica outbreaks include pre-emptive contact isolation, systematic investigations to identify the source of the bacterium and thorough cleaning of equipment and environmental surfaces. As the clinical complexity and incidence of E.meningoseptica infections increase, there is a need for heightened awareness of the potential for this bacterium to cause outbreaks. This will permit timely initiation of active surveillance for infected/colonized patients as well as investigations to identify the likely source of the bacterium, which will, in turn, allow implementation of appropriate infection control measures.

Original languageEnglish
Pages (from-to)244-249
Number of pages6
JournalJournal of Hospital Infection
Volume86
Issue number4
DOIs
Publication statusPublished - 2014

Fingerprint

Cross Infection
Infection Control
Bacteria
Disease Outbreaks
Infection
Critical Care
Incidence
Minocycline
Aptitude
Fluoroquinolones
Vancomycin
Rifampin
Bacteremia
PubMed
Sepsis
Language
Databases
Anti-Bacterial Agents
Phenotype
Lipids

Keywords

  • Contamination source
  • Elizabethkingia meningoseptica
  • Environmental cleaning
  • Infection control
  • Outbreak

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases
  • Medicine(all)

Cite this

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title = "Elizabethkingia meningoseptica: An important emerging pathogen causing healthcare-associated infections",
abstract = "Elizabethkingia meningoseptica has been deemed a potentially important threat to patients in critical care areas because of its multidrug-resistant phenotype and its ability to adapt to various environments. This review considers the incidence, factors which predispose to, and clinical features of, E.meningoseptica sepsis, along with antimicrobial susceptibility patterns of clinical E.meningoseptica isolates and reportedly successful measures for the prevention and control of infections caused by this bacterium. The English-language literature from the PubMed database was reviewed. The incidence of E.meningoseptica bacteraemia has increased over the last decade. Patients at high risk of E.meningoseptica infection include preterm children, the immunocompromised and those exposed to antibiotics in critical care units. Vancomycin, rifampicin, newer fluoroquinolones, piperacillin-tazobactam, minocycline and possibly tigecycline are preferred empirical choices for E.meningoseptica infection according to in-vitro susceptibility data. Combination therapy has been used for infections not responding to single agents. Saline, lipid, and chlorhexidine gluconate solutions as well as contaminated sinks have been implicated as sources of infection following outbreak investigations. In addition to reinforcement of standard infection control measures, actions that have successfully terminated E.meningoseptica outbreaks include pre-emptive contact isolation, systematic investigations to identify the source of the bacterium and thorough cleaning of equipment and environmental surfaces. As the clinical complexity and incidence of E.meningoseptica infections increase, there is a need for heightened awareness of the potential for this bacterium to cause outbreaks. This will permit timely initiation of active surveillance for infected/colonized patients as well as investigations to identify the likely source of the bacterium, which will, in turn, allow implementation of appropriate infection control measures.",
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