Clinical Profile and Susceptibility Patterns of Infections by Elizabethkingia Species in a Tertiary Care Hospital, Bhubaneswar, Odisha

Abstract

BACKGROUND Elizabethkingia meningoseptica is an emerging pathogen causing meningitis, pneumonia, endocarditis, bacteremia, sepsis, wound & soft tissue infections, abdominal, respiratory and ocular infections, dialysis associated peritonitis and prosthesis associated septic arthritis, especially in immunodeficient hosts of various age groups. The prevalence of nosocomial infection by E. meningoseptica has increased, predominantly in patients with invasive procedures, prior use of broad-spectrum antimicrobial and co-morbid conditions. We wanted to determine the prevalence of Elizabethkingia meningoseptica among the clinical samples processed in our laboratory and their antimicrobial susceptibility pattern. METHODS This observational study was conducted in patients admitted to a tertiary care hospital, from October 2017 to October 2020. The study subjects were selected on positive bacterial culture reports after excluding patients of less than 18 years of age and their demographic and clinical features were obtained from their medical records. Blood samples were processed by BacT/Alert. VITEK-2 system was used to identify the bacteria and their antimicrobial susceptibility pattern. RESULTS Among the 3532 clinical samples processed, 16 (0.45 %) bacterial isolates were Elizabethkingia meningoseptica. Out of them, 5 (31.25 %) were from blood and 11 (68.75 %) were from endotracheal tubes. More number of cases 6 (38 %) were seen in the age group of 61 - 70 years. Most of the patients were on mechanical ventilation with common co-morbid condition associated was cardiovascular diseases 11 (68 %). E. meningoseptica was most often sensitive to nalidixic acid and ciprofloxacin (50 %), tigecycline 4 (30 %), minocycline 3 (18 %), cotrimoxazole 2 (15 %), piperacillin-tazobactam 1 (13 %) and minocyclin (18.75 %). CONCLUSIONS Infection with E. meningoseptica is clinically important as the organism causes nosocomial infection and is intrinsically resistant to multiple antibiotics, such as βlactams, aminoglycosides, tetracycline, tigecycline, colistin, chloramphenicol and carbapenems. Early diagnosis and prompt treatment is required to prevent the morbidity and mortality. KEYWORDS Elizabethkingia Meningoseptica, Antimicrobial Susceptibility, Clinical Profile