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Infection
Clinical features and outcomes of critically ill patients with Elizabethkingia meningoseptica: an emerging pathogen
Abdullah Umair, Nosheen Nasir
Acute Crit Care. 2021;36(3):256-261.   Published online July 26, 2021
DOI: https://doi.org/10.4266/acc.2020.01158
  • 5,627 View
  • 183 Download
  • 7 Web of Science
  • 6 Crossref
AbstractAbstract PDF
Background
Elizabethkingia meningoseptica, formerly known as Chryseobacterium meningosepticum, is a non-motile, non-fastidious, catalase and oxidase-positive, aerobic, glucosenon- fermentative, Gram-negative bacillus that was first defined by Elizabeth O. King in 1959. It has emerged as an opportunistic pathogen that has infected patients in extreme age groups and immunocompromised individuals, especially in intensive care settings. There has been an increased interest in this pathogen due to its increasing occurrence around the world, ubiquitous nature, and inherent capacity for antimicrobial resistance.
Methods
We describe an observational study at a tertiary care center in Karachi, Pakistan, based on patients admitted between January 2013 and December 2018, with E. meningoseptica infections. All patients were confirmed to have a positive clinical culture specimen for E. meningoseptica along with symptoms and signs consistent with infection. Data were collected on a structured proforma from the Hospital Information Management Systems.
Results
Sixteen patients with E. meningoseptica that met the criteria for infection were identified, 13 of whom required admission. Eight patients had bacteremia in addition to confirmed E. meningoseptica infection. Two of the isolates were multi-drug resistant and only sensitive to minocycline. Nine out of 13 patients that were admitted required intubation and mechanical ventilation. The median length of hospital stay was 13 days, and five out of the 13 patients died during the hospital stay.
Conclusions
This is the largest case series to date reporting E. meningoseptica infections and highlights the importance of this organism as an emerging nosocomial pathogen.

Citations

Citations to this article as recorded by  
  • Elizabethkingia meningoseptica Outbreak in NICU: An Observational Study on a Debilitating Neuroinfection in Neonates
    Manish Swami, Praneetha Mude, Shrutiprajna Kar, Sushree Sarathi, Ashoka Mohapatra, Usha Devi, Pankaj K. Mohanty, Tapas K. Som, Behera Bijayini, Tanushree Sahoo
    Pediatric Infectious Disease Journal.2024; 43(1): 63.     CrossRef
  • Clinical Characteristics and Risk Factors for Infection and Death in Critically Ill Patients with Pulmonary Infection with Elizabethkingia Spp.
    Mengwen Feng, Min Huang, Yuanyuan Fan, Genyan Liu, Suming Zhou, Jing Zhou
    Infection and Drug Resistance.2024; Volume 17: 2673.     CrossRef
  • Clinical and microbiological features of positive blood culture episodes caused by non-fermenting gram-negative bacilli other than Pseudomonas and Acinetobacter species (2020–2023)
    Roberto Casale, Matteo Boattini, Sara Comini, Paulo Bastos, Silvia Corcione, Francesco Giuseppe De Rosa, Gabriele Bianco, Cristina Costa
    Infection.2024;[Epub]     CrossRef
  • Multi-Drug-Resistant Elizabethkingia meningoseptica: A Rare Cause of Late-Onset Sepsis in a Preterm Neonate
    Abdul Wasey Hashmi, Muhammad Ahmad, Muhammad Muneeb Israr, Ibtesam e Fajar, Farid Adnan
    Cureus.2023;[Epub]     CrossRef
  • Current viewpoint on the epidemiology of nonfermenting Gram-negative bacterial strains
    Despoina Koulenti, Kalwaje Eswhara Vandana, Jordi Rello
    Current Opinion in Infectious Diseases.2023; 36(6): 545.     CrossRef
  • Epidemiological, clinical, and laboratory features of patients infected with Elizabethkingia meningoseptica at a tertiary hospital in Hefei City, China
    Yajuan Li, Tingting Liu, Cuixiao Shi, Bo Wang, Tingting Li, Ying Huang, Yuanhong Xu, Ling Tang
    Frontiers in Public Health.2022;[Epub]     CrossRef
Infection
A Retrospective Study Investigating Risks of Acute Respiratory Distress Syndrome and Mortality Following Human Metapneumovirus Infection in Hospitalized Adults
Hyunjung Hwang, Yujin Kim, Jeong-Woong Park, Sung Hwan Jeong, Sun Young Kyung
Korean J Crit Care Med. 2017;32(2):182-189.   Published online May 31, 2017
DOI: https://doi.org/10.4266/kjccm.2017.00038
  • 6,458 View
  • 85 Download
  • 1 Web of Science
  • 3 Crossref
AbstractAbstract PDFSupplementary Material
Background
Human metapneumovirus (hMPV) is a relatively recently identified respiratory virus that induces respiratory symptoms similar to those of respiratory syncytial virus infection in children. The characteristics of hMPV-infected adults are unclear because few cases have been reported.
Methods
We conducted a retrospective review of hospitalized adult patients with a positive multiplex real-time polymerase chain reaction assay result from 2012 to 2016 at a single tertiary referral hospital in South Korea. We analyzed clinical characteristics of the enrolled patients and divided patients into an acute respiratory distress syndrome (ARDS) group and a non-ARDS group.
Results
In total, 110 adults were reviewed in this study. Their mean age was 61.4 years, and the majority (n = 105, 95.5%) had comorbidities or were immunocompromised. Most of the patients had pneumonia on chest X-ray (n = 88, 93.6%), 22 (20.0%) had ARDS, and 12 (10.9%) expired during hospitalization. The mortality rate for patients with ARDS was higher than that of the other patients (36.4% vs. 5.7%, P = 0.001). The risk factor for hMPV-associated ARDS was heart failure (odds ratio, 5.24; P = 0.044) and laboratory values were increased blood urea nitrogen and increased C-reactive protein. The acquisition site of infection was divided into community vs. nosocomial; 43 patients (39.1%) had a nosocomial infection. The risk factors for nosocomial infection were an immunocompromised state, malignancy and immunosuppressive treatment.
Conclusions
These data suggest that hMPV is one of the important respiratory pathogens important respiratory pathogen that causes pneumonia/ARDS in elderly, immunocompromised individuals and that it may be transmitted via the nosocomial route.

Citations

Citations to this article as recorded by  
  • A Case of Metapneumovirus Pneumonia-Related Acute Respiratory Distress Syndrome in a Young Adult Patient
    Tae Wan Kim, Won-Young Kim
    The Korean Journal of Medicine.2024; 99(2): 111.     CrossRef
  • Human Metapneumovirus Pneumonia Precipitating Acute Respiratory Distress Syndrome in an Adult Patient
    Dena H Tran, Muhammad Sameed, Ellen T Marciniak, Avelino C Verceles
    Cureus.2021;[Epub]     CrossRef
  • Outcomes of severe human metapneumovirus-associated community-acquired pneumonia in adults
    Sang-Ho Choi, Sang-Bum Hong, Jin Won Huh, Jiwon Jung, Min Jae Kim, Yong Pil Chong, Sung-Han Kim, Heungsup Sung, Hyun Jung Koo, Kyung-Hyun Do, Sang-Oh Lee, Chae-Man Lim, Yang Soo Kim, Jun Hee Woo, Younsuck Koh
    Journal of Clinical Virology.2019; 117: 1.     CrossRef
Infection
Experience with Elizabethkingia meningoseptica Infection in Adult Patients at a Tertiary Hospital
Hyun Don Joo, Sun Young Ann, Sung Hyeok Ryou, Youn Seup Kim, Jong Wan Kim, Doh Hyung Kim
Korean J Crit Care Med. 2015;30(4):241-248.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.241
  • 9,683 View
  • 206 Download
  • 1 Crossref
AbstractAbstract PDF
Background
Few reports have documented the clinical characteristics and treatment outcomes of adult patients with Elizabethkingia meningoseptica infection.
Methods
Medical records of patients over 18 years of age and suspected of having an E. meningoseptica infection from March 1, 2006 to February 28, 2013 were reviewed retrospectively. Their clinical characteristics, antimicrobial susceptibility results, and treatment outcomes were analyzed.
Results
E. meningoseptica was isolated from 30 patients. Median age was 68.5 years, and infections were more frequent in males (17, 56.7%). The most common isolation source was sputum (23, 76.7%), and pneumonia was the most common condition (21, 70%) after excluding two cases of colonization. This bacterium was most susceptible to minocycline (27, 90%) and fluoroquinolones, including levofloxacin (20, 66.7%) and ciprofloxacin (18, 60%). The mortality rate due directly to E. meningoseptica infection was 20% (6/30), and uncontrolled pneumonia was the only cause of death. After isolating E. meningoseptica, the numbers of patients with pneumonia (9/9, 100% vs. 12/21, 57.1%), history of hemodialysis (5/9, 55.6% vs. 3/21, 14.3%), tracheostomy (8/9, 88.9 vs. 10/21, 47.6%), and median Charlson comorbidity index score (6 [range, 3–9] vs. 4 [range, 0–9]) were significantly higher in non-survivors than those in survivors (p < 0.05, for each). However, only 12 (40%) patients received appropriate antibiotics.
Conclusions
E. meningoseptica infection most commonly presented as pneumonia in adults with severe underlying diseases. Despite the high mortality rate, the rate of appropriate antibiotic use was notably low.

Citations

Citations to this article as recorded by  
  • Elizabethkingia meningosepticum Isolated from Pleural Fluid: A Diagnostic Dilemma
    Abha Sharma, Shweta Gupta, Tanisha Bharara, Shalini Dewan Duggal, Pragnya Paramita Jena, Renu Gur
    The Indian Journal of Chest Diseases and Allied Sciences.2022; 61(2): 91.     CrossRef

ACC : Acute and Critical Care