Clinical Features and Outcomes of Patients with Elizabethkingia Meningoseptica Infection: An Emerging Pathogen

Abstract Background: Elizabethkingia meningoseptica , formerly known as Chryseobacterium meningosepticum , is a non-motile, non-fastidious, catalase and oxidase-positive, aerobic, glucose-non-fermentative Gram-negative bacillus first defined by Elizabeth O. King in 1959. It has recently emerged as an opportunistic pathogen infecting people in the the extremes of age and the immunocompromised, especially in nosocomial settings. There has been an increased interest in this pathogen due to its rising occurrence around the world, its ubiquity in nature, and inherent capacity for antimicrobial resistance. Methods: We describe a retrospective case series at the Aga Khan University Hospital in Karachi, Pakistan on patients admitted from January 2013 to December 2018 with Elizabethkingia meningoseptica infections. All patients identified to have any clinical culture specimen positive for Elizabethkingia meningoseptica were included. Data was collected on a structured proforma from the Hospital Information Management Systems (HIMS). Results: Sixteen patients with E. meningoseptica were identified. The mean Charlson’s co-morbidity index was 3.25. Nine patients had bacteremia with E. meningosepticum . Three of the isolates were extensively drug resistant with sensitivity only to minocycline. Nine out of 16 patients required intubation and mechanical ventilation. The median length of hospital stay was 13 days and four out of 16 patients died during hospital stay, Conclusion: This is the first case series from Pakistan reporting Elizabethkingia meningoseptica infections.