Infections caused by Elizabethkingia meningoseptica in a tertiary care centre - A retrospective study

Abstract

Elizabethkingia meningoseptica (EM) has emerged as important opportunistic pathogens that can cause sporadic nosocomial outbreaks as well as infections in neonates. They are known for their multidrug resistance and their unique susceptibility pattern. Present study is a retrospective single centre study where the sensitivity pattern and comorbidities associated with infection by this organism is systematically being noted. All samples received in the microbiology lab and yielding EMas identified by automated method (Vitek2, Biomerieux) from October 2020 to September 2021 were included in the study. The strains were re-identified to species level by polymerase chain reaction amplification of 16s r RNA gene.All samples where clinical significance could not be proven and repeat samples from same patient were excluded from analysis. The case sheets of the patients were collected from record section and analyzed for presence of various risk factors.In this study 57 patients were included withmean age of patients being 47.12 and most of the patients belonged to 51-60 age group (22.81%).Most common sample of isolation was blood (57.89%) followed by respiratory samples (26.32%). Majority (89.28%) of patients were in ICU and most of the infections were hospital acquired (92.9%).  Mean duration of ICU stay before isolation was 13.8±8.07. Other major associated factors were diabetes mellitus (42.86%), high dose steroid use (57.14%) and post COVID pneumonia (35.71%). The isolates were resistant to betalactams and combination agents; minocycline (98.2%) followed by cotrimoxazole (47.2%) and levofloxacin (45.6%) and ciprofloxacin (35.1%) were the most useful antibiotics.EM is an emerging nosocomial pathogen in ICU setting. Clinicians and microbiologists need to be aware of its unique sensitivity pattern. In contrast to previous studies we find a high degree of resistance to tigecycline and piperacillintazobactam. Thus in planning combination regimen this should be kept in mind.