Elizabethkingia spp

  • E. anophelis
  • E. meningoseptica
  • E. miricola

Gram Stain

  • Gram negative bacilli - nonfermenter

Clinical Significance

These organisms (formerly belonging to Chryseobacterium spp.) are found in soil, plant, water, food sources, as well as various hospital environments. 

E. anophelis - emerging pathogen isolated from Anopheles mosquitos. It is associated with septicemia, respiratory infections, neonatal meningitis, septic arthritis, cellulitis, and peritonitis in humans. Infections tend to occur in patients with comorbidities and may be nosocomial (possibly from water sources). It is resistant to chlorine, can survive in alcohol, and can grow in up to 42°C.

E. meningoseptica - associated with epidemic meningitis in premature neonates. It has also been associated with pneumonia, septicemia, and hemodialysis related infections.

E. miricola - associated with septicemia.

 

Usual Susceptibility Pattern

E. anophelis is typically susceptible to piperacillin-tazobactam, but expresses broad resistance to other beta-lactam agents, quinolones, TMP/SMX, and aminoglycosides.

E. meningoseptica is resistant to all cephalosporins (including ceftazidime), amoxicillin-clavulanate, carbapenems, and colistin.  Rifampin, piperacillin-tazobactam, and minocycline have variable activity against this organism.  Aminoglycoside, quinolone, and TMP/SMX resistance is common.

E. miricola appears to be quite susceptible to minocycline, levofloxacin/moxifloxacin, but not ciprofloxacin.  It is typically susceptible to piperacillin-tazobactam.

 

Empiric Therapy
Piperacillin-tazobactam