Clinical features, antimicrobial susceptibilities, and outcomes of Elizabethkingia meningoseptica (Chryseobacterium meningosepticum) bacteremia at a medical center in Taiwan, 1999-2006

Eur J Clin Microbiol Infect Dis. 2011 Oct;30(10):1271-8. doi: 10.1007/s10096-011-1223-0. Epub 2011 Apr 3.

Abstract

A total of 118 patients with Elizabethkingia meningoseptica bacteremia at a medical center in Taiwan from 1999 to 2006 were studied. Minimum inhibitory concentrations (MICs) of 99 preserved isolates were determined. The incidence (per 100,000 admissions) of E. meningoseptica bacteremia increased from 7.5 in 1996 to 35.6 in 2006 (p = 0.006). Among them, 84% presented with fever, 86% had nosocomial infections, and 60% had acquired the infection in intensive care units (ICUs). The most common underlying diseases were malignancy (36%) and diabetes mellitus (25%). Seventy-eight percent of patients had primary bacteremia, followed by pneumonia (9%), soft tissue infection, and catheter-related bacteremia (6%). Forty-five patients (38%) had polymicrobial bacteremia. Overall, the 14-day mortality was 23.4%. Multivariate analysis revealed E. meningoseptica bacteremia acquired in an ICU (p = 0.048, odds ratio [OR] 4.23) and presence of effective antibiotic treatment after the availability of culture results (p = 0.049, OR 0.31) were independent predictors of 14-day mortality. The 14-day mortality was higher among patients receiving carbapenems (p = 0.046) than fluoroquinolones or other antimicrobial agents. More than 80% of the isolates tested were susceptible to trimethoprim-sulfamethoxzole, moxifloxacin, and levofloxacin. The MIC(50) and MIC(90) of the isolates to tigecycline and doxycycline were both 4 μg/mL and 8 μg/ml, respectively.

MeSH terms

  • Academic Medical Centers
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Bacteremia / drug therapy
  • Bacteremia / microbiology*
  • Bacteremia / pathology*
  • Child
  • Child, Preschool
  • Chryseobacterium / drug effects
  • Chryseobacterium / isolation & purification*
  • Cross Infection / drug therapy
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Cross Infection / pathology
  • Diabetes Complications
  • Female
  • Flavobacteriaceae Infections / drug therapy
  • Flavobacteriaceae Infections / epidemiology
  • Flavobacteriaceae Infections / microbiology*
  • Flavobacteriaceae Infections / pathology*
  • Humans
  • Incidence
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Neoplasms / complications
  • Risk Factors
  • Survival Analysis
  • Taiwan / epidemiology
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents