Elizabethkingia Infections

Updated: January 30, 2025

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Background

Elizabethkingia is an environmental bacterial genus rarely cause human infections.

Elizabethkingia infections have high mortality due to antibiotic resistance and virulence factors.

E anophelis is a gram-negative bacterium from mosquitoes causes human respiratory illnesses.

Nationwide vigilance revealed that isolates from Michigan and Illinois matched the bacteria involved in the Wisconsin outbreak.

Associated with neonatal meningitis outbreaks in premature infants globally. Elizabethkingia species are considered as resistant opportunistic pathogens.

Elizabethkingia is a genus of gram-negative bacteria found everywhere including soil, freshwater, and hospital settings.

Epidemiology

In the US, 5-10 cases occur annually per state with occasional outbreaks.

E anophelis linked to ongoing outbreak in Wisconsin, Michigan, Illinois since 2015.

First reported E. anophelis outbreak in U.S. and largest Elizabethkingia outbreak documented in history.

At-risk populations include immunocompromised, neonates, and elderly patient.

Anatomy

Pathophysiology

Mosquitoes’ role in E anophelis transmission is unclear but biofilm formation suspected of immune defense resistance.

Etiology

The causes of Elizabethkingia infections are:

Sources of Infection

Transmission

Host Susceptibility

Microbial Virulence

Genetics

Prognostic Factors

The current Elizabethkingia outbreak has a mortality rate of about 30%, with unclear causes of death in affected cases.

Poor outcomes in E meningoseptica infection correlate with hypoalbuminemia and central venous line presence.

Clinical History

Collect details including symptoms based on site of infection, course of illness and past medical history to understand clinical history of patient.

Physical Examination

Skin Examination

Cardiovascular Examination

Respiratory Examination

Neurological Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Acute symptoms are:

Sepsis, meningitis, pneumonia, respiratory infections, fever/cough

Subacute symptoms are:

Localized skin/soft tissue Infections, ocular Infections, chronic Infection

Differential Diagnoses

Sepsis

Meningitis

Endocarditis

Cellulitis

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

Elizabethkingia shows antibiotic resistance in infections with help of beta-lactams, aminoglycosides, and chloramphenicol.

Vancomycin treats nonneonatal Elizabethkingia meningitis but has high inhibitory concentration.

Elizabethkingia infections cause septicemia and can be fatal if antibiotic treatment is delayed.

Consider Elizabethkingia as a potential cause in patients with bloodstream infections.

Elizabethkingia infections are susceptible to multiple antibiotics, while combination treatment is preferred over monotherapy.

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

use-of-non-pharmacological-approach-for-elizabethkingia-infections

Monitor water sources for species presence through routine surveillance. Clean water systems with disinfectants on regular basis.

Install point-of-use filters in high-risk areas and periodically flush water systems to prevent infections.

Require healthcare workers to follow strict hand hygiene protocols with soap and sanitizers.

Proper awareness about elizabethkingia infections should be provided and its related causes with management strategies.

Appointments with a physician and preventing recurrence of disorder is an ongoing life-long effort.

Use of Antibiotics

Levofloxacin:

It inhibits DNA gyrase activity to promote breakage of DNA strands.

Minocycline:

It inhibits protein synthesis to bind with 30S and 50S ribosomal subunits.

Rifampin:

It inhibits DNA-dependent RNA polymerase to bind beta subunit.

Trimethoprim/ sulfamethoxazole:

It blocks two steps in the biosynthesis of nucleic acids and proteins essential.

use-of-intervention-with-a-procedure-in-treating-elizabethkingia-infections

Procedural interventions include microbiological diagnosis, antibiotic therapy, and infection control to enhance outcomes and decrease outbreak risks.

use-of-phases-in-managing-elizabethkingia-infections

The initial diagnosis phase involves initial assessment and stabilization of patient, Microbiological Testing, and imaging to confirm diagnosis.

Pharmacologic therapy is effective in the treatment phase as it includes the use of antibiotics.

In supportive care and management phase, patients should receive required attention such as lifestyle modification and therapeutic interventional therapies.

The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.

Medication

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Elizabethkingia Infections

Updated : January 30, 2025

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Elizabethkingia is an environmental bacterial genus rarely cause human infections.

Elizabethkingia infections have high mortality due to antibiotic resistance and virulence factors.

E anophelis is a gram-negative bacterium from mosquitoes causes human respiratory illnesses.

Nationwide vigilance revealed that isolates from Michigan and Illinois matched the bacteria involved in the Wisconsin outbreak.

Associated with neonatal meningitis outbreaks in premature infants globally. Elizabethkingia species are considered as resistant opportunistic pathogens.

Elizabethkingia is a genus of gram-negative bacteria found everywhere including soil, freshwater, and hospital settings.

In the US, 5-10 cases occur annually per state with occasional outbreaks.

E anophelis linked to ongoing outbreak in Wisconsin, Michigan, Illinois since 2015.

First reported E. anophelis outbreak in U.S. and largest Elizabethkingia outbreak documented in history.

At-risk populations include immunocompromised, neonates, and elderly patient.

Mosquitoes’ role in E anophelis transmission is unclear but biofilm formation suspected of immune defense resistance.

The causes of Elizabethkingia infections are:

Sources of Infection

Transmission

Host Susceptibility

Microbial Virulence

The current Elizabethkingia outbreak has a mortality rate of about 30%, with unclear causes of death in affected cases.

Poor outcomes in E meningoseptica infection correlate with hypoalbuminemia and central venous line presence.

Collect details including symptoms based on site of infection, course of illness and past medical history to understand clinical history of patient.

Skin Examination

Cardiovascular Examination

Respiratory Examination

Neurological Examination

Acute symptoms are:

Sepsis, meningitis, pneumonia, respiratory infections, fever/cough

Subacute symptoms are:

Localized skin/soft tissue Infections, ocular Infections, chronic Infection

Sepsis

Meningitis

Endocarditis

Cellulitis

Elizabethkingia shows antibiotic resistance in infections with help of beta-lactams, aminoglycosides, and chloramphenicol.

Vancomycin treats nonneonatal Elizabethkingia meningitis but has high inhibitory concentration.

Elizabethkingia infections cause septicemia and can be fatal if antibiotic treatment is delayed.

Consider Elizabethkingia as a potential cause in patients with bloodstream infections.

Elizabethkingia infections are susceptible to multiple antibiotics, while combination treatment is preferred over monotherapy.

Infectious Disease

Monitor water sources for species presence through routine surveillance. Clean water systems with disinfectants on regular basis.

Install point-of-use filters in high-risk areas and periodically flush water systems to prevent infections.

Require healthcare workers to follow strict hand hygiene protocols with soap and sanitizers.

Proper awareness about elizabethkingia infections should be provided and its related causes with management strategies.

Appointments with a physician and preventing recurrence of disorder is an ongoing life-long effort.

Infectious Disease

Levofloxacin:

It inhibits DNA gyrase activity to promote breakage of DNA strands.

Minocycline:

It inhibits protein synthesis to bind with 30S and 50S ribosomal subunits.

Rifampin:

It inhibits DNA-dependent RNA polymerase to bind beta subunit.

Trimethoprim/ sulfamethoxazole:

It blocks two steps in the biosynthesis of nucleic acids and proteins essential.

Infectious Disease

Procedural interventions include microbiological diagnosis, antibiotic therapy, and infection control to enhance outcomes and decrease outbreak risks.

Infectious Disease

The initial diagnosis phase involves initial assessment and stabilization of patient, Microbiological Testing, and imaging to confirm diagnosis.

Pharmacologic therapy is effective in the treatment phase as it includes the use of antibiotics.

In supportive care and management phase, patients should receive required attention such as lifestyle modification and therapeutic interventional therapies.

The regular follow-up visits with the physician are scheduled to check the improvement of patients along with treatment response.

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