Clinical and Microbiological Profile of Elizabethkingia meningoseptica Bacteraemia: A Cross-sectional Study from a Tertiary Care Centre in Northern India

Abstract

Introduction: Elizabethkingia meningoseptica (E. meningoseptica) is an emerging pathogen that causes bloodstream infections, especially among immunocompromised or critically ill patients. Due to its multidrug resistance, limited antibiotic treatments are available. Therefore, correct identification with a proper susceptibility report is compulsory to reduce mortality and morbidity caused by this rare pathogen. Aim: To analyse the clinical features, underlying comorbidity, outcomes, and antibiotic resistance potential of E. meningoseptica causing bacteraemia. Materials and Methods: This cross-sectional study was conducted in Department of Microbiology, Rajshree Medical Research Institute (RMRI), Bareilly, Uttar Pradesh, India. The study spanned three years from August 2020 to July 2023. All patients with E. meningoseptica bacteraemia were identified from blood culture reports and included in the study. As it was a duration-based study, all consecutive patients identified with E. meningoseptica bacteraemia were enrolled. The total sample size was 43. Blood samples growing gram negative, non fermenting, non motile isolates that were positive for the oxidase reaction were further identified using the Vitek 2 compact system (Biomerieux, France). All relevant data regarding demographic and clinical characteristics, underlying diseases, and antibiotic treatments were collected from the hospital information system. Patient demographics were presented as mean ± standard deviation. Clinical characteristics and co-morbid conditions were presented as frequency and percentages. Results: The majority of patients were elderly males admitted to the Intensive Care Unit (ICU). The most common underlying co-morbidity was malignancy in 12 (27.9%), and pneumonia in 12 (48.8%) was the major diagnosis among these bacteraemic patients. A total of 10 (23.25%) infections were polymicrobial, with common concomitant pathogens being Pseudomonas aeruginosa and Methicillin-Resistant Staphylococcus aureus (MRSA). Co-trimoxazole, fluoroquinolones, and Piperacillin/ Tazobactam were the most effective antibiotics. Thirty-nine (90.7%) patients recovered completely, while four patients (9.3%) died of complications. Conclusion: Improper antimicrobial therapy increases resistance and mortality among patients with E. meningoseptica infections. It is imperative that clinicians remain vigilant about this rare pathogen and advise antimicrobial susceptibility testing for appropriate treatment, leading to favourable outcomes.