Elizabethkingia Meningoseptica Research Articles

Activity of β-lactam/taniborbactam (VNRX-5133) combinations against carbapenem-resistant Gram-negative bacteria.

Boronates are of growing interest as β-lactamase inhibitors. The only marketed analogue, vaborbactam, principally targets KPC carbapenemases, but taniborbactam (VNRX-5133, Venatorx) has a broader spectrum. MICs of cefepime and meropenem were determined combined with taniborbactam or avibactam for carbapenem-resistant UK isolates. β-Lactamase genes and porin alterations were sought by PCR or sequencing. Taniborbactam potentiated partner β-lactams against: (i) Enterobacterales with KPC, other class A, OXA-48-like, VIM and NDM (not IMP) carbapenemases; and (ii) Enterobacterales inferred to have combinations of ESBL or AmpC activity and impermeability. Potentiation of cefepime (the partner for clinical development) by taniborbactam was slightly weaker than by avibactam for Enterobacterales with KPC or OXA-48-like carbapenemases, but MICs of cefepime/taniborbactam were similar to those of ceftazidime/avibactam, and the spectrum was wider. MICs of cefepime/taniborbactam nonetheless remained >8 + 4 mg/L for 22%-32% of NDM-producing Enterobacterales. Correlates of raised cefepime/taniborbactam MICs among these NDM Enterobacterales were a cefepime MIC >128 mg/L, particular STs and, for Escherichia coli only: (i) the particular blaNDM variant (even though published data suggest all variants are inhibited similarly); (ii) inserts in PBP3; and (iii) raised aztreonam/avibactam MICs. Little or no potentiation of cefepime or meropenem was seen for Pseudomonas aeruginosa and Acinetobacter baumannii with MBLs, probably reflecting slower uptake or stronger efflux. Potentiation of cefepime was seen for Stenotrophomonas maltophilia and Elizabethkingia meningoseptica, which have both chromosomal ESBLs and MBLs. Taniborbactam broadly reversed cefepime or meropenem non-susceptibility in Enterobacterales and, less reliably, in non-fermenters.

Use of Intraventricular Vancomycin in Neonatal Meningitis due to Elizabethkingilla meningoseptica

Elizabethkingia meningoseptica is a non-motile, catalase positive, oxidase positive, non-glucose fermenting, gram negative bacilli which is resistant to common drugs active against gram negative organism. It manifests mainly as meningitis in newborns especially in preterms that are immune compromised. Antibiotics which have shown effectiveness against this organism includes cotrimoxazole, tigecycline, minocycline, quinolones, piperacillin, tazobactam, cefepime and drugs active against gram positive bacteria such as vancomycin and rifampicin. The major reason for the cautioned use of Intraventricular/Intrathecal therapy has been the significant toxicity that was reported by earlier studies. These included seizures in up to 20% of the patients and chemical ventriculitis in as high as 60% of the patients, though those were considered to be dose related. Few papers have also reported side effects such as transient hearing loss and seizures. Here we report a preterm newborn having E. meningoseptica ventriculitis showing improvement with intraventricular vancomycin without any short term adverse effect in first 6 months of life.

Zinc Chelators as Carbapenem Adjuvants for Metallo-β-Lactamase-Producing Bacteria: In Vitro and In Vivo Evaluation.

Infections caused by metallo-β-lactamase (MBL)-producing bacteria are emerging and carry a significant impact on patients' outcome. MBL producers are spread worldwide, both in community and hospital setting, with increasingly reported epidemic clusters and the search for MBL inhibitors is an important topic for public health. MBLs are zinc-dependent enzymes whose functioning can be hampered by zinc chelators. We evaluated the potential of six zinc chelators (disulfiram, nitroxoline, 5-amino-8-hydroxyquinoline, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid [DOTA], cyclam, and N,N,N',N'-tetrakis (2-pyridymethyl) ethylenediamine [TPEN]) in restoring carbapenem activity against MBL producers. Zinc chelators alone or in combination with meropenem against MBL-producing Klebsiella pneumoniae, Chryseobacterium indologenes, Elizabethkingia meningoseptica, and Stenotrophomonas maltophilia isolates were tested in vitro and in vivo (Galleria mellonella). In vitro experiments showed a synergistic activity between TPEN and meropenem toward all the strains. Nitroxoline alone retained activity against S. maltophilia, C. indologenes, and E. meningoseptica. In vivo experiments showed that TPEN or nitroxoline in combination with meropenem increased survival in larvae infected with E. meningoseptica, S. maltophilia, and K. pneumoniae. Based on our data, zinc chelators are potential carbapenem adjuvants molecules (restoring carbapenem activity) against MBL-sustained infections and could represent an interesting option for infections induced by these microorganisms.

Expression of some resistant genes on six Elizabethkingia spp. strains isolated in Vietnam

This study focused on the assessment of the multiantibiotic-resistance and gene expression associated with multi-drug resistance in Elizabethkingia. Six Elizabethkingia spp. strains were isolated from patient samples, and the antibiotic-resistance of the six isolates with all 14 tested antibiotics was confirmed. MacConkey subculture and 16S rRNA sequencing were used to identify the six isolates as; one Elizabethkingia meningoseptica (E. meningoseptica) isolate, and five E. anophelis isolates. Seven genes including four-resistant genes (blaB, blaCME, ant6, lolD and catB and two antibiotics target gene (gyrA and parC) were selected for evaluation of gene expression using Reverse Transcriptase PCR (RT-PCR). The resistant genotype–phenotype correlation of β-lactams (blaB and blaCME) and fluoroquinolones (gyrA and parC) groups was observed. The chloramphenicol resistant gene (catB) was also found in all six isolates. The gene expression level was different between isolates but lacked the relationship with high resistant phenotypes. The aminoglycoside (ant6) and macrolide (lolD) resistant genes were absent, which indicated that other genetic factors could be implicated. The multidrug-resistance of Elizabethkingia spp. is reported for the first time in Vietnam, demonstrating the presence of this drug-resistance bacterium in the Vietnamese hospital environment. The initial results in this study will be the basis for further research regarding Elizabethkingia spp.

Detection of 5 Kinds of Genes Related to Plasmid-Mediated Quinolone Resistance in Four Species of Nonfermenting Bacteria with 2 Drug Resistant Phenotypes.

Objective This study aimed to detect 5 kinds of genes related to plasmid-mediated quinolone resistance in four species of nonfermenting bacteria with 2 drug resistance phenotypes (multidrug resistance and pandrug resistance), which were Acinetobacter baumannii (Ab), Pseudomonas aeruginosa (Pa), Stenotrophomonas maltophilia (Sm), and Elizabethkingia meningoseptica (Em). Methods The Phoenix NMIC/ID-109 panel and API 20NE panel were applied to 19 isolated strains, including 6 Ab strains (2 strains with multidrug resistance and 4 strains with pandrug resistance), 6 Pa strains (3 strains with multidrug resistance and 3 strains with pandrug resistance), 4 Sm strains (2 strains with multidrug resistance and 2 strains with pandrug resistance), and 3 Cm strains (2 strains with multidrug resistance and 1 strain with pandrug resistance). After strain identification and drug susceptibility test, PCR was applied to detect 5 genes related to plasmid-mediated quinolone resistance. The genes detected were quinolone resistance A (qnrA), aminoglycoside acetyltransferase ciprofloxacin resistance variant, acc(6′)-Ib-cr, and 3 integrons (intI1, intI2, and intI3). The amplified products were analyzed by 1% agarose gel electrophoresis and sequenced. Sequence alignment was carried out using the bioinformatics technique. Results Of 19 strains tested, 8 strains carried acc(6′)-Ib-cr and 6 of them were of pandrug resistance phenotype (3 Ab strains, 2 Pa strains, and 1 Sm strain). The carrying rate of acc(6′)-Ib-cr was 60.0% for strains of pandrug resistance (6/10). Two strains were of multidrug resistance (1 Ab strain and 1 Pa strain), and the carrying rate of acc(6′)-Ib-cr was 22.0% (2/9). The carrying rate was significantly different between strains of multidrug resistance and pandrug resistance (P < 0.05). The class 1 integron was detected in 11 strains, among which 6 strains were of pandrug resistance (3 Ab strains, 2 Pa strains, and 1 Sm strain). The carrying rate of the class 1 integron was 60.0% (6/10). Five strains were of multidrug resistance (3 Pa strains, 1 Ab strain, and 1 Em strain), and the carrying rate was 55.6% (5/9). The carrying rate of the class 1 integron was not significantly different between strains of multidrug resistance and pandrug resistance (P > 0.05). Both acc(6′)-Ib-cr and intI1 were detected in 6 strains, which were negative for qnrA, intI2, and intI3. Conclusion Quinolone resistance of isolated strains was related to acc(6′)-Ib-cr and intI1 but not to qnrA, intI2, or intI3. The carrying rate of acc(6′)-Ib-cr among the strains of pandrug resistance was much higher than that among the strains of multidrug resistance. But, the strains of two drug resistant phenotypes were not significantly different in the carrying rate of intI1. The detection rates of the two genes were high and similar in Ab and Pa strains. 1 Em strain carried the class 1 integron.

Chryseobacterium/Elizabethkingia species infections in Saudi Arabia.

Objectives:To describe the epidemiological, clinical, and outcome data of patients infected or colonized with Chryseobacterium/Elizabethkingia spp including antibiotic susceptibility patterns.Methods:This retrospective study was conducted at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. All patients infected or colonized by Chryseobacterium /Elizabethkingia spp who were admitted between June 2013 and May 2019 were included. Data were extracted from patient electronic medical records.Results:We enrolled 27 patients (13 males and 14 females) with a mean age of 35.6 years. Chryseobacterium/Elizabethkingia spp were isolated from blood cultures (n=13, 48%) and tracheal aspirations (n=11, 41%). The most frequent species isolated was Elizabethkingia meningoseptica (n=22). Although 6 patients were considered colonized, the remaining 21 patients presented with ventilator associated pneumonia (n=9), central line associated bloodstream infection (n=4), septic shock (n=4), or isolated bacteremia (n=4). In 25 cases the infections were health-care related. Three patients (11%) died within 28 days. Twenty-six isolates (96.5%) were resistant to carbapenems. Moxifloxacin and cotrimoxazole were the most active antibiotics.Conclusion:Chryseobacterium/Elizabethkingia spp infection is rare, but can be responsible for severe hospital acquired infections. Cotrimoxazole and fluoroquinolone are the most effective antibiotic treatments.

Sepsis Caused by Elizabethkingia meningoseptica Successfully Treated by Polymyxin B: A Case Report

Introduction: Elizabethkingia meningoseptica (EM) is a non-fermenting Gram-negative bacterium that is a conditional pathogen and easily causes infection in neonates and immunocompromised patients. The infection of the bacterium is prone to develop multi-drug resistance, difficult to treat, and associated with a high mortality rate. Case Presentation: A 28-year-old female was admitted to the intensive care unit (ICU) of our hospital due to fulminant myocarditis, cardiogenic shock, acute heart failure, and multiple organ dysfunction syndrome (MODS) on 24 April 2019. The patient developed a lung infection and sepsis after admission. Two sputum culture tests on 27 April and 4 May showed infection with Pseudomonas aeruginosa and multi-drug resistance. The minimum inhibitory concentration (MIC) for imipenem was 4 mg/L and 8 mg/L, respectively. Four blood cultures on 9 May suggested an EM infection and multi-drug resistance, the MIC for imipenem was ≥ 16 mg/L. Due to the serious condition of the patient, imipenem-resistant lung infection, and typical sepsis manifestations, we initiated a regimen of polymyxin B combined with meropenem between 3 and 12 May. The infection was well-controlled and the patient was discharged on 14 May. Conclusions: A polymyxin B-based combinational regimen is effective in the treatment of sepsis due to EM and play an important role in controlling EM-associated mixed infections.

Epidemiology, Treatment, and Prevention of Nosocomial Bacterial Pneumonia.

Septicaemia likely results in high case-fatality rates in the present multidrug-resistant (MDR) era. Amongst them are hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), two frequent fatal septicaemic entities amongst hospitalised patients. We reviewed the PubMed database to identify the common organisms implicated in HAP/VAP, to explore the respective risk factors, and to find the appropriate antibiotic choice. Apart from methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, extended-spectrum β-lactamase-producing Enterobacteriaceae spp., MDR or extensively drug-resistant (XDR)-Acinetobacter baumannii complex spp., followed by Stenotrophomonas maltophilia, Chryseobacterium indologenes, and Elizabethkingia meningoseptica are ranked as the top Gram-negative bacteria (GNB) implicated in HAP/VAP. Carbapenem-resistant Enterobacteriaceae notably emerged as an important concern in HAP/VAP. The above-mentioned pathogens have respective risk factors involved in their acquisition. In the present XDR era, tigecycline, colistin, and ceftazidime-avibactam are antibiotics effective against the Klebsiella pneumoniae carbapenemase and oxacillinase producers amongst the Enterobacteriaceae isolates implicated in HAP/VAP. Antibiotic combination regimens are recommended in the treatment of MDR/XDR-P. aeruginosa or A. baumannii complex isolates. Some special patient populations need prolonged courses (>7-day) and/or a combination regimen of antibiotic therapy. Implementation of an antibiotic stewardship policy and the measures recommended by the United States (US) Institute for Healthcare were shown to decrease the incidence rates of HAP/VAP substantially.

Use of Intraventricular Vancomycin in Neonatal Meningitis Dueto Elizabethkingilla Meningoseptica

Elizabethkingia meningoseptica is a non-motile, catalase positive, oxidase positive, non-glucose fermenting, gram negative bacilli which is resistant to common drugs active against gram negative organism. It presents as neonatal meningitis mostly in preterms as they have low immunity. Antibiotics which have shown effectiveness against this organism includes cefepime, tazobactam, piperacillin, cotrimoxazole, tigecycline, minocycline, quinolones and drugs active against gram positive bacteria such as vancomycin and rifampicin. Intraventricular therapy use has been limited owing to drug toxic effect. Seizures, hearing loss and chemical ventriculitis had been reported mostly as short term side effect. Long term side effect needs more follow up studies. Here we report a preterm newborn having E.meningoseptica ventriculitis showing improvement with intraventricular vancomycin without any short term adverse effect in first 6 months of life.

Polymicrobial meningitis in a renal transplant recipient – “cryptococcus neoformans and acinetobacter baumannii coinfection with elizabethkingia meningoseptica superinfection“

Although rare, polymicrobial meningitis has been infrequently reported in renal transplant recipients (RTRs). In this context, we describe a RTR on triple immunosuppression therapy, with stable graft function, who had presented with fever and altered sensorium of 2 days' duration. Evaluation revealed polymicrobial meningitis, which was initially attributed to concurrent infection by Cryptococcus neoformans and Acinetobacter baumannii and was later superinfected with Elizabethkingia meningoseptica. The overall prognosis in polymicrobial meningitis remains dismal, re-emphasizing the importance of early suspicion and prompt microbiological diagnosis for targeted antimicrobial therapy.

Prevalence and antimicrobial susceptibility patterns of bacteria in ICU patients with lower respiratory tract infection: A cross-sectional study

Objective: To investigate the prevalence of isolated organisms in patients with lower respiratory tract infections and the antibiotic susceptibilities at a tertiary care center. Methods: In this observational and cross-sectional analysis, 114 patients admitted in the intensive care unit were enrolled. The endotracheal aspirates and bronchoalveolar lavage were collected. The bacteria were isolated and identified, and finally, antimicrobial sensitive pattern of the isolated bacteria was examined. Results: The prevalence of infection was 72.72% in male patients and 27.28% in females. The predominant bacteria were Klebsiella pneumoniae (37.50%) followed by Acinetobacter spp. (36.36%), Pseudomonas aeruginosa (7.95%), Escherichia coli (6.81%), Proteus mirabilis (2.27%), atypical Escherichia coli (1.13%), Enterococcus spp. (1.13%), Elizabethkingia meningoseptica (1.13%), Staphylococcus aureus (1.13%), Proteus vulgaris (1.13%), Citrobacter freundii (1.13%), and Citrobacter koseri (1.13%). High resistance to cephalosporins (82.18%) was demonstrated in all Gram-negative bacteria. Bacteria showed susceptibility to colistin (88.75%) followed by tigecycline (83.11%), gentamycin (36.18%), and amikacin (49.23%). Conclusions: As the most frequent respiratory organisms, Klebsiella pneumoniae and Acinetobacter spp. have increased resistance to cephalosporins and susceptibility to colistin followed by tigecycline.

Flavobacteriaceae Bacteremia in Children: A Multicenter Study.

The Flavobacteriaceae family includes rare pathogens in children; Chryseobacterium indologenes and Elizabethkingia meningosepticum are the most common pathogenic species, with a wide range of clinical presentations and high mortality rate. Although rare, diagnosis is important due to inherent resistance to multiple antibiotics, especially those typically prescribed for empiric treatment of aerobic Gram-negative bacterial infections. A multicenter retrospective study conducted in 5 Israeli hospitals, describing Flavobacteriaceae bacteremia confirmed by positive blood culture from 1998 to 2018. Thirteen cases were included; 9 isolates were C. indologenes. Bacteremia was nosocomial or healthcare-associated in all cases. Bacteremia was associated with young age (median, 1 year, range 24 days-17 years), with only 2 (15.4%) cases in neonates, Central line-associated bloodstream infection as a source (5/13, 38%) and malignancy (7/13, 54.8%). Thirty-day all-cause mortality was 23% (3/13). Ninety-one percent of isolates were susceptible to trimethoprim-sulfamethoxazole, 82% to piperacillin-tazobactam and 92% to ciprofloxacin. C. indologenes and E. meningosepticum are rare, nosocomial- or healthcare-associated pediatric bacteremia pathogens. Bacteremia was associated with young age, but in contrast to the literature, the majority of our cases were older than the neonatal age period. In addition, they were associated with central line-associated bloodstream infection and malignancy. The most adequate antibiotics according to resistance patterns were ciprofloxacin, trimethoprim-sulfamethoxazole and piperacillin-tazobactam.

Elizabethkingia meningoseptica (Chryseobacterium meningosepticum) bacteraemia: a series of 12 cases at Prince Sultan Military Medical City KSA.

The aim of this study was to describe the epidemiological data, clinical features and outcome of patients with Elizabethkingia meningoseptica bacteraemia and to report the antimicrobial susceptibility pattern. All patients with E. meningoseptica bacteraemia were retrospectively recruited at the Prince Sultan Military Medical City, Riyadh, Saudi Arabia, between June 2013 and May 2019. Epidemiological data, clinical features and patient outcome, as well as antimicrobial susceptibilities of E. meningoseptica, were collected from patient electronic medical records. Twelve patients (eight male and four female) with E. meningoseptica bacteraemia were included in the study. Eleven patients acquired the infection from the hospital, five of whom were in the intensive care unit. All patients had one or more underlying medical conditions or interventions, including chronic illness (eight cases), major surgery (three cases), pulmonary fibrosis (one case), sickle-cell anaemia (one case) and end-stage renal disease (one patient on haemodialysis). Eleven patients had a prolonged stay in the hospital (≥3 months), and nine patients had received prolonged antibiotic therapy. Three patients had polymicrobial bacteraemia, including Serratia marcescens (two cases) and Enterococcus faecalis (one case). All E. meningoseptica isolates were susceptible to trimethoprim/sulfamethoxazole, piperacillin/tazobactam and moxifloxacin but showed a high degree of resistance to β-lactam antibiotics, aminoglycosides and carbapenems. These findings have important implications for the clinician selecting optimal antimicrobial regimens for patients with risk factors for E. meningoseptica infection.

189. A Case Series of Elizabethkingia meningosepticum Bacteremia in the Cancer Population

BackgroundElizabethkingia meningosepticum (E. meningosepticum) is a ubiquitous microorganism previously known as Chryseobacterium meningosepticum. It is emerging as a pathogen responsible for bacteremia in immunocompromised patients such as cancer patients especially those with a history of prolonged hospital stay and frequent instrumentations.MethodsA retrospective chart review of all cases over 10 years in Moffitt Cancer Center showed a total of three patients with E. meningosepticum infection.ResultsFirst patient (history of multiple myeloma) underwent endoscopy complicated by aspiration pneumonia and blood culture positive for E. meningosepticum infection. He was treated with ciprofloxacin, cefoxitin, minocycline and metronidazole and was discharged in stable conditions after 10 days. The second patient (current acute myelogenous leukemia) had neutropenic fever in the setting of recent chest port infection. Blood culture from chest port showed E. meningosepticum and was treated with ciprofloxacin, meropenem and minocycline successfully. The third patient (history of esophageal adenocarcinoma and acute myelogenous leukemia) had history of recent pneumonia and cellulitis who came in with recurrent neutropenic fever. Blood culture was positive for E. meningosepticum and was treated with ciprofloxacin and minocycline. However, the infection was complicated by multiorgan failure and required tracheostomy. As these three cases illustrate, E. meningosepticum bacteremia has high 28- day mortality rate (41%).ConclusionEarly identification of the pathogen along with empiric treatment with a fluoroquinolone and/or minocycline is indicated to reduce morbidity and mortality.Disclosures All authors: No reported disclosures.

Comparative genomic analyses reveal diverse virulence factors and antimicrobial resistance mechanisms in clinical Elizabethkingia meningosepticastrains.

Three human clinical isolates of bacteria (designated strains Em1, Em2 and Em3) had high average nucleotide identity (ANI) to Elizabethkingia meningoseptica. Their genome sizes (3.89, 4.04 and 4.04 Mb) were comparable to those of other Elizabethkingia species and strains, and exhibited open pan-genome characteristics, with two strains being nearly identical and the third divergent. These strains were susceptible only to trimethoprim/sulfamethoxazole and ciprofloxacin amongst 16 antibiotics in minimum inhibitory tests. The resistome exhibited a high diversity of resistance genes, including 5 different lactamase- and 18 efflux protein- encoding genes. Forty-four genes encoding virulence factors were conserved among the strains. Sialic acid transporters and curli synthesis genes were well conserved in E. meningoseptica but absent in E. anophelis and E. miricola. E. meningoseptica carried several genes contributing to biofilm formation. 58 glycoside hydrolases (GH) and 25 putative polysaccharide utilization loci (PULs) were found. The strains carried numerous genes encoding two-component system proteins (56), transcription factor proteins (187~191), and DNA-binding proteins (6~7). Several prophages and CRISPR/Cas elements were uniquely present in the genomes.

Carbapenemase-Producing Elizabethkingia Meningoseptica from Healthy Pigs Associated with Colistin Use in Spain.

Carbapenems are considered last-resort antimicrobials, especially for treating infections involving multidrug-resistant Gram-negative bacteria. In recent years, extended-spectrum β-lactamase (ESBL) and carbapenemase-producing Gram-negative bacteria have become widespread in hospitals, community settings, and the environment, reducing the range of effective therapeutic alternatives. The use of colistin to treat infection caused by these multi-drug bacteria may favour the selection and persistence of carbapenem-resistant bacteria. In this study, it is described, for the first time to our knowledge, a carbapenemase-producing isolate of Elizabethkingia meningoseptica from healthy pigs in Spain. The isolate we report was recovered during a study to detect colistin-resistant bacteria from faecal samples of healthy food-production animals using a chromogenic selective medium. Unexpectedly, we found an isolate of Elizabethkingia meningoseptica with high Minimum Inhibitory Concentration (MIC) values for several antibiotics tested. Molecular analysis did not show any mcr family genes related with colistin resistance, but two carbapenemase genes, blaB-12_1 and blaGOB-17_1, were detected. This finding in healthy animals could suggest that colistin may favour the selection and persistence of carbapenem-resistant bacteria.

Elizabethkingia Infections in Humans: From Genomics to Clinics.

The genus Elizabethkingia has recently emerged as a cause of life-threatening infections in humans, particularly in immunocompromised patients. Several new species in the genus Elizabethkingia have been proposed in the last decade. Numerous studies have indicated that Elizabethkingia anophelis, rather than Elizabethkingia meningoseptica, is the most prevalent pathogen in this genus. Matrix-assisted laser desorption/ionization–time of flight mass spectrometry systems with an extended spectrum database could reliably identify E. anophelis and E. meningoseptica, but they are unable to distinguish the remaining species. Precise species identification relies on molecular techniques, such as housekeeping gene sequencing and whole-genome sequencing. These microorganisms are usually susceptible to minocycline but resistant to most β-lactams, β-lactam/β-lactam inhibitors, carbapenems, and aminoglycosides. They often exhibit variable susceptibility to piperacillin, piperacillin-tazobactam, fluoroquinolones, and trimethoprim-sulfamethoxazole. Accordingly, treatment should be guided by antimicrobial susceptibility testing. Target gene mutations are markedly associated with fluoroquinolone resistance. Knowledge on the genomic characteristics provides valuable insights into in these emerging pathogens.

Identification and characterization of a novel glycoprotein core xylosidase from the bacterium Elizabethkingia meningoseptica

Although core xylose on glycoproteins has been implicated in allergy, infection and other biological processes, research on core xylose modification is rare. The lack of a β-d-xylosidase that can catalytically remove the core xylose directly from glycoproteins is a reason for this. Through functional genomic analysis, we identified a glycoprotein core xylosidase and named it gpcXase I. gpcXase I is located immediately downstream of glycoprotein core fucosidase cFase I in Elizabethkingia meningoseptica. These two genes form a functional operon for glycoprotein core modifications. Three acidic residues (Asp-200, Asp-304 and Glu-649) were identified as key catalytic sites for gpcXase I activity, suggesting a unique triacdic mechanize for its activity. Asp-200 was identified a novel and essential base catalysts in the catalytic process, Asp-304 and Glu-649 was function as catalytic nucleophiles and acid catalysts, respectively. In addition, IgE-specific reactions were detected in 55% of serum samples collected from 40 allergic patients, and the reactions were significantly attenuated by removal of the core xylose of the allergen by treatment with gpcXase I. gpcXase I is a novel tool for basic and clinical glycomics.

Acinetobacter spp. Coinfection with Elizabethkingia meningoseptica: A Case Report at a Referral Hospital in Iran

Elizabethkingia meningoseptica is an emerging nosocomial gram-negative, rod-shaped pathogen in patients with underlying diseases. This bacterium is also considered to be a major pathogen in hospitalized patients. Some of the main risk factors for E. meningosepticum infections include immunosuppression (e.g., end-stage hepatic and renal diseases) and prematurity in neonates. Furthermore, E. meningosepticum could cause pneumonia, endocarditis, and bacteremia in adults. The uncommon resistance pattern of this bacterium, as well as its intrinsic resistance to colistin, makes the treatment of the associated infections challenging unless the susceptibility patterns are available. In this article, we have presented the first case of pulmonary coinfection with multidrug-resistant (MDR) Acinetobacter spp. and E. meningoseptica in Iran. A 20-year-old female patient was admitted to our hospital with tetralogy of fallot as an underlying disease since childhood. The patient underwent cardiac surgery. On the third postoperative day (POD), the patient developed lung infection and left-lung collapse. Antibiotic therapy was initiated for MDR Acinetobacter spp. obtained from her primary culture of tracheal discharges. When fever persisted in the patient, the secondary culture of her tracheal discharges was observed to be positive for E. meningoseptica. In this case report, no clinical correlations were observed between the E. meningoseptica isolated from respiratory secretions and the primary respiratory infection, suggesting that E. meningoseptica is an indicator of severe underlying diseases rather than an actual pathogen.

Jafar Ghadar Effect of flavolipid extracted from Chryseobacterium meningosepticum on serum lipid profile of Balb/C male mice(mus musculus)

The effect of flavolipid extracted from Chryseobacterium meningosepticum on the serum lipid profile of Balb/c male mice were investigated.The mice were randomaly divided into four groups(n=6), the first group was control treated with 0.9% NaCl ,while that other group were(I.P.) injected with 0.2mL of flavolipid extracted , the serum of second ,third and fourth groups were collected after 24 ,48and 72hrs respectively .from treated with flavolipid Serum total cholesterol,and triglyceride levels were low significantly in group(G2),compared with control group.while low density lipoprotein cholesterol decrease significantly in group G4 compared with control group.There was no significantly difference in high density lipoprotein cholesterol in the all treatd groups. LDL-C/HDL-C ratio was reduced significantly in all groups for injected with flavolipid compared with control group (p≤0.05).