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Qi PQ, Zeng YJ, Peng W, Kuai J. Lung imaging characteristics in a patient infected with Elizabethkingia miricola following cerebral hemorrhage surgery: A case report. World J Clin Cases 2024; 12:169-175. [PMID: 38292629 PMCID: PMC10824168 DOI: 10.12998/wjcc.v12.i1.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/12/2023] [Accepted: 12/18/2023] [Indexed: 01/02/2024] Open
Abstract
BACKGROUND Elizabethkingia miricola is a non-fermenting gram-negative bacterium, which was first isolated from the condensate of the Russian peace space station in 2003. Most studies on this bacterium have been carried out in the laboratory, and clinical case studies are rare. To date, a total of 6 clinical cases have been reported worldwide. CASE SUMMARY We present the first case of postoperative pulmonary infection in a patient with intracerebral hemorrhage due to Elizabethkingia miricola. The imaging characteristics of pulmonary infection were identified and the formulation and selection of the clinical treatment plan for this patient are discussed. CONCLUSION Elizabethkingia miricola infection is rare. When pulmonary infection occurs, computed tomography imaging may show diffuse distribution of a ground glass density shadow in both lungs, the air containing bronchial sign in local areas, thickening of bronchial vascular bundle, and pleural effusion.
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Affiliation(s)
- Ping-Qiang Qi
- Department of Neurosurgery, The Third Affiliated Hospital of Chengdu Medical College Pidu District People’s Hospital, Chengdu 611730, Sichuan Province, China
| | - Yi-Jun Zeng
- Department of Neurosurgery, The Third Affiliated Hospital of Chengdu Medical College Pidu District People’s Hospital, Chengdu 611730, Sichuan Province, China
| | - Wei Peng
- Department of Neurosurgery, The Third Affiliated Hospital of Chengdu Medical College Pidu District People’s Hospital, Chengdu 611730, Sichuan Province, China
| | - Juan Kuai
- Department of Neurosurgery, The Third Affiliated Hospital of Chengdu Medical College Pidu District People’s Hospital, Chengdu 611730, Sichuan Province, China
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2
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Yang S, Si C, Mani R, Keller J, Hoenerhoff MJ. Septicemia caused by an emerging pathogen, Elizabethkingia miricola, in a laboratory colony of African dwarf frogs ( Hymenochirus curtipes). Vet Pathol 2023; 60:394-401. [PMID: 36803058 DOI: 10.1177/03009858231155415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
An outbreak of morbidity and mortality in an African dwarf frog (Hymenochirus curtipes) colony was reported following arrival at an animal research facility. Animals were found dead on arrival or became moribund shortly thereafter, and additional animals showed clinical signs of lethargy, weight loss, and anorexia over the following 3 weeks. Externally, some affected animals presented with multifocal areas of hyperemia in the inguinal and axillary areas and on the limbs, and mottled tan discoloration along the ventral abdomen. Histologically, lesions were consistent with generalized septicemia, characterized by granulomatous meningitis, otitis media, peritonitis (coelomitis), myocarditis and pericarditis, nephritis, pneumonia, and arthritis. Gram staining identified gram-negative rod-shaped bacteria free within tissues and within macrophages. Culture results of coelomic swabs identified moderate to numerous Elizabethkingia miricola. Testing of water from tanks housing affected animals showed elevated levels of nitrites and ammonia, and the presence of Citrobacter, Aeromonas, Pseudomonas, and Staphylococcus spp. cultured from several tank biofilters. E miricola is a newly recognized and rapidly emerging opportunistic pathogen in anurans and has been reported as a cause of septicemia in humans. This report documents the first occurrence of E. miricola septicemia in African dwarf frogs and illustrates the importance of this potential pathogen in the laboratory setting for amphibian research colonies, as well as those individuals directly working with them.
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Affiliation(s)
- Stephanie Yang
- Unit for Laboratory Animal Medicine, University of Michigan Medical School, Ann Arbor, MI
| | - Catherine Si
- Unit for Laboratory Animal Medicine, University of Michigan Medical School, Ann Arbor, MI
| | - Rinosh Mani
- Veterinary Diagnostic Laboratory, Michigan State University College of Veterinary Medicine, Lansing, MI
| | - Jill Keller
- Unit for Laboratory Animal Medicine, University of Michigan Medical School, Ann Arbor, MI
| | - Mark J Hoenerhoff
- Unit for Laboratory Animal Medicine, University of Michigan Medical School, Ann Arbor, MI.,In Vivo Animal Core, Unit for Laboratory Animal Medicine, University of Michigan Medical School, Ann Arbor, MI
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3
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Zajmi A, Teo J, Yeo CC. Epidemiology and Characteristics of Elizabethkingia spp. Infections in Southeast Asia. Microorganisms 2022; 10:microorganisms10050882. [PMID: 35630327 PMCID: PMC9144721 DOI: 10.3390/microorganisms10050882] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 02/04/2023] Open
Abstract
Elizabethkingia spp. is a ubiquitous pathogenic bacterium that has been identified as the causal agent for a variety of conditions such as meningitis, pneumonia, necrotizing fasciitis, endophthalmitis, and sepsis and is emerging as a global threat including in Southeast Asia. Elizabethkingia infections tend to be associated with high mortality rates (18.2–41%) and are mostly observed in neonates and immunocompromised patients. Difficulties in precisely identifying Elizabethkingia at the species level by traditional methods have hampered our understanding of this genus in human infections. In Southeast Asian countries, hospital outbreaks have usually been ascribed to E. meningoseptica, whereas in Singapore, E. anophelis was reported as the main Elizabethkingia spp. associated with hospital settings. Misidentification of Elizabethkingia spp. could, however, underestimate the number of cases attributed to the bacterium, as precise identification requires tools such as MALDI-TOF MS, and particularly whole-genome sequencing, which are not available in most hospital laboratories. Elizabethkingia spp. has an unusual antibiotic resistance pattern for a Gram-negative bacterium with a limited number of horizontal gene transfers, which suggests an intrinsic origin for its multidrug resistance. Efforts to prevent and further understand Elizabethkingia spp. infections and limit its spread must rise to this new challenge.
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Affiliation(s)
- Asdren Zajmi
- Centre for Research in Infectious Diseases and Biotechnology (CeRIDB), Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu 20400, Malaysia;
- Faculty of Health and Life Sciences, Management and Science University, Seksyen 13, Shah Alam 40100, Malaysia
| | - Jeanette Teo
- Department of Laboratory Medicine, National University Hospital, Singapore 119074, Singapore;
| | - Chew Chieng Yeo
- Centre for Research in Infectious Diseases and Biotechnology (CeRIDB), Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu 20400, Malaysia;
- Correspondence: ; Tel.: +60-9-627-5506
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4
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Kalchev Y, Petrova A, Lengerova G, Ivanov I, Murdjeva M. Elizabethkingia miricola Recovered from a Peritoneal Fluid Sample – A Clinical Case Report with Diagnostic Challenges. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Elizabethkingia spp. are Gram-negative, non-spore-forming bacteria that used to be rarely encountered but now they are of growing clinical significance. Furthermore, the diagnostic challenges to identification impede the complete elucidation of their epidemiology and association with human diseases. Case report: A 64-year-old man with liver cirrhosis due to alcohol abuse presented with fatigue, abdominal swelling, and bilateral scrotal edema. A peritoneal fluid sample was cultured and subject to a number of identification methods – API 20 NE (bioMerieux), automated Vitek-2 Compact (bioMerieux), MALDI-TOF MS (Vitek-MS, bioMerieux), and 16S rRNA gene sequencing. A final diagnosis of bacterascites was made on the basis of clinical, laboratory, and microbiological findings. Conclusion: To the best of our knowledge this is the first report of Elizabethkingia miricola being cultured from a peritoneal fluid sample in an immune-compromised host thus pointing to the emerging pathogenic role of the bacterium in patients with liver cirrhosis and ascites.
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5
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Gao H, Li T, Feng L, Zhang S. Elizabethkingia miricola Causes Intracranial Infection: A Case Study. Front Med (Lausanne) 2022; 8:761924. [PMID: 35004734 PMCID: PMC8739271 DOI: 10.3389/fmed.2021.761924] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 12/07/2021] [Indexed: 02/05/2023] Open
Abstract
Background:Elizabethkingia miricola is a rarely encountered bacterium in clinical practice. It is a rare gram-negative rod-shaped bacterium associated with lung and urinary tract infections, but never found in cerebrospinal fluid. This paper reports a case of an adult patient infected by E. miricola via an unknown route of infection causing a severe intracranial infection. Elizabethkingia miricola was detected by culture and Metagenomic next generation sequencing in CSF. Early identification of this strain and treatment with sensitive antibiotics is necessary to reduce morbidity and mortality. Case Report: A 24-year-old male was admitted to a West China Hospital because of headache and vomiting for 2 months. Symptom features included acute onset and long duration of illness. Notably, headache and vomiting were the primary neurological symptoms. Routine cerebrospinal fluid culture failed to identify the bacterium; however, Elizabethkingia miricola bacterium was detected via second-generation sequencing techniques. Elizabethkingia miricola was found to be a multi-drug resistant organism, hence, treatment with ceftriaxone, a commonly used drug for intracranial infections was ineffective. This strain eventually caused severe intracranial infection resulting in the death of the patient. Conclusion: In summary, this study comprehensively describes a case of an adult patient infected by E. miricola and discusses its early identification as well as application of sensitive antibiotics in the emergency setting.
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Affiliation(s)
- Hongguang Gao
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Tian Li
- School of Basic Medicine, Fourth Military Medical University, Xi'an, China
| | - Li Feng
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Shu Zhang
- Department of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, China
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6
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A real-time PCR assay for detection of emerging infectious Elizabethkingia miricola. Mol Cell Probes 2020; 52:101571. [PMID: 32289377 DOI: 10.1016/j.mcp.2020.101571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
Elizabethkingia miricola, a Gram-negative bacillus, is emerging as a life-threatening pathogen in both humans and animals. However, no specific and rapid diagnostic method exists to detect E. miricola. Here, we established a real-time PCR assay for the rapid, sensitive, and specific detection of E. miricola with a wide dynamic range of 108 copies/μL to 102 copies/μL. The detection limit of the real-time assay was 145 copies/μL, which was 100 times more sensitive than conventional PCR. All clinical isolates E. miricola from different host species yield very close Tm (80.25 ± 0.25 °C). Additionally, no cross-reaction or false positives were observed in the assay for non-target bacterial species. The performance of this assay was primarily assessed by testing frog tissue samples. Overall, our study provided a real-time PCR assay, which is a rapid, sensitive, and specific diagnostic method that could be used for early diagnosis and epidemiological investigation of E. miricola.
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7
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Penven M, Lalieu A, Boruchowicz A, Paluch M, Diedrich T, Dewulf G, Cattoen C. Bacteremia caused by Elizabethkingia miricola in a patient with acute pancreatitis and peritoneal dialysis. Med Mal Infect 2020; 50:379-381. [PMID: 32046885 DOI: 10.1016/j.medmal.2020.01.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 01/21/2020] [Indexed: 11/18/2022]
Affiliation(s)
- M Penven
- Laboratoire de microbiologie, centre hospitalier de Valenciennes, avenue Desandrouin, 59300 Valenciennes, France.
| | - A Lalieu
- Service de gastroentérologie, centre hospitalier de Valenciennes, avenue Desandrouin, 59300 Valenciennes, France
| | - A Boruchowicz
- Service de gastroentérologie, centre hospitalier de Valenciennes, avenue Desandrouin, 59300 Valenciennes, France
| | - M Paluch
- Laboratoire de microbiologie, centre hospitalier de Valenciennes, avenue Desandrouin, 59300 Valenciennes, France
| | - T Diedrich
- Laboratoire de microbiologie, centre hospitalier de Valenciennes, avenue Desandrouin, 59300 Valenciennes, France
| | - G Dewulf
- Laboratoire de microbiologie, centre hospitalier de Valenciennes, avenue Desandrouin, 59300 Valenciennes, France
| | - C Cattoen
- Laboratoire de microbiologie, centre hospitalier de Valenciennes, avenue Desandrouin, 59300 Valenciennes, France
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Howard JC, Chen K, Anderson T, Dalton SC. Elizabethkingia miricola bacteraemia in a haemodialysis patient. Access Microbiol 2020; 2:acmi000098. [PMID: 34568756 PMCID: PMC8459099 DOI: 10.1099/acmi.0.000098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/20/2019] [Indexed: 11/18/2022] Open
Abstract
We report a case of catheter-associated Elizabethkingia miricola bacteraemia in a haemodialysis patient. The patient was a 73-year-old home haemodialysis patient who presented with a history of recurrent falls and fevers. Blood cultures grew Gram-negative bacilli identified by MALDI-TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry 6903 MSP Library) and 16S rRNA gene sequencing as E. miricola. E. miricola is an emerging human pathogen and is multidrug-resistant, making the choice of antimicrobial therapy challenging. There are only a small number of case reports of human infection worldwide and this is the second reported case of catheter-related bacteraemia. It has also been found in the hospital environment in South Korea and is pathogenic in black-spotted frogs.
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Affiliation(s)
- Julia C Howard
- Microbiology Department, Canterbury Health Laboratories, Christchurch, New Zealand.,Present address: Microbiology Department, Waikato Hospital, Hamilton, New Zealand
| | - Kevin Chen
- Department of Infectious Diseases, Christchurch Hospital, New Zealand.,Present address: Department of Medicine, Tauranga Hospital, Tauranga, New Zealand
| | - Trevor Anderson
- Microbiology Department, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Simon C Dalton
- Department of Infectious Diseases, Christchurch Hospital, New Zealand
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9
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Lei XP, Yi G, Wang KY, OuYang P, Chen DF, Huang XL, Huang C, Lai WM, Zhong ZJ, Huo CL, Yang ZX. Elizabethkingia miricolainfection in Chinese spiny frog (Quasipaa spinosa). Transbound Emerg Dis 2018; 66:1049-1053. [DOI: 10.1111/tbed.13101] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/24/2018] [Accepted: 12/07/2018] [Indexed: 01/18/2023]
Affiliation(s)
- Xue Ping Lei
- College of Veterinary Medicine Sichuan Agricultural University Wenjiang Sichuan China
| | - Geng Yi
- College of Veterinary Medicine Sichuan Agricultural University Wenjiang Sichuan China
| | - Kai Yu Wang
- College of Veterinary Medicine Sichuan Agricultural University Wenjiang Sichuan China
| | - Ping OuYang
- College of Veterinary Medicine Sichuan Agricultural University Wenjiang Sichuan China
| | - De Fang Chen
- Department of Aquaculture Sichuan Agricultural University Wenjiang Sichuan China
| | - Xiao Li Huang
- Department of Aquaculture Sichuan Agricultural University Wenjiang Sichuan China
| | - Chao Huang
- College of Veterinary Medicine Sichuan Agricultural University Wenjiang Sichuan China
| | - Wei Min Lai
- College of Veterinary Medicine Sichuan Agricultural University Wenjiang Sichuan China
| | - Zi Jun Zhong
- College of Veterinary Medicine Sichuan Agricultural University Wenjiang Sichuan China
| | - Chang Liang Huo
- College of Veterinary Medicine Sichuan Agricultural University Wenjiang Sichuan China
| | - Ze Xiao Yang
- College of Veterinary Medicine Sichuan Agricultural University Wenjiang Sichuan China
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10
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Monteagudo Vela M, Zych B, García Saez D, Simon AR. Fatal infection with Elisabethkingia miricola after lung transplantation. J Hosp Infect 2018; 100:e259-e260. [PMID: 30026007 DOI: 10.1016/j.jhin.2018.07.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 07/09/2018] [Indexed: 01/06/2023]
Affiliation(s)
- M Monteagudo Vela
- Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK.
| | - B Zych
- Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - D García Saez
- Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - A R Simon
- Department of Cardiothoracic Transplantation and Mechanical Circulatory Support, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, London, UK
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11
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Frost F, Nazareth D. Case Report: First report of Elizabethkingia miricola infection in a patient with cystic fibrosis. F1000Res 2018; 7:440. [PMID: 30079241 PMCID: PMC6058470 DOI: 10.12688/f1000research.14441.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2018] [Indexed: 11/20/2022] Open
Abstract
Elizabethkingia miricola is a rare non-fermenting Gram-negative rod that has previously been reported to be associated with blood stream and pulmonary abscess infections, but never before in cystic fibrosis (CF). Here we present the first reported case of
Elizabethkingia miricola infection in a patient with CF and discuss the management options. We describe a patient with CF in whom we observed clinical and spirometric evidence of pulmonary exacerbation with the associated growth of
E. miricola in sputum culture. The period of clinical instability was observed to coincide with the obtainment of four sputum samples from which
E. miricola was cultured; improvement was seen following treatment with ciprofloxacin and the subsequent eradication of
E. miricola. We conclude that
E. miricola is able to survive in the CF lung and in this case was associated with pulmonary exacerbation. Empirical treatment with fluoroquinolones is appropriate, based on our experience.
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Affiliation(s)
- Freddy Frost
- Liverpool Heart & Chest Hospital, Liverpool, L14 3PE, UK
| | - Dilip Nazareth
- Liverpool Heart & Chest Hospital, Liverpool, L14 3PE, UK
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Zdziarski P, Paściak M, Rogala K, Korzeniowska-Kowal A, Gamian A. Elizabethkingia miricola as an opportunistic oral pathogen associated with superinfectious complications in humoral immunodeficiency: a case report. BMC Infect Dis 2017; 17:763. [PMID: 29233117 PMCID: PMC5727958 DOI: 10.1186/s12879-017-2886-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 12/05/2017] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Elizabethkingia miricola is a rare Gram-negative bacterium found in water and clinical specimens. Typical culturing methods often misidentify Elizabethkingia spp. as Flavobacterium or Chryseobacterium. Although diagnosis is based on culturing samples taken from sterile sites, such as blood, a proper identification of this bacterium requires an expertise that goes beyond the capabilities of a typical clinical laboratory. CASE PRESENTATION A 35-year-old woman diagnosed with common variable immunodeficiency was admitted to our center. Previous treatment with antibiotics (amoxicillin plus clavulanate, first and third generation of cephalosporins, macrolides) and systemic corticosteroids (up to 120 mg/day of prednisolone) failed to arrest the spread of inflammation. Gingival recession was observed in her oral cavity, resulting in an apparent lengthening of her teeth. In addition to typical commensal bacteria, including streptococci and neisseriae, strains of Rothia mucilaginosa and Elizabethkingia miricola were identified upon a detailed microbiological examination using a MALDI-TOF MS Biotyper system. The presence of the latter strain correlated with severe periodontitis, lack of IgA in her saliva and serum, a very low IgG concentration (< 50 mg/dl), IgM-paraproteinemia, decreases in C3a and C5a and microvascular abnormality. High-dose immunoglobulin (to maintain IgG > 500 mg/dl) and targeted levofloxacin treatment resulted in immune system reconstitution, oral healing, and eradication of the Elizabethkingia infection. CONCLUSIONS E. miricola rarely causes disease in healthy individuals. However, the overgrowth of commensal bacteria, lack of IgG/IgA, microvasculopathy and complement cascade activation in patients with humoral immunodeficiency may facilitate Elizabethkingia invasion. Overuse of antibiotics, particularly beta-lactams, may cause mucosal colonization by E. miricola, followed by its multiplication combined with periodontitis that prompts bacterial translocation. MALDI-TOF Biotyper analysis may become a method of choice for identification of Elizabethkingia infections.
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Affiliation(s)
- Przemysław Zdziarski
- Department of Clinical Immunology, Lower Silesian Center for Cellular Transplantation, PO Box 1818, 50-385, Wrocław-46, Poland
| | - Mariola Paściak
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Rudolfa Weigla 12, 53-114, Wroclaw, Poland.
| | - Klaudia Rogala
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Rudolfa Weigla 12, 53-114, Wroclaw, Poland
| | - Agnieszka Korzeniowska-Kowal
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Rudolfa Weigla 12, 53-114, Wroclaw, Poland
| | - Andrzej Gamian
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Rudolfa Weigla 12, 53-114, Wroclaw, Poland
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13
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Gupta P, Zaman K, Mohan B, Taneja N. Elizabethkingia miricola: A rare non-fermenter causing urinary tract infection. World J Clin Cases 2017; 5:187-190. [PMID: 28560237 PMCID: PMC5434319 DOI: 10.12998/wjcc.v5.i5.187] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Revised: 02/09/2017] [Accepted: 03/13/2017] [Indexed: 02/05/2023] Open
Abstract
Elizabethkingia miricola (E. miricola) is a gram-negative non-fermentative bacterium which is rarely encountered. It is usually misidentified or considered as a contaminant in routine microbiology laboratories due to the limitations in conventional biochemical techniques. However, with the advent of the matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS), the identification of non-fermenters has become easy and this has led to enhanced understanding of the clinical significance of these uncommonly isolated microorganisms. The genus Elizabethkingia has only two species E. meningoseptica and E. miricola. Both of these organisms are known to be multi-drug resistant and therefore, their accurate identification and antimicrobial susceptibility testing are necessary prior to the initiation of appropriate therapy. In the world literature till date, only 3 cases of sepsis caused by E. miricola have been reported. We present the first case of E. miricola association with urinary tract infection.
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Opota O, Diene SM, Bertelli C, Prod'hom G, Eckert P, Greub G. Genome of the carbapenemase-producing clinical isolate Elizabethkingia miricola EM_CHUV and comparative genomics with Elizabethkingia meningoseptica and Elizabethkingia anophelis: evidence for intrinsic multidrug resistance trait of emerging pathogens. Int J Antimicrob Agents 2016; 49:93-97. [PMID: 27913093 DOI: 10.1016/j.ijantimicag.2016.09.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/30/2016] [Accepted: 09/03/2016] [Indexed: 01/22/2023]
Abstract
Elizabethkingia miricola is a Gram-negative non-fermenting rod emerging as a life-threatening human pathogen. The multidrug-resistant (MDR) carbapenemase-producing clinical isolate E. miricola EM_CHUV was recovered in the setting of severe nosocomial pneumonia. In this study, the genome of E. miricola EM_CHUV was sequenced and a functional analysis was performed, including a comparative genomic study with Elizabethkingia meningoseptica and Elizabethkingia anophelis. The resistome of EM_CHUV revealed the presence of a high number of resistance genes, including the presence of the blaGOB-13 and blaB-9 carbapenemase-encoding genes. Twelve mobility genes, with only two of them located in the proximity of resistance genes, and four potential genomic islands were identified in the genome of EM_CHUV, but no prophages or CRISPR sequences. Ten restriction-modification system (RMS) genes were also identified. In addition, we report the presence of a putative conjugative plasmid (pEM_CHUV) that does not encode any antibiotic resistance genes. Altogether, these findings point towards a limited number of DNA exchanges with other bacteria and suggest that multidrug resistance is an intrinsic trait of E. miricola owing to the presence of a high number of resistance genes within the bacterial core genome.
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Affiliation(s)
- Onya Opota
- Institute of Microbiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Seydina M Diene
- Genomic Research Laboratory, Service of Infectious Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Claire Bertelli
- Institute of Microbiology, University Hospital of Lausanne, Lausanne, Switzerland; SIB Swiss Institute of Bioinformatics, Lausanne, Switzerland
| | - Guy Prod'hom
- Institute of Microbiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Philippe Eckert
- Service of Adult Intensive Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | - Gilbert Greub
- Institute of Microbiology, University Hospital of Lausanne, Lausanne, Switzerland; Infectious Diseases Service, University Hospital of Lausanne, Lausanne, Switzerland.
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