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Kim, Park, Shin, Kim, and Park: Three Adult Cases of Elizabethkingia meningoseptica Infection in a Korean Hospital
Original Article

Korean J Clin Microbiol 2011;14(4):153-157.

Published online: 21 December 2011

DOI: https://doi.org/10.5145/KJCM.2011.14.4.153

Three Adult Cases of Elizabethkingia meningoseptica Infection in a Korean Hospital

Jayoung Kim1, Yeon-Joon Park1, Soyoung Shin1, Yonggoo Kim1, Sun Hee Park2

1Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

2Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence: Yeon-Joon Park, Department of Laboratory Medicine, The Catholic University of Korea, College of Medicine, 505, Banpo 4-dong, Seocho-gu, Seoul 137-701, Korea. (Tel) 82-2-2258-1640, (Fax) 82-2-225-1719, (E-mail) yjpk@catholic.ac.kr

Received 8 August 2011       Revised 5 October 2011       Accepted 12 October 2011

Copyright © 2011 Korean Journal of Clinical Microbiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Elizabethkingia meningoseptica (Chryseobacterium meningoseptica) is a ubiquitous Gram-negative bacillus in the natural and hospital environments. This microorganism causes neonatal meningitis but rarely causes infections in adults, with most adult cases occurring in severely immunocompromised patients. Since E. meningoseptica is inherently resistant to the usual empiric therapy aimed at Gram-negative bacilli and MIC breakpoints for resistance and susceptibility of E. meningoseptica have not been established by the Clinical and Laboratory Standards Institute, it is very difficult to select effective antibiotics for the treatment of E. meningoseptica infection. We report here three cases of E. meningoseptica isolates (two from blood and one from CSF) from adult patients admitted to Seoul St. Mary's hospital over a 3-year period. To the best of our knowledge, this is the first report of adult meningitis due to E. meningoseptica in Korea

Keywords: Elizabethkingia meningoseptica, Blood, CSF

REFERENCES

1. Bloch KC, Nadarajah R, Jacobs R. Chryseobacterium meningosepticum: an emerging pathogen among immunocompromised adults. Report of 6 cases and literature review. Medicine (Baltimore). 1997; 76:30–41.
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Table 1.
Clinical characteristics of patients with infections caused by E. meningoseptica
  No. of case
1 2 3
Sex/Age M/64 M/55 M/45
Year of case 2009.04 2007.05 2006.08
Underlying disease Subdural hemorrhage Mitral valve disease, post-DVR state Pontine hemorrhage
Other associated condition Ventilator, CVC Ventilator, CVC Ventilator, EVD
Diagnosis Bacteremia Bacteremia Meningitis
Place of acquisition Hospital Hospital Hospital
Other bacterial isolates No No S. maltophilia
Specimens Blood Blood CSF
Growth of MacConkey − + +
Antibiotic susceptibility test results      
　Susceptible SXT, VA   PTZ, SXT
　Intermediate   LEV, PTZ  
Antibiotic therapy∗      
　Before AUG, MER CAX, GM CFPS, TC, LEV
　After SXT, VA LEV†, CAX, GM LEV, SXT
Outcome Died Recovered Died
Cause of death Sepsis, multi-organ fai ilure − Brain edema

∗ Antibiotics used before and after the report of susceptibility tests

† Patient 2 was treated with LEV for 3 days. Abbreviations: DVR, double valve replacement; EVD, extra ventricular drainage; CVC, central venous catheter; S. maltophilia, Stenotrophomonas maltophilia; AUG, amoxicillin/clavulanic acid; MER, meropenem; VA, vancomycin; PZT, piperacillin/tazobactam; LV, levofloxacin; CAX, ceftriaxone; GM, gentamicin; CFPS, cefoperazone/sulbactam; TC, ticarcillin/clavulanic acid.

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