Indian Journal of Critical Care Medicine

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 17 , ISSUE 5 ( October, 2013 ) > List of Articles


Elizabethkingia meningoseptica : Emerging nosocomial pathogen in bedside hemodialysis patients

M. S. Ratnamani, Ratna Rao

Keywords : Colistin resistance, Elizabethkingia meningoseptica, hemodialysis

Citation Information : Ratnamani MS, Rao R. Elizabethkingia meningoseptica : Emerging nosocomial pathogen in bedside hemodialysis patients. Indian J Crit Care Med 2013; 17 (5):304-307.

DOI: 10.4103/0972-5229.120323

License: CC BY-ND 3.0

Published Online: 01-08-2014

Copyright Statement:  Copyright © 2013; The Author(s).


Elizabethkingia meningoseptica, a ubiquitous gram-negative aerobic bacillus, is an emerging hospital acquired pathogen in patients on dialysis. It has been isolated in the hospital environment in water supplies, disinfectants, and medical devices. We present here an analysis of eight healthcare-acquired infections with this organism in adults. To the best of our our knowledge, this is the first report of infections with this organism in patients on hemodialysis. Materials and Methods: Over a 6-month period, eight patients were infected with E. meningoseptica in our hospital. These patients had bacteremia and lower respiratory tract infection. All these patients were on on mechanical ventilation and undergoing bedside hemodialysis in the intensive care unit (ICU). Environmental surveillance was done to detect the possible source. Results: These patients had a common denominator of bedside hemodialysis, and use of broad-spectrum antibiotics. E. meningoseptica was isolated from the water and sink of the ICU. Conclusion: E. meningoseptica is emerging as a nosocomial pathogen among patients on hemodialysis. Its unusual resistance pattern coupled with inherent resistance to colistin makes this organism difficult to treat unless susceptibility patterns are available. Isolation of this organism in handwash sink and water is a significant finding as they have been reported to survive in chlorinated water. Disinfecting the sinks and using filtered water for hand washing in critical areas may help in preventing infections with this organism.

PDF Share
  1. Ceyhan M, Yildirim I, Tekeli A, Yurdakok M, Us E, Altun B, et al. A Chryseobacterium meningosepticum outbreak observed in 3 clusters involving both neonatal and non-neonatal pediatric patients. Am J Infect Control 2008;36:453-7.
  2. 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.
  3. Chiu CH, Waddingdon M, Greenberg D, Schreckenberger PC, Carnahan AM. Atypical Chryseobacterium meningosepticum and meningitis and sepsis in newborns and the immunocompromised, Taiwan. Emerg Infect Dis 2000;6:481-6.
  4. Hoque SN, Graham J, Kaufmann ME, Tabaqchali S. Chryseobacterium (Flavobacterium) meningosepticum outbreak associated with colonization of water taps in a neonatal intensive care unit. J Hosp Infect 2001;47:188-92.
  5. du Moulin GC. Airway colonization by Flavobacterium in an intensive care unit. J Clin Microbiol 1979;10:155-60.
  6. Nulens E, Bussels B, Bols A, Gordts B, van Landuyt HW. Recurrent bacteremia by Elizabethkingae indologenes in an oncology patient with a totally implanted intravenous device. Clin Microbiol Infect 2001;7:391-3.
  7. Lee CH, Lin WC, Chia JH, Su LH, Chien C, Mao AH, et al. Community- acquired osteomyelitis caused by Chryseobacterium meningosepticum: Case report and literature review. Diagn Microbiol Infect Dis 2008;60:89-93.
  8. Adachi A, Mori T, Simizu T, Yokoyama A, Takayama N, Ikeda Y, et al. Chryseobacterium meningosepticum septicemia in a recipient of allogeneic cord blood transplantation. Scand J Infect Dis 2004;36:539-40.
  9. Kirby JT, Sader HS, Walsh TR, Jones RN. Antimicrobial susceptibility and epidemiology of a worldwide collection of Chryseobacterium spp: Report from the SENTRY antimicrobial surveillance program (1997-2001). J Clin Microbiol 2004;42:445-8.
  10. Güngör S, Ozen M, Akinci A, Durmaz R. A Chryseobacterium meningosepticum outbreak in a neonatal ward. Infect Control Hosp Epidemiol 2003;24:613-7.
  11. Maraki S, Scoulica E, Manoura A, Papageorgiou N, Giannakopoulou C, Galanakis E. A Chryseobacterium meningosepticum colonization outbreak in a neonatal intensive care unit. Eur J Clin Microbiol Infect Dis 2009;28:1415-9.
  12. Bellais S, Poire L, Naas T, Girlich D, Nordmann P. Genetic biochemical analysis and distribution of the Ambler class A-lactamase CME-2, responsible for extended spectrum cephalosporin resistance in Elizabethkingae (Flavobacterium) meningosepticum. Antimicrob Agents Chemother 2000;44:1-9.
  13. Steinberg JP, Burd EM. Other gram-negative and gram-variable bacilli. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and Practice of Infectious Diseases. Philadelphia: Churchill Livingstone Elsevier; 2010. p. 3015-33.
  14. Chen GX, Zhang RH, Zhou W. Heterogeneity of metallo-β-lactamases in clinical isolates of Elizabethkingae meningosepticum from Hangzhou China. J Antimicrob Chemother 2006;57:750-2.
  15. Amer MZ, Bandey M, Bukhari A, Nemenqani D. Neonatal meningitis which was caused by Elizabethkingia meningoseptica in Saudi Arabia. J Infect Dev Ctries 2011;5:745-7.
  16. Pereira GH, de Oliveira Garcia D, Abboud CS, et al. Nosocomial infections caused by Elizabethkingia meningoseptica: An emergent pathogen. Braz J Infec Dis 2013;17:606-9.
  17. Hawley HB, Gump DW. Vancomycin therapy of bacterial meningitis. Am J Dis Child 1973;126:261-4.
  18. Chang JC, Hsueh PR, Wu JJ, Ho SW, Hsieh WC, Luh KT. Antimicrobial susceptibility of flavobacteria as determined by agar dilution and disk diffusion methods. Antimicrob Agents Chemother 1997;41:1301-6.
  19. Husson MO, Izard D, Bouillet L, Lecherc H. Comparative in-vitro activity of ciprofloxacin against nonfermentors. J Antimicrob Chemother 1985;15:457-62.
  20. Martin K, Crisp C, Jurgensen JH. Outbreak of Flavobacterium meningosepticum in a surgical intensive care unit (SICU). Abstract M52 in Proceedings of the Program and Abstracts of the 5 th Annual meeting of the Society for Healthcare Epidemiology of America (SHEA 1995), San Diego, Calif, USA.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.