TABLE 3.
Case summary of eight patients with Elizabethkingia spp. isolation from blood
| No. | Age/sexa | Initial identificationb | Final identificationc | Underlying diseased | Indwelling device | Warde | No. positive/total pairs, bottles (culture date) | Infection signf |
Previous antibiotic therapy (1 week before culture) | Antimicrobial therapy for Elizabethkingia infection | Outcome |
||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BT (°C) | WBC (per μl) | Microbiologic eradicationg | Clinical responseh | ||||||||||
| 1 | 79/M | E. meningoseptica | E. miricola | Bladder cancer, hypoxic brain damage | Endotracheal tube, central venous line | ICU | 1/3 (Aug. 8, 2011) | 38.0 | 23,990 | None | None | NAi | NA |
| 1/1 (Aug. 9, 2011) | |||||||||||||
| 2 | 69/M | E. meningoseptica | E. miricola | COPD, CRF, cerebral infarction, fungal pneumonia | Endotracheal tube | GW | 1/4 (Aug. 26, 2011) | 35.9 | 9,990 | Meropenem, teicoplanin, levofloxacin | None | NA | NA |
| 3 | 69/M | E. meningoseptica | E. anophelis | Rectal cancer | Endotracheal tube, arterial line, central venous line | ICU | 1/3 (Sep. 25, 2010) | 38.0 | 8,320 | Imipenem, metronidazole | None | NA | NA |
| 4 | 72/F | E. meningoseptica | E. anophelis | Klatskin tumor, DM | Endotracheal tube, arterial line, central venous line | GW | 2/3 (Oct. 30, 2010) | 36.2 | 7,420 | Tigecycline | Tigecycline, ciprofloxacin | Cured | Failed |
| 5 | 72/M | E. meningoseptica | E. anophelis | Alcoholic LC | Endotracheal tube, central venous line | GW | 3/3 (Nov. 13, 2012) | 37.8 | 2,400 | Imipenem, colistin, teicoplanin, minocycline | Trimethoprim-sulfamethoxazole | Cured | Cured |
| 2/2 (Nov. 15, 2012) | |||||||||||||
| 6 | 67/F | E. meningoseptica | E. anophelis | Myelofibrosis, splenomegaly, thrombotic endocarditis | Central venous line | GW | 4/4 (Nov. 22, 2012) | 37.5 | 11,180 | Ciprofloxacin, cefazolin | Trimethoprim-sulfamethoxazole | Cured | Cured |
| 1/3 (Nov. 23, 2012 | |||||||||||||
| 1/1 (Nov. 24, 2012) | |||||||||||||
| 2/4 (Nov. 26, 2012) | |||||||||||||
| 7 | 49/M | E. meningoseptica | E. anophelis | Mitral valve replacement, valvular heart failure | Endotracheal tube, arterial line | ICU | 1/5 (Mar. 20, 2013) | 38.6 | 16,630 | Piperacillin-tazobactam, cefepime, teicoplanin | None | NA | NA |
| 8 | 63/M | E. meningoseptica | E. anophelis | Pneumonectomy, lung transplantation, RA | Endotracheal tube, chest tube, arterial line, central venous line | ICU | 2/3 (Sep. 20, 2013) | 36.4 | 2,890 | Meropenem, colistin | Trimethoprim-sulfamethoxazole, tigecycline | Cured | Cured |
| 2/3 (Sep. 22, 2013) | |||||||||||||
| 4/4 (Sep. 24, 2013) | |||||||||||||
M, male; F, female.
Identified by Vitek 2 with GN card for no. 1 to 7 and by MALDI-TOF Bruker Biotyper for No. 8.
Final identification was done by 16S rRNA gene sequencing.
COPD, chronic obstructive pulmonary disease; CRF, chronic renal failure; LC, liver cirrhosis; RA, rheumatic arthritis; DM, diabetes mellitus.
GW, general ward.
BT, body temperature; WBC, white blood cell.
Microbiologic eradication was the absence of the original pathogens detected from blood (7 days after the first positive blood culture).
Clinical response: a favorable clinical response was defined as the resolution of fever (defined as ≥38.0°C), leukocytosis (WBC, ≥11 × 106/μl), and hypotension (mean arterial pressure of <65 mm Hg), in addition to no longer requiring support from vasoactive agents. Patients who had persistence or deterioration in clinical parameters or who died were classified as treatment failures.
NA, not applicable. There was no follow up data due to transfer of the patient within 7 days.