Elizabethkingia Infections Treatment & Management

Updated: Feb 03, 2017
  • Author: Meenal Malviya, MBBS, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Treatment

Approach Considerations

Elizabethkingia is typically resistant to antibiotics used to treat gram-negative infections, including extended-spectrum beta-lactams, aminoglycosides, tetracycline, and chloramphenicol. Vancomycin has been used to treat nonneonatal Elizabethkingia meningitis in the past, but it has a high minimum inhibitory concentration (MIC). Alternatives include ciprofloxacin, minocycline, trimethoprim-sulfamethoxazole, rifampin, and novobiocin. [13]

Treatment of the  2015-2016  ElizabethkingiaOutbreak in Wisconsin, Michigan, and Illinois

Elizabethkingia infections involved in the current multistate outbreak typically manifest as septicemia and can be fatal if treatment with appropriate antibiotic therapy is delayed. Patients with underlying health issues and bloodstream infections of unknown etiology should prompt consideration of Elizabethkingia as a possible cause.

These Elizabethkingia infections have been found to be susceptible to several antibiotics, including fluoroquinolones, minocycline, rifampin, and trimethoprim/sulfamethoxazole. If possible, combination treatment is recommended over monotherapy. For best results, treatment should be selected based on antimicrobial susceptibility testing on a case-by-case basis. [3]

Bacterial detection software in some clinical laboratories may misidentify Elizabethkingia as other bacteria. When such cases result in identification of F meningosepticum or C meningosepticum, the CDC has advised that these results be reported to the state health department for consultation and that the infection be treated presumptively as infection with E anophelis. [3]

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Prevention

Infection-control measures in healthcare settings

In the context of the current Elizabethkingia outbreak, the Wisconsin Department of Health Services (DHS) Division of Public Health (DPH) recommends contact precautions in addition to standard precautions during the management of patients with Elizabethkingia infections. The DPH recommends contact precautions for the duration of admission in acute-care facilities. Receiving facilities should be made aware of the patient’s infection status upon transfer.

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