Elizabethkingia meningoseptica infection

Elizabethkingia meningoseptica infection is a bacterial infection that rarely infects humans. If a human does become ill, this bacteria causes an infection in the bloodstream and can cause meningitis. The Elizabethkingia meningoseptica bacteria is a waterborne bacteria, but it can also be found in soils and plants. 

Definition & Facts

Elizabethkingia meningoseptica was first discovered in 1959 by bacteriologist Elizabeth King, after many children fell ill with this meningitis in hospitals and orphanages. Infections from this bacteria are most commonly found in premature infants receiving care in neonatal units, as they are very susceptible to infection at this time.

Elizabethkingia meningoseptica can also cause infection in the elderly, people with compromised immune systems, and individuals with underlying medical conditions. However, healthy children and adults can also rarely become infected with this disease under the right conditions.

The state of Wisconsin in 2016 had an outbreak of a related bacteria, Elizabethkingia anophelis that infected over 45 individuals and resulted in 17 deaths. While most of these infections happened in the elderly, some of the infections occurred in the general population. Since Elizabethkingia bacteria is resistant to antibiotics, it is different to treat. More research that explores how to effectively treat the disease is currently ongoing. 

Symptoms & Complaints

Since the Elizabethkingia meningoseptica bacteria causes bacteremia or infection of the blood in the body, fever is also present in those afflicted. A fever caused by this bacteria will usually reach temperatures of over 100 degrees Fahrenheit, or over 37.8 degrees Celcius. Infected individuals may also experience other general signs of infection, including fatigue, low appetite, headache, muscle soreness, chills, and digestive problem such as diarrhea. 

Causes

This infection is caused by the Elizabethkingia meningoseptica bacteria, which can be found in bodies of water, soil, and certain plants, including some tropical trees found in Asia. Infection from this bacteria is usually caused by accidental contamination of some sort, and is often a hospital-acquired infection. Contamination can be found in hospitals in the form of contaminated catheter lines, feeding tubes, or other medical equipment. Contamination can also occur in laboratories, nutritional supplements, and tap water.

If a person is exposed to something that has been contaminated with Elizabethkingia meningoseptica, or if they have encountered the bacteria in nature, they may become infected with the illness. This is much more likely if the person is already ill with a serious disease, such as diabetes, cancer, immune system deficiency, or pneumonia. A healthy individual may be exposed to this bacteria and not have any symptoms or infection. 

Diagnosis & Tests

If someone is feeling ill with symptoms that could related to the Elizabethkingia meninogseptica bacteria, they will need to make an appointment with their health care professional, such as a primary care physician. If symptoms are causing serious issues or illness, someone who is ill may need to visit their local emergency room or urgent care clinic for treatment instead.

At this point, if someone is suspected to have an Elizabethkingia meningoseptica infection, they will need to have blood drawn in order to test for the bacteria. Although the infection itself is rare, most hospital and clinic laboratories are equipped to test for this disease.

Since having an Elizabethkingia meningoseptica infection can lead to other illnesses, such as pneumonia, bronchitis, meningitis, and endocarditis (inflammation of the heart), doctors may do additional testing. Other tests could include a chest X-ray, ECG (electrocardiogram), or ultrasounds. Having a variety of test results available will ensure doctors can provide the patient with the most accurate diagnosis in order to start effective treatment. 

Treatment & Therapy

Since Elizabethkingia meningoseptica is a rare disease that has not been extensively studied, treatment options are limited. This bacteria is known for its resistance to antibiotics, meaning most traditional medications for bacterial infection are unable to be used. Nevertheless, antibiotics such as vancomycin, ciprofloxacin, piperacillin/tazobactam or trimethoprim-sulfamethoxazole may be prescribed.

Since this infection can be fatal, patients diagnosed with this illness are typically hospitalized as soon as possible. This is especially true for people who may be suffering from dehydration or pneumonia due to their infection. Once in a medical care facility, patients will receive an IV from a nurse in order to start intravenous therapy of fluids, medications, and other necessary supplements.

As a person with this illness develops more complications as the disease progresses, they may need additional treatment. For example, if a person develops severe cellulitis or other skin and soft tissue damage, they may require specialized care. If a patient develops bronchitis or pneumonia, they may need a respiratory specialist to provide treatment as well.

Treatment for an Elizabethkingia meningoseptica infection will focus on stabilizing the patient as much as possible and making them comfortable while the disease runs its course, since at this time, the infection is so resistant to antibiotics.

Prevention & Prophylaxis

The first would be to ensure that any invasive equipment these people come into contact with, such as medical equipment, is properly sterilized and is free of bacteria. Individuals who have invasive home health care at home, such as a PICC line or disposable catheters, should be especially careful to avoid infection.

People who are already very ill may also want to avoid natural bodies of water, and should only drink filtered water in order to avoid contaminated tap water, especially if they have a well as their main water source.

For the other major risk group, premature infants, it will be important for their caregivers to ensure they have a safe, clean environment. Healthy children and adults typically do not need to worry about prevention, as coming into contact with Elizabethkingia meningoseptica bacteria is rare on its own, and falling ill from it is even less likely to happen.