Key points
- Elizabethkingia bacteria are found in the environment worldwide.
- The bacteria rarely infect people but have high mortality rates when they do make people sick.
- This is largely due to the population most affected: preterm children and those with weakened immune systems.
- Elizabethkingia are naturally resistant to antibiotics; so testing is important to determine the best treatment regimen.
Overview
Elizabethkingia are gram-negative bacteria that are naturally resistant to many commonly prescribed antibiotics. Elizbethkingia is a rare infection in the United States, occurring in 5-10 people per state per year (250-500 cases annually). It also causes small, localized outbreaks, usually in healthcare settings.
While it rarely infects healthy people, Elizabethkingia bacteria present a high risk of mortality in people who are immunocompromised. Early clinical recognition and testing are critical to ensure appropriate treatment and the best chance of patient survival.
Signs and symptoms
The infection is more common in preterm babies, people who have underlying immunosuppressing conditions and those in critical care units.
The most common symptom is primary bacteremia. Meningitis is common and is responsible for many of the Elizabethkingia deaths in pediatric cases. The infection can also cause:
- Pneumonia and/or bronchitis
- Endocarditis
- Skin and soft tissue infection
- Urinary tract infections
- Bone infections
- Catheter-associated bloodstream infections
- Infections at surgery sites
Testing
Cases are diagnosed through culture of body fluids, most often blood testing.
CDC provides MALDI-TOF testing to confirm the bacterial species Elizabethkingia anophelis. Differentiating between E. anophelis and E. meningoseptica is needed for the best patient outcome. The testing also can help determine if cases are part of the ongoing outbreak.
For consultation or testing questions, contact CDC's Special Bacteriology Reference Laboratory at SBRL@cdc.gov.
Treatment and recovery
Elizabethkingia are naturally resistant to many commonly prescribed antibiotics.
This makes early recognition of Elizabethkingia as the infectious cause critical to ensure patients receive appropriate diagnosis and effective treatment. Different strains are susceptible to less commonly used antibiotics.