Multidrug resistant Elizabethkingia meningoseptica bacteremia - Experience from a level 1 trauma centre in India
Multidrug resistant Elizabethkingia meningoseptica bacteremia - Experience from a level 1 trauma centre in India
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DOI：
10.5582/irdr.2018.01077
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发表时间：
2018-08-01
影响因子：
1.3
通讯作者：
Mathur, Purva
中科院分区：
文献类型：
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作者：
Govindaswamy, Aishwarya;Bajpai, Vijeta;Mathur, Purva
elizabeth ethkingia meningoseptica （E. meningoseptica）是一种非发酵革兰氏阴性菌，通常在土壤和水中检测到，但很少报告引起人类感染。然而，它正在成为重症监护病房（icu）住院患者的院内病原体。由于缺乏有效的治疗方案和对多种抗生素的固有耐药性，由这种微生物引起的感染具有很高的死亡率。我们报告我们在ICU重症监护期间脓毒性休克患者中处理elizabeth ethkingia脑膜炎败血症（E. meningoseptica）败血症的经验。在两年多的时间里，有4例因脑膜炎脓毒杆菌感染而脓毒症进入多发创伤ICU。所有患者均采用机械通气、中心静脉导管（CVC）和各种广谱抗生素治疗。在这四名患者中，三人死亡，一人康复。对于经验性治疗无效的患者，脑膜炎脓毒杆菌感染应被视为脓毒症的可能病因，因为这导致抗菌治疗的不恰当选择，导致患者发病率和死亡率增加。其不寻常的耐药模式以及对粘菌素的固有抗性使得这种生物体难以治疗，除非有易感性模式可用。
Elizabethkingia meningoseptica (E. meningoseptica) is a non-fermenting gram negative organism that is commonly detected in the soil and water but is rarely reported to cause human infection. However it is emerging as a nosocomial pathogen in patients admitted in intensive care units (ICUs). Infections caused by this organism have a high mortality rate due to lack of effective therapeutic regimens and its intrinsic resistance to multiple antibiotics. We report our experience in managing Elizabethkingia meningoseptica (E. meningoseptica) septicemia in our ICU patients with septic shock during prolonged intensive care management. Over a two year period four cases were admitted into the polytrauma ICU developed sepsis due to E. meningoseptica. All these patients were on mechanical ventilation, had central venous catheter (CVC) and were exposed to various broad spectrum antibiotics. Of the four patients, three died and one recovered. E. meningoseptica infection should be considered as a possible etiological agent of sepsis in patients who do not respond to empirical therapy, as this results in an inappropriate choice of antimicrobial therapy, leading to increased morbidity and mortality of patients. Its unusual resistance pattern along with inherent resistance to colistin makes this organism difficult to treat unless susceptibility patterns are available.