Prevalence, microbiological features, and clinical characteristics of Elizabethkingia isolates in a tertiary hospital, Jiangxi Province, China

Abstract

Background

Elizabethkingia infections have become life-threatening hospital-acquired infections worldwide, marked by rising morbidity, multidrug resistance, and poor prognoses. However, information on the epidemiological and clinical characteristics of Elizabethkingia infections in mainland China is limited. This study aimed to analyze the molecular and clinical characteristics, and drug susceptibility of clinical Elizabethkingia isolates from a hospital in Jiangxi Province, China.

Methods

A total of 103 Elizabethkingia isolates, identified by conventional methods, were collected from patients at a university-affiliated hospital in 2022 and 2023. Species identification was conducted using 16S rRNA gene sequencing. The feasibility of the Vitek MS was also evaluated. Antimicrobial susceptibility testing, resistance gene identification, and pulsed-field gel electrophoresis were performed.

Results

The mean age of the patients was 61 years (excluding one 13-day-old infant) and 75.3 % were men. In total, 86.4 % of patients admitted to the intensive care unit were infected with Elizabethkingia. COVID-19, respiratory disease, and ICU admission were significantly different between the surviving and dying groups (p < 0.05). Sequencing of 103 isolates identified 92 strains of Elizabethkingia anophelis, eight strains of Elizabethkingia meningoseptica, two strains of Elizabethkingia bruuniana, and one strain of Elizabethkingia ursingii. The Vitek MS had a correct identification rate of 87 % for Elizabethkingia anophelis. More than 90 % of the Elizabethkingia isolates were susceptible to minocycline, but resistant to other drugs, including ceftazidime, aztreonam, and imipenem. Resistance genotype analysis showed that blaBlaB and blaCME were highly prevalent in the Elizabethkingia isolates. Molecular typing revealed 29 different pulsed-field gel electrophoresis types with clonal transmission between wards.

Conclusions

Multidrug-resistant Elizabethkingia is being increasingly detected. Therefore, a larger database is required for Elizabethkingia strain identification. This database could be beneficial for the subsequent determination of optimal antimicrobial drugs for treating infections caused by various Elizabethkingia strains. Our pulsed-field gel electrophoresis model showed that most Elizabethkingia isolates exhibit sufficient genetic diversity and clonal transmission. Therefore, adequate attention should be directed towards this pathogen.