Transmission and genomic insights into Elizabethkingia miricola: A zoonotic pathogen with intrinsic resistance and nosocomial outbreak potential.

Abstract

Elizabethkingia miricola is an emerging opportunistic pathogen with increasing human clinical isolation. Infections pose major therapeutic challenges. This study sequenced the genomes of five clinical E. miricola isolates and employed comparative genomics with globally sourced strains to investigate resistance mechanisms, pathogenicity, phylogenetic relationships, and transmission patterns. Phylogenetic analysis revealed that E. miricola evolution exhibits no strict correlation with sample source, geographical origin, or region. Isolates from amphibians clustered within clinical lineages, implicating environmental reservoirs-potentially sink water-as infection sources. Geographically, pathogenic E. miricola demonstrates worldwide dissemination, with high prevalence in China and Europe. Putative transmission networks indicate intra-hospital spread and transnational circulation, suggesting nosocomial outbreak risks. Shared resistance genes (including BlaB and GOB β-lactamases) and virulence profiles between human and anuran strains highlight intrinsic resistance and pathogenic potential. Minocycline and doxycycline exhibited potent antimicrobial activity, indicating promising therapeutic alternatives. These findings highlight the zoonotic threat of E. miricola via nosocomial and potentially international horizontal transmission. Preventing outbreaks necessitates enhanced genomic surveillance of this pathogen.