Invasive paediatric Elizabethkingia meningoseptica infections are best treated with a combination of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or fluoroquinolone

J Med Microbiol. 2019 Aug;68(8):1167-1172. doi: 10.1099/jmm.0.001021. Epub 2019 Jun 14.

Abstract

Objectives: Elizabethkingia meningoseptica is a multi-drug-resistant organism that is associated with high mortality and morbidity in newborn and immunocompromised patients. This study aimed to identify the best antimicrobial therapy for treating this infection.

Methods: A retrospective descriptive study was conducted from 2010 to 2017 in a tertiary paediatric hospital in Singapore. Paediatric patients aged 0 to 18 years old with a positive culture for E. meningoseptica from any sterile site were identified from the hospital laboratory database. The data collected included clinical characteristics, antimicrobial susceptibility and treatment, and clinical outcomes.

Results: Thirteen cases were identified in this study. Combination therapy with piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluoroquinolone resulted in a cure rate of 81.8 %. The mortality rate was 15.4 % and neurological morbidity in patients with bacteraemia and meningitis remained high (75 %).

Conclusions: Treatment with combination therapy of piperacillin/tazobactam and trimethoprim/sulfamethoxazole or a fluroquinolone was effective in this study, with low mortality rates being observed.

Keywords: Elizabethkingia meningoseptica; bacteraemia; children; hospital acquired infection; meningitis.

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Female
  • Flavobacteriaceae / drug effects
  • Flavobacteriaceae / isolation & purification
  • Flavobacteriaceae Infections / drug therapy*
  • Flavobacteriaceae Infections / epidemiology
  • Flavobacteriaceae Infections / microbiology
  • Fluoroquinolones / pharmacology
  • Fluoroquinolones / therapeutic use*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Microbial Sensitivity Tests
  • Piperacillin, Tazobactam Drug Combination / pharmacology
  • Piperacillin, Tazobactam Drug Combination / therapeutic use*
  • Retrospective Studies
  • Risk Factors
  • Singapore / epidemiology
  • Treatment Outcome
  • Trimethoprim, Sulfamethoxazole Drug Combination / pharmacology
  • Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use*

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones
  • Piperacillin, Tazobactam Drug Combination
  • Trimethoprim, Sulfamethoxazole Drug Combination