Elizabethkingia spp. infections in a university hospital: coinfection with SARS-CoV-2 and first report of Elizabethkingia anophelis in Chile

Abstract

Background: Elizabethkingia is a genus of gramnegative bacteria whose relevance as an opportunistic pathogen in immunosuppressed hosts and critically ill patients has been progressively recognized in recent years. This genus is mainly composed of E. meningoseptica, E. anophelis, and E. miricola. Although E. meningoseptica was initially reported as the most relevant pathogenic species, thanks to advances in microbiological identification techniques E. anophelis has been recognized as the main pathogen of this group. Aim: To characterize Elizabethkingia spp.`s infections in a health network and made a brief review of this infection. Method: We conducted a review of clinical cultures that were positive for Elizabethkingia sp. in the Microbiology Laboratory of the UC-CHRISTUS Health Network (Chile), between 2017 and 2021. Results: Seventeen positive cultures were obtained corresponding to seven clinical cases, all originating from a university hospital. All cases had known risk factors for Elizabethkingia sp. infection, including recent use of antibiotics. Notably, previous use of carbapenems was present in 85.7% of the patients. Four cases occurred in patients with SARS-CoV-2 pneumonia, a coinfection not previously reported in the literature. Elizabethkingia anophelis was identified by ribosomal RNA sequencing in 80% of the recovered strains, which corresponds to the first report of this species in Chile. Conclusion: We report the clinical experience of a university hospital with infections by Elizabethkingia spp., including the first cases of coinfection in patients with SARS-CoV-2 pneumonia and the first identification of Elizabethkingia anophelis in Chile.