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Rare Elizabethkingia anophelis meningitis case in a Danish male

INTRODUCTION. Elizabethkingia anophelis is a Gram-negative, aerobic, non-motile rod belonging to the family Flavobacteriaceae. Over the last 5 years, it has emerged as an opportunistic human pathogen involved in neonatal meningitis and sepsis, as well as nosocomial outbreaks. It has been isolated fr...

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Autores principales: Nielsen, Hans Linde, Tarpgaard, Irene Harder, Fuglsang-Damgaard, David, Thomsen, Philip Kjettinge, Brisse, Sylvain, Dalager-Pedersen, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Microbiology Society 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152398/
https://www.ncbi.nlm.nih.gov/pubmed/30323938
http://dx.doi.org/10.1099/jmmcr.0.005163
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author Nielsen, Hans Linde
Tarpgaard, Irene Harder
Fuglsang-Damgaard, David
Thomsen, Philip Kjettinge
Brisse, Sylvain
Dalager-Pedersen, Michael
author_facet Nielsen, Hans Linde
Tarpgaard, Irene Harder
Fuglsang-Damgaard, David
Thomsen, Philip Kjettinge
Brisse, Sylvain
Dalager-Pedersen, Michael
author_sort Nielsen, Hans Linde
collection PubMed
description INTRODUCTION. Elizabethkingia anophelis is a Gram-negative, aerobic, non-motile rod belonging to the family Flavobacteriaceae. Over the last 5 years, it has emerged as an opportunistic human pathogen involved in neonatal meningitis and sepsis, as well as nosocomial outbreaks. It has been isolated from the midgut of the Anopheles gambiae mosquito, but there is no evidence for a role of the mosquito in human infections, and very little is known regarding the routes of transmission to humans. Recent studies, primarily from South-East Asia, suggest that E. anophelis, and not Elizabethkingia meningoseptica, is the predominant human pathogen of this genus. However, identification to the species level has been difficult due to the limitations of the current MALDI-TOF MS (matrix-associated laser desorption ionization-time of flight MS) systems for correct species identification. CASE PRESENTATION. Here, we present a rare case of E. anophelis meningitis in a Danish male, who had a travel exposure to Malaysia 7 weeks before hospitalization. A multidrug-resistant Elizabethkingia species was isolated from blood and cerebrospinal fluid, and genomic sequencing was used to characterize the phylogenetic position of the isolate, which was determined as associated with previously described sublineage 11. The patient was successfully treated with intravenous moxifloxacin and rifampicin for 2 weeks with no major sequelae, but we did not find the source of transmission. CONCLUSION. All clinical microbiologists should be aware of the present limitations of the MALDI-TOF MS systems for correct species identification, and therefore we recommend the use of genome sequencing for the correct identification at the species and sublineage level.
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spelling pubmed-61523982018-10-15 Rare Elizabethkingia anophelis meningitis case in a Danish male Nielsen, Hans Linde Tarpgaard, Irene Harder Fuglsang-Damgaard, David Thomsen, Philip Kjettinge Brisse, Sylvain Dalager-Pedersen, Michael JMM Case Rep Case Report INTRODUCTION. Elizabethkingia anophelis is a Gram-negative, aerobic, non-motile rod belonging to the family Flavobacteriaceae. Over the last 5 years, it has emerged as an opportunistic human pathogen involved in neonatal meningitis and sepsis, as well as nosocomial outbreaks. It has been isolated from the midgut of the Anopheles gambiae mosquito, but there is no evidence for a role of the mosquito in human infections, and very little is known regarding the routes of transmission to humans. Recent studies, primarily from South-East Asia, suggest that E. anophelis, and not Elizabethkingia meningoseptica, is the predominant human pathogen of this genus. However, identification to the species level has been difficult due to the limitations of the current MALDI-TOF MS (matrix-associated laser desorption ionization-time of flight MS) systems for correct species identification. CASE PRESENTATION. Here, we present a rare case of E. anophelis meningitis in a Danish male, who had a travel exposure to Malaysia 7 weeks before hospitalization. A multidrug-resistant Elizabethkingia species was isolated from blood and cerebrospinal fluid, and genomic sequencing was used to characterize the phylogenetic position of the isolate, which was determined as associated with previously described sublineage 11. The patient was successfully treated with intravenous moxifloxacin and rifampicin for 2 weeks with no major sequelae, but we did not find the source of transmission. CONCLUSION. All clinical microbiologists should be aware of the present limitations of the MALDI-TOF MS systems for correct species identification, and therefore we recommend the use of genome sequencing for the correct identification at the species and sublineage level. Microbiology Society 2018-08-09 /pmc/articles/PMC6152398/ /pubmed/30323938 http://dx.doi.org/10.1099/jmmcr.0.005163 Text en © 2018 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Nielsen, Hans Linde
Tarpgaard, Irene Harder
Fuglsang-Damgaard, David
Thomsen, Philip Kjettinge
Brisse, Sylvain
Dalager-Pedersen, Michael
Rare Elizabethkingia anophelis meningitis case in a Danish male
title Rare Elizabethkingia anophelis meningitis case in a Danish male
title_full Rare Elizabethkingia anophelis meningitis case in a Danish male
title_fullStr Rare Elizabethkingia anophelis meningitis case in a Danish male
title_full_unstemmed Rare Elizabethkingia anophelis meningitis case in a Danish male
title_short Rare Elizabethkingia anophelis meningitis case in a Danish male
title_sort rare elizabethkingia anophelis meningitis case in a danish male
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6152398/
https://www.ncbi.nlm.nih.gov/pubmed/30323938
http://dx.doi.org/10.1099/jmmcr.0.005163
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