Clinical Characteristics and Drug Resistance Analysis of Elizabethkingia meningoseptica Colonization/Infection in Hospital Settings.

OBJECTIVE

This study investigated the clinical characteristics of hospital-acquired Elizabethkingia meningoseptica (EM) colonization/infection and its antimicrobial resistance profiles, to provide evidence-based references for EM infection prevention, control, and treatment.

METHODS

A retrospective analysis was performed on the clinical data and antimicrobial susceptibility results of 49 patients with hospital-acquired EM colonization/infection at the Hongqiao Campus of Huashan Hospital Affiliated to Fudan University between 2021 and 2024. Clinical characteristics, specimen sources, antimicrobial susceptibility, and outcomes were summarized, and clinical features were compared between the EM infection and colonization groups.

RESULTS

Fifty hospital-acquired EM strains were included, mainly from the ICU (56.1%) and respiratory tract (88.0%). Patients were mostly male, with prolonged hospitalization, multiple comorbidities (pulmonary infection 91.8%, anemia 81.6%), combined antimicrobial use (91.8%) and invasive procedures (100% with indwelling urinary catheters). EM was highly susceptible to TMP-SMX, doxycycline, and minocycline, but resistant to most β-lactams, carbapenems, and aminoglycosides. Overall all-cause mortality was 20.4%. Forty-one percent of patients of patients were colonized without progression to infection. Only immunosuppressant use was an independent risk factor for EM infection (OR=5.571, 95%CI:1.42-21.86, P=0.014).

CONCLUSION

Hospital-acquired EM mainly affects ICU patients with severe comorbidities, prolonged hospitalization, and invasive procedures, with profound intrinsic resistance. TMP-SMX, doxycycline, and minocycline are preferred therapeutic options. EM colonization does not always progress to infection but may facilitate nosocomial transmission. Immunosuppressant use may correlate with the clinical presentation of EM, with underlying mechanisms requiring further exploration. Early identification and isolation of colonized patients are critical for EM infection control.