Emergence and clonal transmission of Elizabethkingia meningoseptica in adult and paediatric intensive care units: An integrated clinical, microbiological, and genomic analysis.

Elizabethkingia meningoseptica is an emerging nosocomial pathogen with complex antimicrobial resistance. We conducted a retrospective study in intensive care units (August 2022-December 2024) involving thirteen patients (ten adults, three paediatric). Universal resistance to piperacillin/tazobactam, aminoglycosides but susceptibility to minocycline was observed. Environmental sampling revealed contamination in water outlets and sink holes. Whole genome sequencing demonstrated clonal relationships between clinical and environmental isolates, confirming nosocomial transmission. Neurological complications were significantly associated with mortality. Following targeted interventions including enhanced disinfection and thermal water flushing, no new cases occurred during three-month follow-up. This study highlights environmental surveillance and integrated infection control importance.