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Investigation of Phylogeny and Drug Resistance Mechanisms of Elizabethkingia anophelis Isolated from Blood and Lower Respiratory Tract.
Microb Drug Resist. 2021 Mar 03 [Online ahead of print]MD

Abstract

Elizabethkingia species are environmental bacteria associated with opportunistic infections in vulnerable populations. Traditionally, Elizabethkingia meningoseptica was considered the predominant pathogenic species. However, commercial identification systems have routinely misidentified Elizabethkingia anophelis as E. meningoseptica, leading to a mischaracterization of clinical strains and an underestimation of the role of E. anophelis in human disease. Elizabethkingia spp. harbor multidrug resistance (MDR) genes that pose challenges for treatment. Differentiation between Elizabethkingia spp. is particularly important due to differences in antimicrobial resistance (AMR) and epidemiological investigation. In this study, we describe a case of MDR E. anophelis isolated from the blood and lower respiratory tract of a patient who was successfully treated with minocycline. These isolates were initially misidentified by matrix assisted laser desorption ionization-time of flight as E. meningoseptica, whereas whole genome sequencing (WGS) confirmed the isolates as E. anophelis with the closest related strain being E. anophelis NUHP1, which was implicated in a 2012 outbreak in Singapore. Several AMR genes (blaBlaB, blaBlaGOB, blaCME, Sul2, erm(F), and catB) were identified by WGS, confirming the mechanisms for MDR. This case emphasizes the utility of WGS for correct speciation, elucidation of resistance genes, and relatedness to other outbreak strains. As E. anophelis is associated with a high mortality and has been found in hospital system sinks, WGS is critically important for determining strain relatedness and tracking outbreaks in the hospital setting.

Authors+Show Affiliations

Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, USA.Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, USA.Division of Infectious Diseases, UCLA Medical Center, University of California, Los Angeles, Los Angeles, California, USA. Department of Medicine, UCLA Medical Center, University of California, Los Angeles, Los Angeles, California, USA.Division of Infectious Diseases, UCLA Medical Center, University of California, Los Angeles, Los Angeles, California, USA.Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, USA.Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, USA.Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, California, USA.Division of Infectious Diseases, UCLA Medical Center, University of California, Los Angeles, Los Angeles, California, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33656389

Citation

Larkin, Paige M K., et al. "Investigation of Phylogeny and Drug Resistance Mechanisms of Elizabethkingia Anophelis Isolated From Blood and Lower Respiratory Tract." Microbial Drug Resistance (Larchmont, N.Y.), 2021.
Larkin PMK, Mortimer L, Malenfant JH, et al. Investigation of Phylogeny and Drug Resistance Mechanisms of Elizabethkingia anophelis Isolated from Blood and Lower Respiratory Tract. Microb Drug Resist. 2021.
Larkin, P. M. K., Mortimer, L., Malenfant, J. H., Gaynor, P., Contreras, D. A., Garner, O. B., Yang, S., & Allyn, P. (2021). Investigation of Phylogeny and Drug Resistance Mechanisms of Elizabethkingia anophelis Isolated from Blood and Lower Respiratory Tract. Microbial Drug Resistance (Larchmont, N.Y.). https://doi.org/10.1089/mdr.2020.0263
Larkin PMK, et al. Investigation of Phylogeny and Drug Resistance Mechanisms of Elizabethkingia Anophelis Isolated From Blood and Lower Respiratory Tract. Microb Drug Resist. 2021 Mar 3; PubMed PMID: 33656389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Investigation of Phylogeny and Drug Resistance Mechanisms of Elizabethkingia anophelis Isolated from Blood and Lower Respiratory Tract. AU - Larkin,Paige M K, AU - Mortimer,Leanne, AU - Malenfant,Jason H, AU - Gaynor,Pryce, AU - Contreras,Deisy A, AU - Garner,Omai B, AU - Yang,Shangxin, AU - Allyn,Paul, Y1 - 2021/03/03/ PY - 2021/3/3/entrez PY - 2021/3/4/pubmed PY - 2021/3/4/medline KW - Elizabethkingia anophelis KW - multidrug resistance KW - whole genome sequencing JF - Microbial drug resistance (Larchmont, N.Y.) JO - Microb Drug Resist N2 - Elizabethkingia species are environmental bacteria associated with opportunistic infections in vulnerable populations. Traditionally, Elizabethkingia meningoseptica was considered the predominant pathogenic species. However, commercial identification systems have routinely misidentified Elizabethkingia anophelis as E. meningoseptica, leading to a mischaracterization of clinical strains and an underestimation of the role of E. anophelis in human disease. Elizabethkingia spp. harbor multidrug resistance (MDR) genes that pose challenges for treatment. Differentiation between Elizabethkingia spp. is particularly important due to differences in antimicrobial resistance (AMR) and epidemiological investigation. In this study, we describe a case of MDR E. anophelis isolated from the blood and lower respiratory tract of a patient who was successfully treated with minocycline. These isolates were initially misidentified by matrix assisted laser desorption ionization-time of flight as E. meningoseptica, whereas whole genome sequencing (WGS) confirmed the isolates as E. anophelis with the closest related strain being E. anophelis NUHP1, which was implicated in a 2012 outbreak in Singapore. Several AMR genes (blaBlaB, blaBlaGOB, blaCME, Sul2, erm(F), and catB) were identified by WGS, confirming the mechanisms for MDR. This case emphasizes the utility of WGS for correct speciation, elucidation of resistance genes, and relatedness to other outbreak strains. As E. anophelis is associated with a high mortality and has been found in hospital system sinks, WGS is critically important for determining strain relatedness and tracking outbreaks in the hospital setting. SN - 1931-8448 UR - https://www.unboundmedicine.com/medline/citation/33656389/Investigation_of_Phylogeny_and_Drug_Resistance_Mechanisms_of_Elizabethkingia_anophelis_Isolated_from_Blood_and_Lower_Respiratory_Tract. L2 - https://www.liebertpub.com/doi/10.1089/mdr.2020.0263?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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