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Spalting and All That

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Spalting and All That The organism discovered by Elizabeth King… Elizabethkingia Outbreak In 1970, the American Society for According to CDC spokesperson, Microbiology created an award in Melissa Brower, within a year, it is memory of the former not uncommon to see up to ten microbiologist and American cases of hospital acquired illnesses veteran, Elizabeth O. King. After related to Elizabethkingia spp. due earning her degrees in Zoology, to either medical devices or B.S. and Medical Technology, contaminated water. In this M.S., King became a member of instance, however, between By Rebecca Cage the Woman’s Army Corps and November 2015 and April 2016, May 2016 worked as a commanding officer at there have been 57 patients who Fort Detrick during WWII. In have tested positive for having the addition to serving our country CDC characterized outbreak strain then working for the CDC, King’s of Elizabethkingia anopheles. Out Rebecca Cage is a Technical Support most well-known contribution to of the 57, 18 of those patients lost Specialist and R&D Microbiologist at clinical microbiology was in their lives after developing the Hardy Diagnostics. She graduated discovering the difficult-to-identify infection. with a degree in Microbiology from California Polytechnic State University organism now known as in San Luis Obispo, California, and she Elizabethkingia. enjoys working with customers to answer their technical questions. King originally started her work to Rebecca is also involved with various describe Elizabethkingia spp. in research projects in the R&D 1959, at which time it was thought Laboratory. to be a species of Flavobacterium. Over the next seven years she accumulated 24 strains from seven states until she was able to distinguish Elizabethkingia species Figure 1: Elizabethkingia from others. anophelis grown on blood agar www.HardyDiagnostics.com plate. CDC photo. Her description of this bacterium has come in handy especially Elizabethkingia is a gram-negative, within the last six months, helping rod-shaped bacterium in the officials of southern Wisconsin Flavobacteriaceae family that investigate the mysterious infects the blood, causing outbreak that has resulted in the bacteremia and meningitis. When death of 18 individuals. cultured onto blood agar, it grows as a white-yellow, semi- translucent, shiny colony with morphology being entire, circular the bacteria can be identified and References: colonies. It has been reported that how effective the antibiotic 1. http://www.sciencedirect.com/sc only some strains are recoverable therapy is. ience/article/pii/S221425091500 from MacConkey agar after 0037 multiple subcultures. Often times, Elizabethkingia spp. 2. http://ijs.microbiologyresearch.o are multi-drug resistant organisms, rg/content/journal/ijsem/10.1099 These bacteria are non-spore resistant specifically to /ijs.0.63541-0#/#tab2 3. http://www.cabdirect.org/abstrac formers, non-motile, and are non- Aminoglycosides and Beta- ts/19592704321.html;jsessionid= fermentative, while having a lactams, including Carbapenems. 292F3E064802DC2E09027FDF positive reaction to catalase and Combination treatments with 622405A2 oxidase. Once grown on culture Fluoroquinolones or antibiotics 4. http://www.se- media, the colony is processed such as Vancomycin and Rifampin asm.org/elizabeth-o-king-award/ through a bacterial detection have been effective in the past, but 5. https://www.dhs.wisconsin.gov/ system. However, the bacterial there are currently no susceptibility news/releases/030216a.htm detection systems currently being breakpoints by CLSI that can be 6. http://www.cdc.gov/elizabethkin used in hospital laboratories cannot used for susceptibility screening of gia/about/index.html yet distinguish between Elizabethkingia. Elizabethkingia anophelis and Elizabethkingia meningoseptica, The CDC is the only laboratory in so all strains collected from this the United States that, using pulsed outbreak are being sent to the CDC field gel electrophoresis (PFGE), for analysis. can distinguish E. anophelis from the other species of this genus, so by collecting each of the strains that patients contracted in Wisconsin, the CDC was able to compile AST data characterizing the MIC of antibiotics used against this strain of E. anophelis. This outbreak strain of E. anophelis has a high MIC >32ug/mL to Vancomycin, a low MIC Figure 2: Elizabethkinia <0.5ug/mL to Rifampin, and an anophelis colonies on a blood MIC of 2ug/mL to agar plate. CDC photo. Fluoroquinolones such as Ciprofloxacin and Levofloxacin. Outbreaks of meningitis and Wisconsin Department of Health bacteremia caused by Services and the Division of Public Elizabethkingia are infrequent, Health officials are working because this bacterium is most diligently to determine the source commonly found in the soil or of this Elizabethkingia outbreak. water; however, when nosocomial There are still many questions that Elizabethkingia infections do need answers, but it has already occur, at-risk patients are those \been confirmed after collecting who are immunocompromised, nose and throat swabs from all of undergoing hemodialysis, or who those exposed that this outbreak is have diabetic nephropathy. not spread person to person. Like most bacterial infections, the best success with clearing the Rebecca Cage infection is based on how quickly Santa Maria, CA .
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