Elizabethkingia Meningoseptica Bacteria in Bloodstream

Decoding Elizabethkingia Meningoseptica: What ICU Patients Need to Know

Avery Sinclair in Health & Wellness November 2025 • 4 min read.

"A Deep Dive into Bacteremia, Risks, and Recovery in the ICU"

Infections acquired within the intensive care unit (ICU) present significant challenges, often leading to increased illness, higher mortality rates, and substantial healthcare costs. Bacteremia, the presence of bacteria in the bloodstream, is particularly critical, with mortality rates hovering around 35%. Adding to the complexity, the rise of drug-resistant pathogens makes managing these infections even more difficult.

Elizabethkingia meningoseptica (EM), formerly known as Chryseobacterium meningosepticum, is a bacterium known to cause infections primarily in newborns and adults with weakened immune systems. What sets EM apart is its natural resistance to many commonly used antibiotics, making treatment more challenging. While the incidence of EM infections is on the rise, comprehensive clinical information remains limited, hindering clinicians' ability to make informed decisions.

This article explores the complexities surrounding EM bacteremia in adult ICU patients. By analyzing clinical data and comparing EM infections to other glucose non-fermenting Gram-negative bacteria (GNF-GNB) bacteremia, we aim to provide insights that can aid in earlier diagnosis, more effective treatment strategies, and ultimately, improved patient outcomes. Understanding the unique characteristics of EM bacteremia is crucial for healthcare providers navigating the challenges of ICU infections.

What Makes EM Bacteremia Different?

Elizabethkingia Meningoseptica Bacteria in Bloodstream

To understand the impact of EM bacteremia, researchers conducted a retrospective cohort study in a 35-bed respiratory ICU in Taiwan. Over three years (2006-2009), they tracked 70 patients who developed GNF-GNB bacteremia more than 48 hours after being admitted to the ICU. The study compared the clinical features and outcomes of patients with EM bacteremia (19 cases) to those with other GNF-GNB bacteremia (51 cases).

The study revealed several key differences between EM bacteremia and other GNF-GNB bacteremia:

Primary Bacteremia: EM bacteremia was more frequently identified as primary, meaning the infection's origin couldn't be confirmed by a specific site or occurred too rapidly to determine.
Prior Antibiotic Use: Patients with EM bacteremia had less prior antibiotic use.
Severity at Onset: EM bacteremia presented with lower APACHE II scores (a measure of disease severity) and less shock at the onset of bacteremia.
Antibiotic Treatment: EM bacteremia had a significantly lower rate of appropriate antibiotic use and a longer time to receive appropriate antibiotics.

Multivariate analysis confirmed that primary bacteremia was an independent predictor of EM bacteremia (odds ratio 4.294, 95% confidence interval 1.292-14.277, p = 0.017). This means that when EM bacteremia occurs, it is more likely to be identified without a clear source of infection, setting it apart from other bacterial infections in the ICU.

Implications for Patient Care

The study underscores that while EM bacteremia may not lead to significantly higher in-hospital mortality compared to other GNF-GNB bacteremia, its distinct characteristics require careful attention. The increased likelihood of primary bacteremia and the potential for delayed appropriate antibiotic therapy highlight the need for vigilance in identifying and treating EM infections.

Clinicians should consider EM bacteremia in ICU patients, particularly when the source of infection is unclear or when patients haven't recently been on antibiotics. Given the natural resistance of EM to many common antibiotics, timely susceptibility testing and the selection of appropriate antimicrobial agents are crucial to improving outcomes.

Further research is needed to explore optimal treatment strategies for EM bacteremia and to identify clinical markers that can facilitate earlier diagnosis. By improving our understanding of this emerging pathogen, we can enhance the care and outcomes for vulnerable ICU patients.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1016/j.jmii.2018.08.016, Alternate LINK

Title: Comparisons Of Clinical Features And Outcomes Between Elizabethkingia Meningoseptica And Other Glucose Non-Fermenting Gram-Negative Bacilli Bacteremia In Adult Icu Patients

Subject: Infectious Diseases

Journal: Journal of Microbiology, Immunology and Infection

Publisher: Elsevier BV

Authors: Wei-Chih Chen, Yen-Wen Chen, Hsin-Kuo Ko, Wen-Kuang Yu, Kuang-Yao Yang

Published: 2020-04-01

Everything You Need To Know

What exactly is Elizabethkingia meningoseptica, and why is it a concern in the ICU setting?

Elizabethkingia meningoseptica, often referred to as EM, is a bacterium known for causing infections, particularly in newborns and individuals with compromised immune systems. A key characteristic of EM is its inherent resistance to many commonly prescribed antibiotics, which complicates treatment strategies. EM bacteremia in ICU patients presents unique challenges, often requiring a different approach compared to other bacterial infections.

According to the study, what were the key differences observed between patients with Elizabethkingia meningoseptica (EM) bacteremia and those with other types of GNF-GNB bacteremia?

In the study, primary bacteremia was more frequently associated with Elizabethkingia meningoseptica (EM) bacteremia, meaning the source of the infection wasn't readily identifiable. Patients with EM bacteremia also had less prior antibiotic use and, initially, presented with lower APACHE II scores, indicating less severe illness at the onset. However, they experienced delays in receiving appropriate antibiotic treatment.

How does the presentation of Elizabethkingia meningoseptica (EM) bacteremia as 'primary bacteremia' influence treatment strategies and patient outcomes in the ICU?

A key difference highlighted in the study is that Elizabethkingia meningoseptica (EM) bacteremia is more likely to present as primary bacteremia, where the infection's origin cannot be easily determined. This is significant because, unlike other Glucose Non-Fermenting Gram-Negative Bacteria (GNF-GNB) bacteremia, the absence of a clear infection site can delay targeted treatment, potentially affecting patient outcomes. This aspect underscores the importance of considering EM as a possibility even when the source of infection is unclear.

Even if in-hospital mortality rates aren't significantly higher, what are the broader implications of Elizabethkingia meningoseptica (EM) bacteremia for patient care and outcomes in the ICU?

While the study didn't find significantly higher in-hospital mortality with Elizabethkingia meningoseptica (EM) bacteremia compared to other Glucose Non-Fermenting Gram-Negative Bacteria (GNF-GNB) bacteremia, the implications are that EM bacteremia requires careful and prompt attention due to its distinct characteristics. The increased likelihood of primary bacteremia and potential delays in appropriate antibiotic therapy underscore the need for heightened vigilance in identifying and effectively treating EM infections to optimize patient outcomes.

Can you elaborate on the design and scope of the retrospective cohort study mentioned, including the number of participants and the bacteria being compared?

The retrospective cohort study involved tracking 70 patients in a 35-bed respiratory ICU in Taiwan over three years (2006-2009). These patients had developed Glucose Non-Fermenting Gram-Negative Bacteria (GNF-GNB) bacteremia more than 48 hours after ICU admission. Researchers compared 19 cases of Elizabethkingia meningoseptica (EM) bacteremia with 51 cases of other GNF-GNB bacteremia, analyzing clinical features and patient outcomes to identify key differences and implications for treatment.