Neonatal meningitis secondary to Elizabethkingia meningoseptica infection

• Published in: Journal of global infectious diseases 2023-01, Vol.15 (1), p.23-27
• Main Authors: Goel, Srishti, Jhajra, Sandeep, Nangia, Sushma, Kumar, Ajay, Nanda, Debasish
• Format: Article
• Language: English
• Subjects: Antibiotics; Development and progression; elizabethkingia; Hydrocephalus; India; Infants (Newborn); Infections; Meningitis; Mortality; Neonatal care; neonate; Neonates; Neonatology; Nosocomial infections; Original; Sulbactam; Tazobactam; United States
• ISSN: 0974-777X; 0974-8245
• DOI: 10.4103/jgid.jgid_111_22

Introduction: Elizabethkingia meningoseptica, a rare cause of sepsis and meningitis in neonates, often associated with a wide spectrum of clinical presentation. The objective of the study was to describe the clinical characteristics and outcome of neonates, who developed meningitis secondary to Elizabethkingia meningoseptica infection at a tertiary care Neonatal unit in India. Methods: This retrospective study was conducted in the neonatal unit of a tertiary care hospital in New Delhi. The clinical data including demographic data, clinical presentation, management, and outcome data were collected and analyzed. Results: During the study, 7 neonates with meningitis secondary to Elizabethkingia infection were identified. Majority of the neonates were preterm with a median gestational age of 31 (interquartile range: 29-33.5) weeks and a median birth weight of 1250 g (interquartile range: 1024-2065). The median age of onset of symptoms was 7 days. Lethargy (100%), apnea (85%), seizure (71%), and feeding difficulties (42%) were the common clinical presentations. Overall mortality during the period was 28.5%, and 60% of the survivor developed hydrocephalus. Isolated strains were resistant to the commonly used antibiotics (piperacillin-tazobactam, aminoglycosides, meropenem, and colistin) effective against Gram-negative organisms. The environmental screening was done but the potential source of infection could not be identified conclusively. Conclusion: Meningitis in neonates caused by Elizabethkingia represents a potentially life-threatening infection and is often associated with significant neurological impairment, especially in premature neonates. A prolonged duration of antibiotic therapy, longer hospital stay, and likelihood of adverse neurologic sequelae during the hospital stay and follow-up should be anticipated in such cases of meningitis.