Elizabethkingia meningoseptica in Neonates: Insights from a NICU Outbreak in Northern India
Abstract
Background Elizabethkingia meningoseptica is an aerobic, Gram-negative bacterium commonly found in the environment and has emerged as a significant nosocomial pathogen, particularly in neonatal intensive care units (NICUs). It predominantly affects premature and immunocompromised neonates, causing meningitis, bacteremia, and pneumonia. The organism’s resistance to common antibiotics poses a challenge for effective treatment, with high mortality and long-term morbidity rates, including hydrocephalus and developmental delays. Clinical Description This case series aims to highlight the clinical-laboratory profile, antibiotic resistance patterns, complications, and outcomes of neonatal meningitis caused by E. meningoseptica in a NICU setting, with a review of the literature. The case series includes six neonates with suspected or confirmed E. meningoseptica meningitis, spanning gestational ages from 29+1 weeks to 39 weeks. Clinical presentations varied, including poor feeding, lethargy, apnea, seizures, and fever. Management and Outcome All neonates were identified with E. meningoseptica infection either through blood or cerebrospinal fluid (CSF) analysis. Blood and CSF culture antibiotic susceptibility showed sensitivity/intermediate sensitivity to levofloxacin, minocycline, ciprofloxacin, and cefoperazone-sulbactam. Complications included hydrocephalus and seizures. Summary E. meningoseptica represents a significant neonatal pathogen with a high risk of neurological…
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