Volume 21, Number 2—February 2015
Research
Evidence for Elizabethkingia anophelis Transmission from Mother to Infant, Hong Kong
Susanna K.P. Lau1, Alan K.L. Wu1, Jade L.L. Teng1, Herman Tse1, Shirly O.T. Curreem, Stephen K.W. Tsui, Yi Huang, Jonathan H.K. Chen, Rodney A. Lee, Patrick C.Y. Woo, and Kwok-Yung Yuen
Table
Clinical characteristics and results of testing for 3 patients infected with Elizabethkingia anophelis, Hong Kong, 2012*
| Characteristics | Patient 1 | Patient 2† | Patient 3 |
|---|---|---|---|
| Patient age/sex | 21 d/M | 33y/F | 0 d/F |
| Signs/symptoms |
Fever |
Fever, PPROM |
Apnea at birth |
| Blood test results | |||
| Total leukocytes, × 109 cells/L | 16.0 (5.0–19.5) | 15.2 (3.7–9.3) | 5.1 (10.0–27.0) |
| Neutrophils, × 109 cells/L | 6.8 (2.0–9.5) | 12.5 (1.8–6.2) | 1.2 (5.0–17.0) |
| Lymphocytes, × 109 cells/L | 6.8 (2.5–11.0) | 1.7 (1.0–3.2) | 3.4 (3.0–10.0) |
| Monocytes, × 109 cells/L | 2.3 (0.2–1.2) | 0.8 (0.2–0.7) | 0 (0.5–2.0) |
| Hemoglobin, g/dL | 14.0 (11.0–19.0) | 10.7 (11.5–15.4) | 16.1 (13.5–19.5) |
| Platelets, × 109/L | 180 (180–460) | 241 (160–420) | 186 (100–300) |
| C-reactive protein, mg/L |
109 (<8.0) |
108 (<5.0) |
70.6 (<8.0) |
| CSF test results | |||
| Total leukocytes, × 106 cells/L | 1,445 | NA | 5,850 |
| Polymorphs, % | 67 | NA | 1 |
| Lymphocytes, % | 33 | NA | 99 |
| Protein, g/L | 1.33 (0.15–0.45) | NA | 2.69 (0.15–0.45) |
| Glucose, mmol/L | 2.2 (2.8–4.4) | NA | 1.5 (2.8–4.4) |
| CSF/serum glucose, % |
38 |
NA |
24 |
| Positive culture sites for E. anophelis |
Blood, CSF |
Placental swab, uterine swab |
Blood, CSF |
| Phenotypic characteristics of isolates | |||
| Colony pigment | Pale yellow | None | None |
| Citrate utilization |
Negative |
Delayed positive |
Delayed positive |
| Antimicrobial drug susceptibilities of isolates | |||
| Ampicillin | Resistant | Resistant | Resistant |
| Pipercillin | Susceptible | Susceptible | Susceptible |
| Cefoperazone/sulbactam | Susceptible | Susceptible | Susceptible |
| Cefotaxime | Intermediate | Resistant | Resistant |
| Ceftazidime | Resistant | Resistant | Resistant |
| Imipenem | Resistant | Resistant | Resistant |
| Amikacin | Resistant | Resistant | Resistant |
| Gentamicin | Resistant | Resistant | Resistant |
| Kanamycin | Resistant | Resistant | Resistant |
| Streptomycin | Resistant | Resistant | Resistant |
| Tobramycin | Resistant | Resistant | Resistant |
| Ciprofloxacin | Susceptible | Susceptible | Susceptible |
| Moxifloxacin | Susceptible | Susceptible | Susceptible |
| Tetracycline | Resistant | Resistant | Resistant |
| Trimethoprim/sulfamethoxazole | Susceptible | Susceptible | Susceptible |
| Rifampin | Susceptible | Susceptible | Susceptible |
| Chloramphenicol |
Resistant |
Resistant |
Resistant |
| Vancomycin MIC, μg/mL |
16 |
4 |
4 |
| Antimicrobial drug regimen |
Ampicillin + cefotaxime; vancomycin + piperacillin + rifampin |
Penicillin G; cefuroxime + metronidazole; ciprofloxacin |
Ampicillin + cefotaxime; vancomycin + pipercillin/tazobactam + rifampin |
| Complications | None | None | Respiratory distress, intraventricular hemorrhage |
*Reference ranges are shown in parentheses. PPROM, prolonged premature rupture of membranes; CSF, cerebrospinal fluid.
†Mother of patient 3.
1These authors contributed equally to this article.
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Page updated: January 20, 2015
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