Identification and epidemiological relatedness of clinical Elizabethkingia meningoseptica isolates from central Taiwan.

BACKGROUND Elizabethkingia meningoseptica is an opportunistic pathogen. Identification of E. meningoseptica based on conventional methods is rather labor- and time-consuming. The information on epidemiological relatedness and microbiological characteristics of E. meningoseptica isolates from central Taiwan was limited. METHODS Forty E. meningoseptica isolates identified by conventional methods were collected by the Central Laboratory of Central Region Hospital Alliance between 2007 and 2011. The amplification of 16S ribosomalDNA gene by polymerase chain reaction with species-specific or universal primers following DNA sequencing was used as a standard identification method. The feasibility of Vitek 2 GN card was also evaluated. Some clinical information of the patients and the drug susceptibilities and epidemiological relatedness of the isolates were analyzed. RESULTS For the 40 isolates, 39 E. meningoseptica and one Chryseobacterium indologenes were identified using 16S rDNA sequencing. Among the 39 isolates, all could be identified using species-specific primers, whereas only 84.6% could be identified by Vitek 2 GN card with excellent discrimination. All E. meningoseptica isolates were susceptible to minocycline but resistant to many drugs examined including ceftazidime, amikacin, colistin, and imipenem. The pulsed field gel electrophoresis (PFGE) patterns demonstrated that most isolates were quite genetic diversity. The patients had average age of 72.2 ± 14.5 years old (excluded one child patient of 1 year old) and 79.5% of patients were male. Twenty-three patients (59.0%) had underlying diseases. CONCLUSION The designed species-specific primers could be used to identify E. meningoseptica with 100% of specificity and sensitivity, whereas the Vitek 2 GN card showed considerable ability in E. meningoseptica identification. The PFGE patterns showed that most isolates were genetic diversity enough to exclude the possibility of intrahospital spread.