Affiliations: Department of Microbiology, St. John's Medical
College, Bangalore, Karnataka, India
Note: [] Correspondence: Dr. Sethumadhavan Muralidharan, M.D.,
Department of Microbiology, St. John's Medical College, Bangalore--560034,
Karnataka, India. Tel.: +91 80 22065052; Fax: +91 80 25520777; E-mail: dr.murali.2009@gmail.com
Abstract: Elizabethkingia meningoseptica is known to cause meningitis in
premature neonates and severe infections in immunocompromised adults. It may
cause a therapeutic dilemma as it often shows discrepancies between various
methods of antimicrobial susceptibility testing. Here, we present a case of
multi drug resistant E. meningoseptica meningitis and sepsis in a
premature baby, which caused a therapeutic challenge. The strain was
susceptible to piperacillin, piperacillin-tazobactam and
trimethoprim/sulfamethoxazole by disk diffusion method. On the other hand the
minimum inhibitory concentration values for these antibiotics were much higher
to be interpreted as resistant by VITEK 2C (bioMérieux). This case showed
significant clinical improvement with combination therapy of
piperacillin-tazobactam and amikacin, and the same drugs were continued.
Relying on the clinical outcome in this case, we observe that VITEK 2C may be
less accurate than disk diffusion method for detection of antimicrobial
resistance in this organism.
