About Elizabethkingia
Elizabethkingia is a genus of bacteria commonly found in the environment worldwide and has been detected in from soil, river water and reservoirs. However, it rarely makes people sick.
Cases are diagnosed through culture of body fluids, most often blood testing. Elizabethkingia has mostly caused meningitis in newborn babies and meningitis or bloodstream and respiratory infections in people with weakened immune systems.
About 5-10 cases per state per year are reported in the United States, with a few small, localized outbreaks reported in both the US and other countries, usually in healthcare settings.
Treatment
Elizabethkingia are Gram-negative bacteria that tend to be naturally resistant to many of the antibiotics that physicians may typically use to treat infections. However, the strain responsible for most of the cases in the current outbreak can be treated with several other antibiotics, so early recognition of the bacteria is critical to ensure patients receive appropriate diagnosis and treatment.
Confirmation of the species Elizabethkingia anophelis and determination whether cases are part of the ongoing outbreak is done through MALDI-TOF (which detects the protein fingerprints of a microbe) and optical mapping at CDC.
Multistate Outbreak of Infections Caused by Elizabethkingia anophelis
Current Case Counts
As of March 30, 2016 (Updated March 30, 2016)
| State | Number of confirmed cases (includes deaths)* | Number of deaths among confirmed cases* |
|---|---|---|
| Wisconsin | 56 | 17 |
| Michigan | 1 | 1 |
CDC, the Wisconsin Department of Health Services (WDHS), and the Michigan Department of Health and Human Services (MDHHS) are investigating an outbreak of infections caused by a bacteria called Elizabethkingia anophelis, which is usually found in the environment. The majority of the infections identified to date have been bloodstream infections, but some patients have had Elizabethkingia isolated from other sites, such as their respiratory systems or joints.
The majority of the patients who have had Elizabethkingia infections as part of this outbreak are over the age of 65 years, and all have had serious underlying health conditions. It has not yet been determined whether the deaths associated with this outbreak were caused by the bacterial infection, the patients’ underlying health conditions, or both.
Wisconsin was first notified of six potential cases between December 29, 2015 and January 4, 2016 and set up statewide surveillance on January 5, 2016. In response to the outbreak of Elizabethkingia infections in Wisconsin, Michigan sent a state health alert on February 8 , 2016 asking providers and laboratories to review records for Elizabethkingia specimens identified since January 1, 2014. On February 29, 2016, the MDHHS Bureau of Laboratories received anElizabethkingia from a recently submitted blood sample and forwarded the isolate to CDC for additional testing, where it was determined to match the bacteria causing the outbreak in Wisconsin
CDC issued a nationwide call for cases on January 20, 2016, via the Emerging Infections Network and again on March 2, 2016, via the Epidemic Information Exchange system, also known as Epi-X. These alerts asked states to look for any infections similar to the ones reported in Wisconsin, and to send isolates from any potential cases to CDC for testing to determine if they match the bacteria causing infections in the Wisconsin. To date, the only isolate that has matched the Wisconsin outbreak is the single case in western Michigan.
Although Elizabethkingia is a common organism in the environment (water and soil), it rarely causes infections. CDC is assisting with testing samples from a variety of potential sources, including healthcare products, water sources and the environment; to date, none of these have been found to be a source of the bacteria.
CDC will continue to work with WDHS and MDHHS to identify the source of the bacteria and develop ways to prevent these infections.
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