A systematic review of reported symptomatic Elizabethkingia infection cases in children and adults

• Published in: Acta tropica Vol. 263; p. 107544
• Main Authors: Jiang, Bowen, Zhang, Wenping, Deng, Ning, Li, Gang, Ren, Chao, Sun, Fang, Wang, Xiaojun, Xi, Shaohu, Wei, Shijie
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2025
• Subjects: Adult; adults; Anti-Bacterial Agents - therapeutic use; Antibiotic resistance; cardiovascular diseases; Child; Child, Preschool; diabetes; Elizabethkingia; Emerging infectious diseases; Flavobacteriaceae - classification; Flavobacteriaceae - isolation & purification; Flavobacteriaceae Infections - diagnosis; Flavobacteriaceae Infections - drug therapy; Flavobacteriaceae Infections - epidemiology; Flavobacteriaceae Infections - microbiology; Flavobacteriaceae Infections - mortality; Flavobacteriaceae Infections - pathology; human diseases; Humans; Infant; Infant, Newborn; mortality; Neonatal meningitis; patients; species; species identification; Systematic review; therapeutics; Treatment Outcome; Systematic review; Elizabethkingia; Neonatal meningitis; Emerging infectious diseases; Antibiotic resistance
• ISSN: 0001-706X; 1873-6254; 1873-6254
• DOI: 10.1016/j.actatropica.2025.107544

•Summarizing clinical data on Elizabethkingia infections in neonates, children, and adults.•Identifying Elizabethkingia anophelis as the species with the highest reported mortality rate.•Highlighting better recovery rates in neonates (100 %) and infants (85.72 %) compared to adults.•Demonstrating the importance of species-specific identification for targeted antibiotic therapy.•Calling for improved diagnostic tools and age-specific treatment strategies in future research. Elizabethkingia infections are caused by the species Elizabethkingia, which recently has become important as a cause of serious infection among neonates and immunocompromised adults. The systematic review summarized clinical data on symptomatic infections caused by Elizabethkingia, including species identification, patient outcomes, and therapeutic approaches. The PRISMA guidelines were followed in conducting the systematic review. A literature search was made across major databases such as PubMed, Scopus, and Web of Science. The inclusion criteria emphasized case reports and case series on symptomatic human infection caused by Elizabethkingia species. The studies would involve pediatric and adult subjects. Data extraction was to be performed independently by two reviewers, and because the data were heterogeneous, a narrative synthesis was done. A total of 45 studies were included, covering cases from 2011. Elizabethkingia anophelis had the highest mortality rate (39.1 %), followed by E. meningoseptica (11.8 %) and E. miricola (33.3 %). Pediatric cases, particularly neonates, showed favorable recovery rates, with a 100 % recovery in neonates and 85.72 % in infants. In contrast, adults had a higher mortality rate (33.33 %), particularly those with comorbidities such as diabetes and cardiovascular disease. Species identification was crucial for determining appropriate antimicrobial treatment, with E. anophelis demonstrating significant antibiotic resistance. Clinical outcomes from Elizabethkingia infection are quite variable, depending on species and age group. Neonates and children generally tend to have better outcomes with appropriate and timely treatment, but adults, especially those with comorbidities, have higher mortality rates. Precise species identification and targeted treatment strategies play an important role in optimizing patient outcomes. Future research should be directed at fine-tuning diagnostic techniques, exploring the evolving taxonomy, and developing age-specific therapeutic regimens.