Elizabethkingia meningoseptica Carbapenem Resistance in Cerebrospinal Fluid Cultures of Patients Suspected of Bacterial Meningitis: A Case Report

Yashinta Octavian Gita Setyanda
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Abstract

Background: Elizabethkingia meningoseptica is a Gram-negative bacterium that rarely causes meningitis in children. These infections are often resistant to carbapenem antibiotics, making diagnosis and treatment more complicated. Case presentation: A 1-month-old male patient was treated to the PICU of Dr. M. Djamil General Hospital Padang with symptoms of decreased consciousness, seizures, and fever. The patient was diagnosed with bacterial meningitis and was referred from Sungai Dareh Regional General Hospital with previous therapy for 4 days. A cerebrospinal fluid examination showed increased protein and decreased glucose, and a CT scan showed hydrocephalus. The cerebrospinal fluid culture showed growth of Elizabethkingia meningoseptica which was resistant to imipenem and meropenem. The patient was treated with a combination of non-carbapenem antibiotics and recovered from meningitis. Conclusion: Carbapenem-resistant Elizabethkingia meningoseptica is a rare causative agent of meningitis in children. Early diagnosis and treatment with appropriate non-carbapenem antibiotics are essential to increase the chance of cure.
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疑似细菌性脑膜炎患者脑脊液培养物中的 Elizabethkingia meningoseptica 卡巴培南耐药性:病例报告
背景:脑膜炎伊丽莎白金格菌(Elizabethkingia meningoseptica)是一种革兰氏阴性细菌,很少引起儿童脑膜炎。这些感染通常对碳青霉烯类抗生素产生耐药性,从而使诊断和治疗变得更加复杂。病例介绍:一名 1 个月大的男性患者因意识减退、抽搐和发烧症状被送往巴东 M. Djamil 医生综合医院的重症监护病房。该患者被诊断为细菌性脑膜炎,由 Sungai Dareh 地区综合医院转诊,之前曾接受过 4 天的治疗。脑脊液检查显示蛋白质增加,葡萄糖减少,CT 扫描显示脑积水。脑脊液培养显示,脑膜炎伊丽莎白金丝菌生长,对亚胺培南和美罗培南耐药。患者接受了非碳青霉烯类抗生素联合治疗,脑膜炎痊愈。结论对碳青霉烯类耐药的脑膜炎伊丽莎白金格菌是一种罕见的儿童脑膜炎致病菌。早期诊断和使用适当的非碳青霉烯类抗生素治疗对增加治愈机会至关重要。
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