elizabethkingiameningoseptica an emerging infection by dr.t.v.rao md
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8/18/2019 Elizabethkingia�meningoseptica an emerging Infection by Dr.T.V.Rao MD
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ELIZABETHKINGIA
MENINGOSEPTICADr.T.V.Rao MD
4/6/16 Dr.T.V.Rao MD 1
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Elizabeth i!"ia
#e!i!"o$e%ti&a• Elizabeth i!"ia#e!i!"o$e%ti&a i$ a"ra#'!e"ati(e ro)'$ha%e) ba&teri*#
+i)el, )i$trib*te) i!!at*re -e.". re$h+ater/ $alt +ater/ or$oil0. It #a, be!or#all, %re$e!t i!1$h a!) ro"$ b*t i$4/6/16 Dr.T.V.Rao MD
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Hi$tor, o Elizabeth i!"ia• I! 3454/ theA#eri&a!ba&teriolo"i$t
Elizabeth O. Ki!"-+ho i$olate)Ki!"ella i! 34670+a$ $t*),i!"
*!&la$$i1e)4/6/16 Dr.T.V.Rao MD
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I#%orta!t Ba&teria $tablea!) a)o%t$ to E!(iro!#e!t
• Elizabeth i!"ia#e!i!"o$e%ti&a ha$bee! )ee#e) a%ote!tiall, i#%orta!tthreat to %atie!t$ i!&riti&al &are area$be&a*$e o it$#*lti)r*"'re$i$ta!t
%he!ot,%e a!) it$4/6/16 Dr.T.V
.Rao MD
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Elizabethkingia is foun in theen!iron"ent
•Co##o!l, o*!) i!the e!(iro!#e!t/%arti&*larl, i! $oila!) +ater/Elizabeth i!"ia rarel,&a*$e$ )i$ea$e i!other+i$e health,i!)i(i)*al$.
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8!&o##o! %atho"e! a!)Re$%irator, &olo!izer
• Elizabeth i!"ia areba&teria that arerarel, re%orte) to&a*$e ill!e$$ i!h*#a!$/ a!) are*!&o##o!&olo!izer$ o there$%irator, tra&t
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Ge!eral Chara&teri$ti&$ E.#e!i!"o$e%ti&a
• E.#e!i!"o$e%ti&a
i$ a $%e&ie$ oGra#'!e"ati(e/obli"ateaerobi&/ !o!'
a$ti)io*$/ !o!'$%ore or#i!"/!o! er#e!tati(e9 !o!#otile9
$le!)er9 $li"htl,4/6/16 Dr.T.V.Rao MD
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Elizabeth i!"ia• Elizabeth i!"iai$ a "e!*$ oba&teria&o##o!l, o*!)i! the
e!(iro!#e!t+orl)+i)e a!)ha$ bee!)ete&te) i! $oil/
ri(er +ater a!)4/6/16 Dr.T.V.Rao MD
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Elizabeth i!"ia #e!i!"o$e%ti&a o! -a0$hee% bloo) a"ar a!) -b0 Ma&Co! e,
a"ar
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Ma"!i1e) (ie+ o theColo!ie$ o Elizabeth i!"ia
a!o%heli$• Three i!)i(i)*alElizabeth i!"iaa!o%heli$ &olo!ie$"ro+i!" !e:t toea&h other o!bloo) a"ar. Photo&o*rte$, CDC
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Bio&he#i&all, rea&ti!"• Catala$e %o$iti(e/ o:i)a$e
%o$iti(e/ a!) i!)ole'%o$iti(e/O; "l*&o$e o:
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Gro+th Chara&ter$• E. #e!i!"o$e%ti&a"ro+$ +ell i! re"*lari!&*bator$ o! bloo)a"ar a!) &ho&olatea"ar. Colo!ie$ are(er, %ale ,ello+ a!)#a, !ot be ea$il,
e(i)e!t at ?@ ho*r$.E. #e!i!"o$e%ti&a$trai!$ either are !ot%i"#e!te) or%ro)*&e a +ea
,ello+ !o!)i *$ible4/6/16 Dr.T.V.Rao MD
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I! e&tio!• E. #e!i!"o$e%ti&a%re)o#i!a!tl,&a*$e$ o*tbrea $ o#e!i!"iti$ i!%re#at*re !e+'bor!$ a!) i! a!t$ i!!eo!atal i!te!$i(e
&are *!it$ o4/6/16 Dr.T.V.Rao MD
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Tra!$#i$$io! a!)So*r&e$ o the I! e&tio!
• Neo!atal i! e&tio!$ )*eto C. #e!i!"o$e%ti&*#&o*l) be thro*"h (erti&altra!$#i$$io!9 ho+e(er/ !o)ata abo*t thi$ i!) otra!$#i$$io! o theor"a!i$# i$ a(ailable. A$#a!, i!ter(e!tio!$-e!)otra&heal i!t*batio!/&e!tral a!) %eri%herali!tra(a$&*lar4/6/16 Dr.T.V.Rao MD
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Ca! be a !o$o&o#ialI! e&tio!
• Ma orit, o the C.#e!i!"o$e%ti&*#i! e&tio!$ re%orte)ha(e bee! i! NIC8$/
the i! e&tio!$ othe$e !eo!ate$ areo te! &o!$i)ere) a$!o$o&o#ial
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I! e&tio!• So#e o the o*tbrea $ ha(e bee!li! e) to $o*r&e$ li e &o!ta#i!ate)li%i) $to& bottle$/ &o!ta#i!ate)(e!o*$ &atheter li!e$ a!) !*tritio!al
$ol*tio!/ a!) ta% +ater. Theba&teri*# i$ al$o a rare &a*$e o!o$o&o#ial %!e*#o!ia/ e!)o&ar)iti$/%o$to%erati(e ba&tere#ia/ a!)
#e!i!"iti$ i! i##*!o&o#%ro#i$e)4/6/16 Dr.T.V.Rao MD
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I! e&tio!• O!l, re&e!tl, ha$it al$o bee!
o*!) to &a*$e
$o t ti$$*ei! e&tio! a!)$e%$i$ i! thei##*!o&o#%ete!
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C*rre!t #etho)$ to i)e!ti ,• State &li!i&al #i&robiolo", laboratorie$&a! &hara&terize the i$olate$ *$i!"
%*l$e)'1el) "el ele&tro%hore$i$/ a#etho) that &a! i)e!ti , theElizabeth i!"ia "e!*$ &orre&tl,. I$olate$$e!t to CDC $ S%e&ial Ba&teriolo",Re ere!&e Laborator, are &o!1r#e) a$the $%e&ie$ E a!o%heli$ o! the ba$i$ o
the %atho"e! $ %rotei! %ro1le/ a& *ire)*$i!" the #a$$ $%e&tro#etr, #etho)MALDI'To; -#atri:'a$$i$te) la$er)e$or%tio!=io!izatio! ti#e'o '2i"ht0/a!) o%ti&al #a%%i!" o the ba&terial"e!o#e.
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Treat#e!t a!) Dr*" re$i$ta!t%atter!$
• Thi$ ba&teri*# i$ *$*all,#*ltire$i$ta!t toa!tibioti&$ t,%i&all,%re$&ribe) or treati!""ra#'!e"ati(e ba&teriali! e&tio!$/ i!&l*)i!"
e:te!)e)'$%e&tr*# beta'la&ta# a"e!t$ -)*e to%ro)*&tio! b, #o$t $trai!$o t+o beta la&ta#a$e$o!e ESBL a!) o!e Cla$$ BCarba%e!e#'H,)rol,zi!"#etallola&ta#a$e0/
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6 )a, ol) Bloo) a"ar "ro+th oElizabeth i!"ia #e!i!"io$e%ti&a
• 6 )a, ol) Bloo) a"ar "ro+th oElizabeth i!"ia #e!i!"io$e%ti&a+ith 5*" (a!&o#,&i! -+ith azo!e o &leari!"0 a!) 37 *"&oli$ti! )i$ $. Thi$ $trai! )i) !ot%ro)*&e the 2e:ir*bi! %i"#e!t.Li e B*r hol)eria &e%a&ia thi$or"a!i$# &a! be Coli$ti!re$i$ta!t a!) %artiall,Va!&o#,&i! $e!$iti(e
• Co%, ri"ht o the %i&t*re a!) %roto&ol %er#i$$io! i$ "ra!te) to&o%,/ )i$trib*te a!)=or #o)i , thi$ )o&*#e!t *!)er the ter#$ othe GN8 ;ree Do&*#e!tatio! Li&e!$e/ Ver$io! 3.? or a!, later(er$io! %*bli$he) b, the ;ree So t+are ;o*!)atio!9 +ith !oI!(aria!t Se&tio!$/ !o ;ro!t'Co(er Te:t$/ a!) !o Ba& 'Co(er Te:t$.A &o%, o the li&e!$e i$ i!&l*)e) i! the $e&tio! e!title) GN8 ;reeDo&*#e!tatio! Li&e!$e.
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Choo$i!" the A!tibioti&$• Tho*"h (a!&o#,&i!ha$ bee! *$e) i! the%a$t/ it$ hi"h MIC -36F"=#l0 ha$ le) to a$ear&h or
alter!ati(e$/e$%e&iall, or#e!i!"iti$. Pre$e!tl,&i%ro2o:a&i!/
#i!o&,&li!e/ '4/6/16 Dr.T.V.Rao MD
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Pre)i&tor$ o %oor o*t&o#e• H,%oalb*#i!e#ia/ i!&rea$e)
%*l$e rate atthe o!$et oi! e&tio!/ a!)&e!tral (e!o*$li!e i! e&tio!+erea$$o&iate)
+ith a %oor4/6/16 Dr.T.V.Rao MD
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Tre!)$ i! #a!a"e#e!t oo*tbrea $
• CDC a!) the a e&te)$tate$ &o!ti!*e to +orto+ar) #a!a"i!" theo!"oi!" o*tbrea . The*!e:%e&te) !*#ber oi! e&tio!$ +ith thi$*!*$*al %atho"e!re#i!)$ *$ o thei#%orta!&e o !e+ a!)e#er"i!" te&h!olo"ie$/$*&h a$ a)(a!&e)#ole&*lar )ete&tio! a!)
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. I! e&tio! Co!trol I!ter(e!tio!$
• O*tbrea $ o Gra#'!e"ati(eba&terial i! e&tio!$ are *$*all,)*e to tra!$ie!t &arria"e othe or"a!i$#$ o! the ha!)$ ohealth&are +or er$ .S*$&e%tible %atie!t$ #a,be&o#e &olo!ize) a ter
a& *iri!" the or"a!i$# ro#the health&are +or er/ a!)i! e&tio! #a, or #a, !ot)e(elo%.
• Ha!) +a$hi!" b, Health &are +or er$%ote!tiall, $to%$ $%rea)
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The Me)i&al Pro e$$io! Nee)#ore a+are!e$$ o! the
e#er"i!" i! e&tio!• I! a))itio! to rei! or&e#e!t o $ta!)ar)i! e&tio! &o!trol #ea$*re$/ a&tio!$ thatha(e $*&&e$$ *ll, ter#i!ate) E.#e!i!"o$e%ti&a o*tbrea $ i!&l*)e %re'e#%ti(e &o!ta&t i$olatio!/ $,$te#ati&i!(e$ti"atio!$ to i)e!ti , the $o*r&e o theba&teri*# a!) thoro*"h &lea!i!" oe *i%#e!t a!) e!(iro!#e!tal $*r a&e$. A$the &li!i&al &o#%le:it, a!) i!&i)e!&e o E.#e!i!"o$e%ti&a i! e&tio!$ i!&rea$e/ there4/6/16 Dr.T.V.Rao MD
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Re$o*r&e$ a!) Re ere!&e$
• CDC o! Elizabeth i!"ia• Me)$&a%e I! e&tio*$ )i$ea$e$• IKIPEDIA ON LINE RESO8RCE
• Re(ie+ Arti&le Elizabeth i!"ia #e!i!"o$e%ti&*#-Chr,$eoba&teri*# #e!i!"o$e%ti&*#0 I! e&tio!$ i!Chil)re! Meh#et Ce,ha! a!) Mel)a CeliI!ter!atio!al o*r!al o Pe)iatri&$ Vol*#e ?733-?7330/ Arti&le ID ?35? J/ J %a"e$
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• Pro"ra# Create) b, Dr.T.V.Rao MD orMe)i&al a!) Para#e)i&al Pro e$$io!al$
or a+are!e$$ o! the e#er"i!" tre!)$
o! Elizabeth i!"ia #e!i!"o$e%ti&a• E"ail
• o(tort!rao)g"ail.(o"
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