Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2017; 5(5): 187-190
Published online May 16, 2017. doi: 10.12998/wjcc.v5.i5.187
Elizabethkingia miricola: A rare non-fermenter causing urinary tract infection
Parakriti Gupta, Kamran Zaman, Balvinder Mohan, Neelam Taneja
Parakriti Gupta, Kamran Zaman, Balvinder Mohan, Neelam Taneja, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: All authors have contributed equally to the acquisition of data, writing, drafting the article and revision of the manuscript; all the authors have given the final approval for the article to be published.
Institutional review board statement: The present case report has been retrospectively reviewed and reported and it didn’t require any institutional ethics committee approval.
Informed consent statement: The patient involved in this study has given written informed consent authorizing use and disclosure of his health information.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Neelam Taneja, Professor, Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. drneelampgi@yahoo.com
Telephone: +91-172-2755160 Fax: +91-172-2744401
Received: November 16, 2016
Peer-review started: November 21, 2016
First decision: January 14, 2017
Revised: February 9, 2017
Accepted: March 12, 2017
Article in press: March 13, 2017
Published online: May 16, 2017
Abstract

Elizabethkingia miricola (E. miricola) is a gram-negative non-fermentative bacterium which is rarely encountered. It is usually misidentified or considered as a contaminant in routine microbiology laboratories due to the limitations in conventional biochemical techniques. However, with the advent of the matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS), the identification of non-fermenters has become easy and this has led to enhanced understanding of the clinical significance of these uncommonly isolated microorganisms. The genus Elizabethkingia has only two species E. meningoseptica and E. miricola. Both of these organisms are known to be multi-drug resistant and therefore, their accurate identification and antimicrobial susceptibility testing are necessary prior to the initiation of appropriate therapy. In the world literature till date, only 3 cases of sepsis caused by E. miricola have been reported. We present the first case of E. miricola association with urinary tract infection.

Keywords: Elizabethkingia miricola, Antibiotics, Urinary tract infections, Matrix-assisted laser desorption ionization time-of-flight, Non-fermenters

Core tip: Non-fermenters except Pseudomonas and Acinetobacter are less commonly associated with urinary tract infection (UTI). But recently an upsurge in a number of reported cases has been noted due to the use of MALDI-TOF which is an easy and reliable identification technique. Till date in literature, there is no reported case of Elizabethkingia miricola (E. miricola) causing UTI, although its significance in blood and sputum samples of sepsis patients has been demonstrated earlier. This is the first case report showing a clinical association of E. miricola with symptomatic UTI and also demonstrating the multidrug resistance nature of this organism.