Elizabethkingia miricola: A rare non-fermenter causing urinary tract infection

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

Figure 1

Culture plates showing the growth of Elizabethkingia miricola on (A) cystein-lactose-electrolyte-deficient medium agar and (B) MacConkey agar.