Biliary tract infection or colonization with Elizabethkingia meningoseptica after endoscopic procedures involving the biliary tract.

OBJECTIVE

This study was performed to investigate the clinical significance of detecting Elizabethkingia meningoseptica in the bile.

METHODS

We herein report a case series of biliary colonization or infection with E. meningoseptica. Twenty patients with E. meningoseptica recovered from the bile were treated at a 4,300-bed teaching hospital in China between January 2009 and December 2012. The clinical information for the cases of E. meningoseptica recovered from the bile and the microbiological data of the E. meningoseptica isolates were examined.

RESULTS

Most of the 20 patients were not immunocompromised, although they had cholelithiasis and had recently received antimicrobial agents. All cases were treated with indwelling nasobiliary tubes and endoscopic retrograde cholangiopancreatography and/or endoscopic sphincterotomy prior to the detection of E. meningoseptica in the bile. The average time between the placement of the nasobiliary tube and the detection of E. meningoseptica in the bile was 6.6 days. E. meningoseptica caused cholangitis in five cases, one of which also involved secondary septicemia, and colonized the nasobiliary tubes or biliary tract in the remaining 15 cases. All but two patients recovered and were discharged. Two patients died of septicemia; E. meningoseptica and Escherichia coli were the causative pathogens in one case and other organisms were the causative pathogens in the other.

CONCLUSION

E. meningoseptica is an unusual causative pathogen of healthcare-associated cholangitis. Cholangitis resulting from this bacterium is generally associated with good outcomes, although secondary septicemia can be life-threatening.