伊莉莎白菌 （Elizabethkingia spp.） 對臨床的影響及相關感染管制的預防

The Clinical Impact and Infection Control of Elizabethkingia spp

伊莉莎白菌 （Elizabethkingia spp.） 廣泛存在於院內的環境，隨著被伊莉莎白菌感染個案報導的增加，再加上伊莉莎白菌本身的多重抗藥性及被伊莉莎白菌感染後病患的高死亡率，相關的伊莉莎白菌感染與院內感染已成為越來越重要的議題。根據文獻記載，主要造成人類感染的伊莉莎白菌有 Elizabethkingia meningoseptica, E. anophelis 與 E. miricola 等三種。儘管伊莉莎白菌的微生物鑑定上缺少高鑑別度的鑑定方法，感染伊莉莎白菌的病患之間享有一些共通的危險因素 （risk factors），包括感染多發生在長時間住院、曾使用廣效抗生素、加護病房患者、使用呼吸器、免疫力較差、或有多重共病症的患者。除血液和肺部感染外，伊莉莎白菌還可以造成其他器官的感染，藥物敏感試驗有效的抗生素包含trimethoprim-sulfamethoxazole、rifampin、piperacillin-tazobactam 等。在伊莉莎白菌院內的傳播以接觸傳染為主，因此伊莉莎白菌的感染控制重點需加強環境清潔消毒，洗手，及落實接觸隔離。

Elizabethkingia spp. exists in various hospital environments and this hasbeen an emerging issue because of the multidrug resistance of these organismsand the associated high mortality rate. Three main species can cause infectionin humans, namely E. meningoseptica, E. anopheles, and E. miricola, whichshare some clinical characteristics. Most of them infect patients with prolongedhospitalization, broad-spectrum antibiotic use, admission to the intensivecare unit, ventilator use, immunocompromised status, and comorbidities.Elizabethkingia spp. can cause many kinds of infection in patients, althoughmost cases reported were of bacteremia or pneumonia and can be treatedwith TMP-SMX, rifampin, or piperacillin-tazobactam. Contact is the main routeof nosocomial spreading, and implementing the policy of infection control,including environmental cleaning, hand washing, and contact isolation, is theonly way to prevent an outbreak.