新興多重抗藥菌伊莉莎白國王菌（Elizabethkingia spp.）之抗藥、機轉與治療困境

Antimicrobial Resistance, Mechanisms, and Therapeutic Challenges of Emerging Multidrug-Resistant Elizabethkingia Species

伊莉莎白國王菌屬（Elizabethkingia species.）是新興的伺機性格蘭氏陰性菌，多數引起院內感染，因天生具多重抗藥性治療不易，故常造成感染病患之高死亡率。1959年，Elizabeth O. King首次分離出此類細菌，當時命名為Flavobacterium meningosepticum。隨後分類學演進，將其歸入獨立的Elizabethkingia spp.，目前至少包含8個物種：E. anophelis、E. meningoseptica、E. miricola、E. bruuniana、E. ursingii、E. argenteiflava、E. occulta及E. umeracha，臨床上以E. anophelis為最常見，此菌屬主要造成新生兒和免疫功能不全患者的感染。近年來，全球各地（如美國、亞洲各國）皆有Elizabethkingia感染增加或院內群聚的報告。由於該菌對多種抗生素之抗藥性，治療選擇極其受限，並缺乏治療指引，因此對臨床醫師而言是一項挑戰。本報告將針對Elizabethkingia spp.的鑑定方法、流行病學、抗生素敏感性與抗藥性機制、以及可能的治療建議，做一統整性介紹。

Elizabethkingia spp. are emerging opportunistic Gram-negative pathogens that can cause serious nosocomial infections, particularly in immunocompromised individuals. Characterized by intrinsic multidrug resistance, these bacteria are associated with high mortality rates and limited treatment options. First isolated in 1959 by Elizabeth O. King and initially named Flavobacterium meningosepticum, this group of bacteria has since been reclassified into a distinct genus, Elizabethkingia, which currently includes at least eight species: E. anophelis, E. meningoseptica, E. miricola, E. bruuniana, E. ursingii, E. argenteiflava, E. occulta, and E. umeracha. Among these, E. anophelis is the most frequently encountered in clinical settings and is known to cause severe infections in neonates and immunocompromised hosts. Recently, an increasing number of cases and outbreaks have been reported worldwide, particularly in the United States and Asia. Due to the organism’s intrinsic resistance to multiple antibiotics and the absence of standardized treatment guidelines, managing Elizabethkingia infections presents a significant clinical challenge. This review summarizes current knowledge on species identification, epidemiology, antimicrobial susceptibility profiles, resistance mechanisms, and therapeutic considerations for Elizabethkingia spp.