Elizabeth King’s Yellow Bacillus Makes a Come Back

Elizabethkingia is a gram-negative bacterium that was first identified in 1959.  At the time it was simply called ‘yellow bacillus’ because of the color it produced on chocolate and blood agar plates.  This bacteria’s virulence and prevalence seems to show up in circumstances where it is least expected, thus peaking the interest of scientists.  

This bacterium occurs naturally in both water and soil.  It is found to thrive in hospitals making this the transition route to get to humans.  Intrinsically resistant to multiple drugs, this bacterium is of particular concern to public health officials.  First-line antibiotics used to treat people with acquired infections have proved impotent.  As such, doctors are using other drugs such as colistin which is less commonly used.

Agricultural use, misuse and abuse has drained our weaponry of offensive bacteria.  When there are reports of hospital acquired Elizabethkingia, coupled with resistance to antibiotics, the environment is ripe for an epidemic and could lead to disease outbreak.

Reports of both Elizabethkingia meningoseptica and anopheles have risen.  As at late 2015 only 5 cases were reported in the US a year by the CDC.  However, by the beginning of December 2015, Wisconsin reported 60 cases of the infection all of them confirmed.  This resulted in 18 dead and 1 person who was suspected to have died of this bacterial infection. In addition, there was one report of a related case and 10 unrelated ones reported by the public health department in Illinois.  The Michigan health and human services department also confirmed one case.

Other parts in the world are also reflecting this trend. A case study recently published by Science Reports looked at 5 hospitals in Hong Kong.  Elizabethkingia was found in 21 cases and E. anopheles was found in 17 of the 21 cases.  With this uncommon infection emerging in 2 different continents, and with its resistance to antibiotics, this could mean that the upcoming years may have trouble.

The place where the showdown of humans vs. bacteria seems set to occur is in China. Since this country has billions of mouths to feed, they use effective and cheap antibiotics to ensure the increase of meat production.  Colistin, is an antibiotic that was discovered during the same period that Dr. Elizabeth King was discovering her bacteria.  With known toxicity to the kidney this antibiotic is hardly ever used. However, when first line antibiotics proved ineffective against hospital acquired infections that included acinetobacter, klebsiella and E.coli, it came into use.  

In China, colistin being cheap and also easy to mix into feed for pigs, become something that most Chinese farmers use regularly.  Resistance to colistin was first noted in the year 2013 by Chinese officials in a pig that had been kept under a farming environment that was quite intensive.  Going into meat markets and slaughterhouses, the officials found that fifteen percent of the meat from chicken and pigs was resistant as well.

Using plasmids bacteria can evade drug actions without necessarily integrating the plasmid into their bacterial genomes.  Even though initially colistin resistance did not seem to have gone through this process, researchers recently found plasmid that was resistant to colistin in a pig raised in China. They also confirmed that the resistance could be transferred from E.coli to another bacterial strain.  With these deadly infections on the rise and the ease of transference of resistance mechanism we could be up against a bacterial takeover.

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