Elizabethkingia anophelis: The First Italian Report of Neonatal Meningitis and Sepsis Associated With Breast-Pump–Expressed Milk

Elizabethkingia anophelis (E. anophelis) is an emerging opportunistic pathogen and environmental gram-negative rod. It has been implicated in neonatal meningitis, sepsis, and nosocomial outbreaks, having also been isolated from contaminated medical equipment. Infections by E. anophelis are associated with morbidity and mortality, primarily due to its intrinsic multidrug resistance. The determinants of transmission, pathogenicity, antibiotic resistance, and global epidemiology remain poorly understood, and no established therapeutic guidelines are currently available. Newborn positive blood culture, CSF, and breast milk samples were inoculated on Blood Agar plates and incubated at 37 °C, 5% CO2 for 24 hours. The isolates were identified by mass spectrometry. The minimal inhibitory concentrations (MICs) were obtained by gradient strip method following manufacturer's instructions. We report here the first documented case in Italy of neonatal meningitis and sepsis caused by E. anophelis associated with maternal expressed breast milk. The combination therapy of vancomycin, cotrimoxazole, and levofloxacin for pediatric E. anophelis infection has yielded success.