Mixed infection of the tracheobronchial tree caused by the bacteria Elizabethkingia anophelis in a victim with a traumatic brain injury: etiology and diagnostic and antibacterial therapy (clinical case)

A clinical case of tracheobronchial tree infection caused by Elizabethkingia anophelis in a man with traumatic brain injury is presented. The pathogen is characterized by its active ubiquity and resistance to several antimicrobial drugs, including ampicillin, chloramphenicol, kanamycin, streptomycin, and tetracycline. Additionally, poly-resistant bacteria Acinetobacter baumannii and Klebsiella pneumoniae were found in the discharge of other loci. Microbiological diagnostics performed using modern bacteriological analyzers Vitek 2 Compact and Phoenix M50 with a 99 and 90% reliability, respectively, showed Elizabethkingia meningoseptica. The Autof MS 1000 mass spectrometer was used to determine Elizabethkingia anophelis, with a high confidence >9.5 of 10. The pathogen under study was found to be resistant to the main groups of antibacterial agents, but sensitive to high levofloxacin doses. The use of combined antibacterial therapy regimens using meropenem, linezolid, and levofloxacin for 7 days and additional inhalation administration of sodium colistimethate on day 15 showed a positive result with the elimination of all identified microorganisms. The study of this clinical case is beneficial in avoiding difficulties in identifying Elizabethkingia anophelis using modern bacteriological analyzers and selecting effective antibacterial therapy regimens and optimizing the duration of their administration, which thus prevents the appearance of a new hospital infection and improves the prognosis of the clinical course of the underlying disease.