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Unlike  Elizabethkingia meningoseptica , the clinical importance of  E. anophelis  is poorly understood. We determined the clinical and molecular epidemiology of bacteremia caused by  Elizabethkingia- like species from five regional hospitals in Hong Kong. Among 45 episodes of  Elizabethkingia -like bacteremia, 21 were caused by  Elizabethkingia , including 17  E. anophelis , three  E. meningoseptica  and one  E. miricola ; while 24 were caused by other diverse genera/species, as determined by 16S rRNA gene sequencing. Of the 17 cases of  E. anophelis  bacteremia, 15 (88%) were clinically significant. The most common diagnosis was pneumonia (n = 5), followed by catheter-related bacteremia (n = 4), neonatal meningitis (n = 3), nosocomial bacteremia (n = 2) and neutropenic fever (n = 1).  E. anophelis  bacteremia was commonly associated with complications and carried 23.5% mortality. In contrast, of the 24 episodes of bacteremia due to non- Elizabethkingia  species, 16 (67%) were clinically insignificant. Compared to non- Elizabethkingia  bacteremia,  Elizabethkingia  bacteremia was associated with more clinically significant infections ( P  < 0.01) and positive cultures from other sites ( P  < 0.01), less polymicrobial bacteremia ( P  < 0.01), and higher complication ( P  < 0.05) and mortality ( P  < 0.05) rates.  Elizabethkingia  bacteremia is predominantly caused by  E. anophelis  instead of  E. meningoseptica .  Elizabethkingia  bacteremia, especially due to  E. anophelis , carries significant morbidity and mortality, and should be considered clinically significant unless proven otherwise.

Elizabethkingia anophelis bacteremia is associated with clinically significant infections and high mortality