| Summary: | <i>Elizabethkingia</i> species (spp.), which can colonize hospital environments, are emerging nosocomial pathogens presenting high mortality. Due to their intrinsic resistance to a broad range of antibiotics, optimal antibiotic dosage has yet to be determined against infections caused by <i>Elizabethkingia</i> spp. This study aimed to investigate the risk factors for the mortality of infections caused by <i>Elizabethkingia</i> spp. and assess the clinical implications of their antimicrobial susceptibility patterns. Data from 210 patients affected by <i>Elizabethkingia</i>-induced pneumonia and bacteremia between 1 November 2005 and 31 May 2016, were analyzed. Further antimicrobial susceptibility tests for moxifloxacin, rifampin, and vancomycin using <i>Elizabethkingia</i> isolates were performed to compensate for the <i>Elizabethkingia</i> spp. susceptibility panel in patients affected after 2013. The mean age of the patients was 66.5 ± 18 years and the 28-day mortality rate was 25.2% (53/210). In the univariate analysis, history of prior stay in an intensive care unit, central venous catheter use, presented thrombocytopenia, immunocompetent status, a high simplified acute physiology score II (SAPS II score), a high C-reactive protein (CRP)/albumin ratio on the day of isolation and seven days later, and a high minimum inhibitory concentration (MIC) value of rifampin were significantly associated with a higher mortality rate. In the multivariate logistic regression analysis, the MIC values of rifampin (odds ratio (OR): 1.045; 95% confidence interval (CI): 1.006–1.085; <i>p</i> = 0.023), SAPS II score (OR: 1.053; 95% CI: 1.022–1.084; <i>p</i> = 0.001), and initial CRP/albumin ratio (OR: 1.030; 95% CI: 1.009–1.051; <i>p</i> = 0.004) were significantly associated with 28-day mortality. To reduce the mortality associated with <i>Elizabethkingia</i> infections, prediction of the clinical course using initial CRP/albumin ratio and SAPS II and early intervention are essential. Rifampin is a promising candidate as the drug of choice in treating <i>Elizabethkingia</i> infections.
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