Genomic Investigation of a Putative Endoscope-Associated Carbapenem-Resistant Enterobacter cloacae Outbreak Reveals a Wide Diversity of Circulating Strains and Resistance Mutations

Clin Infect Dis. 2018 Jan 18;66(3):460-463. doi: 10.1093/cid/cix934.

Abstract

A genomic epidemiologic investigation of a putative carbapenem-resistant Enterobacter cloacae outbreak revealed few plausible instances of nosocomial transmission, highlighting instead the frequent importation of E. cloacae into our hospital. Searching for genetic determinants of carbapenem resistance demonstrated that most resistance is due to convergent mutations in phylogenetically diverse E. cloacae.

Keywords: CRE; Enterobacter cloacae; carbapenem resistance; genomic epidemiology; healthcare-associated infection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Bacterial Proteins / genetics
  • Bacterial Typing Techniques
  • Carbapenem-Resistant Enterobacteriaceae / drug effects
  • Carbapenem-Resistant Enterobacteriaceae / genetics
  • Carbapenems / pharmacology*
  • Cross Infection / etiology
  • Cross Infection / microbiology
  • Disease Outbreaks*
  • Drug Resistance, Bacterial / genetics*
  • Endoscopy / adverse effects*
  • Enterobacter cloacae / drug effects*
  • Enterobacter cloacae / genetics*
  • Enterobacteriaceae Infections / etiology
  • Enterobacteriaceae Infections / transmission
  • Equipment Contamination
  • Genetic Variation
  • Genomics
  • Humans
  • Microbial Sensitivity Tests
  • Multilocus Sequence Typing
  • Mutation
  • beta-Lactamases / biosynthesis
  • beta-Lactamases / genetics

Substances

  • Anti-Bacterial Agents
  • Bacterial Proteins
  • Carbapenems
  • beta-Lactamases