Clonal spread and accumulation of β-lactam resistance determinants in Enterobacter aerogenes and Enterobacter cloacae complex isolates from infection and colonization in patients at a public hospital in Recife, Pernambuco, Brazil
Cabral, Adriane Borges and Maciel, Maria Amélia Vieira and Barros, Josineide Ferreira and Antunes, Marcelo Maranhão and Barbosa de Castro, Célia Maria Machado and Lopes, Ana Catarina Souza,, 66, 70-77 (2017),
doi = https://doi.org/10.1099/jmm.0.000398,
publicationName = Microbiology Society,
issn = 0022-2615,
abstract= Enterobacter aerogenes and Enterobacter cloacae complex are the two species of this genus most involved in healthcare-associated infections that are ESBL and carbapenemase producers. This study characterized, phenotypically and genotypically, 51 isolates of E. aerogenes and E. cloacae complex originating from infection or colonization in patients admitted to a public hospital in Recife, Pernambuco, Brazil, by antimicrobial susceptibility profile, analysis of β-lactamase genes (bla TEM, bla SHV, bla CTX-M, bla KPC, bla VIM, bla IMP and bla SPM), PCR and DNA sequencing, plasmid profile and ERIC-PCR. In both species, the genes bla TEM, bla CTX-M and bla KPC were detected. The DNA sequencing confirmed the variants bla TEM-1, bla CTX-M-15 and bla KPC-2 in isolates. More than one gene conferring resistance in the isolates, including the detection of the three previously cited genes in strains isolated from infection sites, was observed. The detection of bla CTX-M was more frequent in isolates from infection sites than from colonization. The gene bla KPC predominated in E. cloacae complex isolates obtained from infections; however, in E. aerogenes isolates, it predominated in samples obtained from colonization. A clonal relationship among all of E. aerogenes isolates was detected by ERIC-PCR. The majority of E. cloacae complex isolates presented the same ERIC-PCR pattern. Despite the clonal relation presented by the isolates using ERIC-PCR, different plasmid and resistance profiles and several resistance genes were observed. The clonal dissemination and the accumulation of β-lactam resistance determinants presented by the isolates demonstrated the ability of E. aerogenes and E. cloacae complex, obtained from colonization and infection, to acquire and maintain different resistance genes.,
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