Elective distribution of resistance to beta-lactams among Enterobacter cloacae genetic clusters - 15/08/18

Doi : 10.1016/j.jinf.2018.05.005

Simon Garinet ^a, Vincent Fihman ^b, Hervé Jacquier ^c, Stéphane Corvec ^d, Alban Le Monnier ^e, Thomas Guillard ^f, Vincent Cattoir ^g, Jean-Ralph Zahar ^h, Paul-Louis Woerther ⁱ, Etienne Carbonnelle ^j, Alain Wargnier ^k, Solen Kernéis ^l, Philippe C Morand ^m,^⁎
on behalf of the
GMC^ⁿ
Additional members of GMC (Groupe de Microbiologie Clinique) who contributed data are listed at the end of the article.
^a Service de Bactériologie, Hôpitaux Universitaires Paris Centre, site Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
^b Service de Microbiologie-Hygiène, Unité de Bactériologie-Hygiène, Hôpitaux Universitaires Paris Val de Seine, Hôpital Louis-Mourier, Assistance Publique-Hôpitaux de Paris, Paris, France
^c Service de Bactériologie-Virologie, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France
^d Service de Bactériologie-Hygiène hospitalière, Centre Hospitalo-Universitaire de Nantes, Nantes, France
^e Laboratoire de Microbiologie, Centre Hospitalier de Versailles, Le Chesnay, France
^f Laboratoire de Bactériologie-Virologie-Hygiène Hospitalière, Hôpital Robert Debré, CHU de Reims, Reims, France
^g Service de Microbiologie, Centre Hospitalo-Universitaire de Caen; Université de Caen Basse-Normandie, Caen, France
^h Laboratoire de Microbiologie-Hygiène, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
ⁱ Laboratoire de Microbiologie, Institut Gustave Roussy, Villejuif, France
^j Laboratoire de Microbiologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris; Université Paris Descartes, Paris, France
^k Laboratoire de Microbiologie, Hôpital Saint-Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
^l Equipe Mobile d'Infectiologie, Hôpitaux Universitaires Paris Centre, site Cochin, Assistance Publique-Hôpitaux de Paris; Université Paris Descartes, Paris, France
^m Service de Bactériologie, Hôpitaux Universitaires Paris Centre, site Cochin, Assistance Publique-Hôpitaux de Paris; Université Paris Descartes, Paris, France

^⁎Corresponding author.

Highlights

•	“Enterobacter cloacae” clinical isolates belong to different genetic clusters.
•	ESBL expression is selectively distributed among genetic clusters.
•	Rapid identification of genetic clusters would improve the targeting of empirical therapy.

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Summary

Objectives

The Enterobacter cloacae complex (Ecc), routinely referred to as “E. cloacae” in clinical microbiology, encompasses several species with 12 genetic clusters and one sequence crowd that can be identified based on hsp60 sequencing. Little is known about the pathogenicity and distribution of resistance to antibiotics among the Ecc.

Methods and Results

In this prospective multicentre study, a total of 193 Ecc clinical isolates were collected from 10 academic hospitals distributed nationally across France and identified at the genetic cluster level on the basis of hsp60 sequencing. E. hormaechei isolates, which belong to clusters VI-VIII, were the largest group (53%), followed by cluster III that accounted for 28% of clinical isolates. All other Ecc clusters were present except cluster VII (E. hormaechei subsp. hormaechei). Cephalosporinase overproduction and ESBL were significantly more present in E. hormaechei (33% and 20%) than in other clusters (19% and 3%, respectively).

Conclusions

These results suggest that rapid identification of “E. cloacae” at the genetic cluster level could improve adequacy of empirical antibiotic treatment and reduce the unnecessary use of broad spectrum antibiotics.

Le texte complet de cet article est disponible en PDF.

Plan

Introduction

Material and methods

Strain collection and patients

Identification methods

ESBL typing

Statistical analysis

Nucleotide sequence accession numbers

Results

Bacterial isolates characterization

Patients

Clinical isolation sites and association with pathogenicity

Susceptibility to antibiotics

Discussion

Additional members of the GMC (Groupe de Microbiologie Clinique) who contributed data

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Vol 77 - N° 3

P. 178-182 - septembre 2018 Retour au numéro

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Elective distribution of resistance to beta-lactams among Enterobacter cloacae genetic clusters - 15/08/18

Highlights

Summary

Objectives

Methods and Results

Conclusions

Plan

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