Long-Term, Low-Frequency Cluster of a German-Imipenemase-1-Producing Enterobacter hormaechei ssp. steigerwaltii ST89 in a Tertiary Care Hospital in Germany

Microbial Drug Resistance : MDR : Mechanisms, Epidemiology, and Disease
Andreas F WendelColin R MacKenzie

Abstract

Enterobacter cloacae complex is a common cause of hospital outbreaks. A retrospective and prospective molecular analysis of carbapenem-resistant clinical isolates in a tertiary care center demonstrated an outbreak of a German-imipenemase-1 (GIM-1) metallo-beta-lactamase-producing Enterobacter hormaechei ssp. steigerwaltii affecting 23 patients between 2009 and 2016. Thirty-three isolates were sequence type 89 by conventional multilocus sequence typing (MLST) and displayed a maximum difference of 49 out of 3,643 targets in the ad-hoc core-genome MLST (cgMLST) scheme (SeqSphere+ software; Ridom, Münster, Germany). The relatedness of all isolates was confirmed by further maximum-likelihood phylogeny. One clonal complex of highly related isolates (≤15 allele difference in cgMLST) contained 17 patients, but epidemiological data only suggested five transmission events. The blaGIM-1-gene was embedded in a class-1-integron (In770) and the Tn21-subgroup transposon Tn6216 (KC511628) on a 25-kb plasmid. Environmental screening detected one colonized sink trap in a service room. The outbreak was self-limited as no further blaGIM-1-positive E. hormaechei has been isolated since 2016. Routine molecular screening of carbapenem-nonsusceptible ...Continue Reading

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Citations

Jul 19, 2019·Clinical Microbiology Reviews·Anne Davin-RegliJean-Marie Pagès
Feb 29, 2020·Infection and Drug Resistance·Jian-Jun GouBei-Wen Zheng

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Datasets Mentioned

BETA
CP017179.1
CP012167.1
CP010376.2
CP012169.1
CP010386.1
CP10382.1
CP012168.1
CP010374.1
CP012170.1
CP010375.2

Methods Mentioned

BETA
PCR
electrophoresis
Assay

Software Mentioned

FigTree
FastQC
wgMLST
RAxML
SeqSphere
Qubit
Ridom SeqSphere +
PlasmidFinder
NanoDrop
CLC Genomics Workbench

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