Molecular epidemiology of an outbreak of multidrug-resistant Enterobacter aerogenes infections and in vivo emergence of imipenem resistance.

Journal of Clinical Microbiology
Y De GheldreM J Struelens

Abstract

Molecular typing was used to investigate an outbreak of infection caused by multidrug-resistant Enterobacter aerogenes (MREA) susceptible only to gentamicin and imipenem in an intensive care unit (ICU). Over a 9-month period, ciprofloxacin-resistant E. aerogenes isolates were isolated from 34 patients, or 4.1% of ICU admissions, compared with a baseline rate of 0.1% in the previous period (P < 0.001). Infection developed in 15 (44%) patients. In vivo emergence of imipenem resistance (MIC, 32 micrograms/ml) of organisms causing deep-seated infection was observed in two (13%) of these patients following prolonged therapy with imipenem and gentamicin. Arbitrarily primed PCR (AP-PCR) analysis with ERIC1R and ERIC2 primers and pulsed-field gel electrophoresis (PFGE) analysis of XbaI macrorestriction patterns concordantly showed that outbreak-associated MREA isolates were clonally related and distinct from epidemiologically unrelated strains. AP-PCR and PFGE showed discrimination indices of 0.88 and 0.98, respectively. Space-time clustering of cases within units suggests that the epidemic-related MREA isolates were transmitted on the hands of the health care personnel. A case-control study and repeated environmental culture surveys f...Continue Reading

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Citations

Aug 21, 2002·Infection Control and Hospital Epidemiology : the Official Journal of the Society of Hospital Epidemiologists of America·Michael PiagnerelliDanielle Govaerts
May 25, 2004·Antimicrobial Agents and Chemotherapy·Charléric BornetJean-Marie Pagès
Apr 1, 2000·Revista Do Instituto De Medicina Tropical De São Paulo·C R GonçalvesK Irino
Apr 2, 2002·Expert Opinion on Investigational Drugs·Francesco BlasiPaolo Tarsia
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Feb 24, 2001·Pediatrics International : Official Journal of the Japan Pediatric Society·S OanaY Kohno
Jan 17, 2007·The Journal of Antimicrobial Chemotherapy·Pierre BogaertsYouri Glupczynski
Jun 5, 2015·Frontiers in Microbiology·Anne Davin-Regli, Jean-Marie Pagès
Jul 12, 2003·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Stephen ParodiDavid Pegues
Dec 18, 2020·Frontiers in Microbiology·Hans Rudolf PfaendlerHeike Freidank
Jul 19, 2019·Clinical Microbiology Reviews·Anne Davin-RegliJean-Marie Pagès
Dec 3, 1999·Biochemical and Biophysical Research Communications·J ChevalierM Malléa
Aug 26, 1998·International Journal of Antimicrobial Agents·H BujdákováM Kettner
Jun 11, 2002·Biochemical and Biophysical Research Communications·Monique MalléaJean-Marie Pagès
Jul 3, 1998·Journal of Clinical Microbiology·S JalaluddinJ P Butzler
Mar 7, 2001·Journal of Clinical Microbiology·Y De GheldreUNKNOWN Groupement pour le Dépistage, l'Etude et la Prevention des Infections Hospitalières (GDEPIH-GOSPIZ)
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Mar 4, 2000·Journal of Clinical Microbiology·C BornetC Bollet

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