DOI: 10.1101/494807Dec 12, 2018Paper

Molecular epidemiology of carbapenem-resistant Enterobacter cloacae complex infections uncovers high frequency of non-carbapenemase-producers in five tertiary care hospitals from Colombia

BioRxiv : the Preprint Server for Biology
Astrid Cienfuegos-GalletJ Natalia Jiménez

Abstract

Background. Infections caused by carbapenem-resistant Enterobacter cloacae (CR-Ecl) have been increasingly reported in the clinical setting; here we describe the clinical and molecular characteristics of CR-Ecl infections in a KPC endemic region. Methods. A cross-sectional study was conducted in five tertiary-care hospitals in Medellín-Colombia. All patients infected by CR-Ecl from June-2012 to June-2014 were included. Sociodemographics and clinical information was retrieved from medical records. Antimicrobial susceptibility testing, phenotypic and molecular carbapenemase detection were performed. Analysis of hsp60 and PFGE was done in a subset of isolates. Results. Of 109 patients enrolled, 60.55% (66/109) were infected with non-carbapenemase-producing-Ecl (non-CP-Ecl). CP-Ecl patients were frequently hospitalized in the ICU (37.21% vs 12.12%) and had exposure to carbapenems (39.53% vs 15.15%) compared to non-CP-Ecl infected patients. All-cause 30-day mortality was higher in CP-Ecl than non-CP-Ecl infected patients (27.91% vs 19.70%). CP-Ecl harbored KPC-2 (83.72%) and KPC-3 (6.97%). Analysis of hsp60 showed that CP-Ecl belonged primarily to cluster-VI of Enterobacter xiangfangensis (12/34) and cluster-XI (12/34) corresponding...Continue Reading

Related Concepts

Carbapenems
Cross-Sectional Studies
Gene Clusters
Intensive Care Unit
Electrophoresis, Gel, Pulsed-Field
Clotting Factor XI Assay
Molecular Epidemiology
Carbapenemase
Enterobacter hormaechei
Resistance to Infection

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