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Most Enterobacter aerogenes strains in France belong to a prevalent clone
C Bosi1, A Davin-Regli, C Bornet
1Enveloppe Bactérienne, Antibiotiques et Colonisation, CJF 96-06 INSERM, Faculté de Médecine, Université de la Mediterranée, 13385 Marseille Cedex 05, France.
Abstract:
The aim of this study was to determine the distribution in France of the Enterobacter aerogenes prevalent clone isolated in the hospitals of the Marseille area (A. Davin-Regli, D. Monnet, P. Saux, C. Bosi, R. Charrel, A. Barthelemy, and C. Bollet, J. Clin. Microbiol. 34:1474-1480, 1996). A total of 123 E. aerogenes isolates were collected from 23 hospital laboratories and analyzed by random amplification of polymorphic DNA and enterobacterial repetitive intergenic consensus-PCR to determine their epidemiological relatedness. Molecular typing revealed that 21 of the 23 laboratories had isolated this prevalent clone harboring the plasmid encoding for extended-spectrum beta-lactamase of the TEM-24 type. Most isolates were susceptible only to imipenem and gentamicin. Their dissemination seems to be clonal and was probably the result of the general use of broad-spectrum cephalosporins and quinolones. Four isolates showed an alteration of their outer membrane proteins, causing decrease of susceptibility to third-generation cephalosporins and imipenem and leading to the critical situation of having no alternative therapeutic. The large dissemination of the E. aerogenes prevalent clone probably results from its good adaptation to the antibiotics administered in France and the hospital environment, particularly in intensive care units.
Insights
A prevalent clone of Enterobacter aerogenes, resistant to most antibiotics, has spread throughout French hospitals. This dissemination is linked to antibiotic use and poses a critical therapeutic challenge.
Area of Science:
- Microbiology
- Epidemiology
- Infectious Diseases
Background:
- Enterobacter aerogenes is an opportunistic pathogen frequently isolated from hospital environments.
- The emergence of antibiotic resistance in E. aerogenes poses a significant threat to patient care.
Purpose of the Study:
- To investigate the national distribution of a specific Enterobacter aerogenes clone prevalent in the Marseille area.
- To determine the molecular relatedness and antibiotic resistance profiles of this prevalent clone across France.
Main Methods:
- Collection of 123 E. aerogenes isolates from 23 French hospital laboratories.
- Molecular typing using random amplification of polymorphic DNA (RAPD) and enterobacterial repetitive intergenic consensus-PCR (ERIC-PCR).
- Antimicrobial susceptibility testing, focusing on resistance to beta-lactams and other common antibiotics.
Main Results:
- The prevalent E. aerogenes clone was identified in 21 out of 23 laboratories surveyed.
- This clone frequently harbored a plasmid encoding for TEM-24 extended-spectrum beta-lactamase (ESBL).
- Most isolates exhibited resistance to multiple antibiotics, with susceptibility limited to imipenem and gentamicin; four isolates showed reduced susceptibility to carbapenems and third-generation cephalosporins due to outer membrane protein alterations.
Conclusions:
- The clonal dissemination of this multidrug-resistant E. aerogenes clone across France is significant.
- The spread is likely driven by the widespread use of broad-spectrum cephalosporins and quinolones.
- The clone's adaptation to the hospital environment and antibiotic pressure contributes to its prevalence, highlighting a critical therapeutic challenge, especially in intensive care units.