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Assessment of Intestinal Transcytosis of Neonatal Escherichia coli Bacteremia Isolates
08:32

Assessment of Intestinal Transcytosis of Neonatal Escherichia coli Bacteremia Isolates

Published on: February 17, 2023

Emergence of VIM-4- and SHV-12-producing Enterobacter cloacae in a neonatal intensive care unit

Emese Juhász1, Laura Jánvári, Akos Tóth

  • 1Semmelweis University, Institute of Laboratory Medicine, Diagnostic Laboratory of Clinical Microbiology, Nagyvárad Tér 4, Budapest, 1089, Hungary.

International Journal of Medical Microbiology : IJMM
|June 23, 2012
PubMed

Insights

Multidrug-resistant Enterobacter cloacae, producing VIM-4 metallo-beta-lactamase and SHV-12 extended-spectrum beta-lactamase, emerged in a neonatal intensive care unit. Active surveillance and molecular epidemiology are crucial for infection control in NICUs.

Area of Science:

  • Medical Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Routine screening for multidrug-resistant bacteria in neonatal intensive care units (NICUs) is essential for early detection.
  • Emergence of multidrug-resistant Enterobacter cloacae with suspected clonal transmission prompted active surveillance.

Purpose of the Study:

  • To characterize 60 Enterobacter cloacae isolates from a 7-month period in 2010.
  • To investigate antibiotic resistance mechanisms, including extended-spectrum beta-lactamase (ESBL) and carbapenemase production.
  • To determine the clonal relationship among the isolates.

Main Methods:

  • Antibiotic susceptibility testing (MIC values) and phenotypic testing for ESBL and carbapenemase production.
  • Molecular characterization of Metallo-beta-lactamase (MBL) genes, ESBL genes, and class-1 integrons.
  • Pulsed-field gel electrophoresis (PFGE) for assessing clonal relatedness.

Main Results:

  • All 60 Enterobacter cloacae isolates from 16 neonates were VIM-4 MBL producers.
  • Fifty-three isolates also produced SHV-12 ESBL.
  • The bla(VIM-4) gene was consistently associated with the In238a class-1 integron.
  • PFGE revealed identical genetic patterns, indicating clonal transmission.

Conclusions:

  • Active microbiological surveillance and molecular epidemiology are vital components of infection control strategies in NICUs.
  • The study highlights the successful implementation of surveillance in identifying and characterizing a multidrug-resistant Enterobacter cloacae outbreak.

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