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Multidrug-Resistant Enterobacter cloacae Complex Emerging as a Global, Diversifying Threat

Medini K Annavajhala1, Angela Gomez-Simmonds1, Anne-Catrin Uhlemann1

  • 1Division of Infectious Diseases, Department of Medicine, Columbia University, New York, NY, United States.

Frontiers in Microbiology
|February 16, 2019
PubMed

Insights

The Enterobacter cloacae complex (ECC) causes infections, with carbapenem-resistant strains (CREC) posing a growing threat. This review details advances in understanding CREC

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Genomics

Background:

  • The Enterobacter cloacae complex (ECC) comprises significant nosocomial pathogens responsible for diverse infections.
  • Increasing broad-spectrum antibiotic resistance, notably carbapenem resistance, has heightened focus on carbapenem-resistant E. cloacae complex (CREC).

Purpose of the Study:

  • To review recent advancements in the molecular epidemiology of multidrug-resistant ECC.
  • To focus on the global expansion and characteristics of CREC.

Main Methods:

  • Utilized various molecular typing techniques including heat-shock protein sequence, pulsed-field gel electrophoresis, comparative genomic hybridization, and multilocus sequence typing.
  • Employed whole-genome sequencing and comparative genomics for global clonal composition analyses of ECC and CREC.

Main Results:

  • Identified over 1069 ECC sequence types across 18 global phylogenetic clusters.
  • Revealed diverse multidrug-resistant ECC clones and potential epidemic lineages through epidemiological and genomic studies.
  • Highlighted the acquisition of carbapenemase genes as a key mechanism for resistance in CREC.

Conclusions:

  • ECC, particularly CREC, represents a significant and expanding global health challenge due to multidrug resistance.
  • Molecular epidemiology and genomic analyses are crucial for tracking and understanding the spread of resistant strains.
  • The ability of ECC to acquire diverse resistance genes underscores the need for continued surveillance and novel therapeutic strategies.
Keywords:
bacterial genomicscarbapenem-resistant Enterobacter cloacae complexcarbapenem-resistant Enterobacteriaceaecarbapenemasemultidrug-resistance

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