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
Summary
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.
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