Enterobacter cloacae cross-colonization in neonates demonstrated by ribotyping

Area of Science:

• Microbiology
• Infectious Diseases
• Hospital Epidemiology

Background:

• Intestinal colonization by Enterobacter cloacae, particularly strains with derepressed cephalosporinase, poses a significant risk in pediatric settings.
• Understanding the transmission dynamics of such resistant bacteria is crucial for infection control.

Purpose of the Study:

• To investigate the prevalence and transmission of Enterobacter cloacae with derepressed cephalosporinase in a pediatric ward.
• To evaluate the efficacy of different typing methods for identifying cross-contamination.

Main Methods:

• Epidemiological study involving environmental and patient (stool, blood) sampling over a 12-month period.
• Bacterial isolates were characterized using antibiotyping, biotyping, and ribotyping (EcoRI and BamHI endonucleases).
• Focus on 36 Enterobacter cloacae isolates from neonates, the neonatal environment, and other wards.

Main Results:

• Fifty-two Enterobacter cloacae isolates were recovered from 200 neonates, and 14 from the ward environment.
• A common antibiotic resistance pattern, including derepressed cephalosporinase and aminoglycoside resistance, was observed in 32 isolates.
• Ribotyping demonstrated a single predominant pattern among 28 isolates, proving to be the most effective method for identifying cross-contamination.

Conclusions:

• Ribotyping is a highly discriminatory method for tracing Enterobacter cloacae transmission within a pediatric ward.
• The findings underscore the potential for cross-contamination of resistant Enterobacter cloacae in healthcare settings.
• Effective infection control strategies are essential to mitigate the spread of multidrug-resistant organisms in neonatal units.