MLST reveals potentially high-risk international clones of Enterobacter cloacae*

作者：Radosław Izdebski, Anna Baraniak, Małgorzata Herda, J. Fiett, Marc J. M. Bonten, Yehuda Carmeli, Herman Goossens, Waleria Hryniewicz, C. Brun‐Buisson, Marek Gniadkowski, on behalf of the MOSAR WP2, WP3 and WP5 study groups, Anna D. Grabowska, E. Nikonorow, Lennie P. G. Derde, Mirjam J. D. Dautzenberg, Amos Adler, Meital Kazma, Shiri Navon‐Venezia, Surbhi Malhotra‐Kumar, Christine Lammens, Uga Dumpis, Helen Giamarellou, Igor Muzlovič, Giuseppe Nardi, George L. Petrikkos, Pascal Stammet, J. Salomon, C. Lawrence, Pierre Legrand, Angelo Rossini, A. Salvia, J. Vidal Samso, J. Fierro, Mical Paul, Yaffa Lerman · 发表于：Journal of Antimicrobial Chemotherapy · 年份：2014 · DOI：10.1093/jac/dku359 · 被引用次数：146 · 研究领域：Antibiotic Resistance in Bacteria、Antimicrobial Resistance in Staphylococcus、Antibiotics Pharmacokinetics and Efficacy

OBJECTIVES: To perform the first multinational Enterobacter cloacae clonality study, using the MLST scheme newly developed in Japan. METHODS: The analysis included 195 rectal carriage E. cloacae isolates resistant to expanded-spectrum cephalosporins (ESCs), collected from patients in 12 hospital units across Europe and Israel. All of the isolates were typed by PFGE and 173 isolates were subjected to MLST. ESC resistance was analysed phenotypically; genes encoding ESBLs and carbapenemases were identified by PCR and sequencing. RESULTS: MLST distinguished 88 STs, which correlated with the PFGE data. PFGE was more discriminatory, producing 129 pulsotypes (169 patterns). Numerous STs were observed in several countries each. The most widespread were ST66, ST78, ST108 and ST114, each having at least 10 isolates from three to five countries, diversified into multiple pulsotypes, with clusters of related isolates in one or more centres. Analysis of the STs against the MLST database revealed several epidemic clonal complexes, such as those with central genotypes ST74 (including ST78) or ST114 (including ST66). ESC resistance was equally related to overexpression of the AmpC cephalosporinase and to ESBL production. Among ESBL producers some spreading subclones were identified, including specific ST66, ST78 and ST114 pulsotypes, associated with CTX-M-15 production. Several isolates produced carbapenemase VIM-1 or KPC-2. CONCLUSIONS: Together with the information available in the MLST da...