The dissemination of multidrug-resistant Enterobacter cloacae throughout the UK and Ireland.
Enterobacter cloacae is a clinically important Gram-negative member of the Enterobacteriaceae, which has increasingly been recognized as a major pathogen in nosocomial infections. Despite this, knowledge about the population structure and the distribution of virulence factors and antibiotic-resistance determinants of this species is scarce. In this study, we analysed a systematic collection of multidrug-resistant E. cloacae isolated between 2001 and 2011 from bloodstream infections across hospitals in the UK and Ireland. We found that the population is characterized by the presence of multiple clones formed at widely different time periods in the past. The clones exhibit a high degree of geographical heterogeneity, which indicates extensive dissemination of these E. cloacae clones across the UK and Ireland. These findings suggest that a diverse, community-based, commensal population underlies multidrug-resistant E. cloacae infections within hospitals.
Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK.
Danesh
D
Moradigaravand
Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK.
Sandra
S
Reuter
British Society for Antimicrobial Chemotherapy, Griffin House, 53 Regent Place, Birmingham B1 3NJ, UK.
Veronique
V
Martin
Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK.|Department of Medicine, University of Cambridge, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK.|London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK.
Sharon J
SJ
Peacock
Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK.
Julian
http://orcid.org/0000-0002-7069-5958
J
Parkhill
PLoS Genet. 2015 Jul 31;11(7):e1005413
26230489
Antimicrob Agents Chemother. 2008 Jul;52(7):2449-54
18458126
Clin Microbiol Rev. 1997 Apr;10(2):220-41
9105752
Bioinformatics. 2015 Nov 15;31(22):3691-3
26198102
J Hosp Infect. 2001 Nov;49(3):173-82
11716634
J Hosp Infect. 2016 Jun;93(2):145-51
27107615
PLoS One. 2010 Mar 10;5(3):e9490
20224823
J Antimicrob Chemother. 2015 Jan;70(1):48-56
25216820
J Hosp Infect. 1993 Apr;23(4):287-97
8099928
Future Microbiol. 2012 Jul;7(7):887-902
22827309
Bioinformatics. 2014 Jul 15;30(14):2068-9
24642063
JPEN J Parenter Enteral Nutr. 1991 Jul-Aug;15(4):474-5
1910114
Science. 2010 Jan 22;327(5964):469-74
20093474
Can J Microbiol. 1997 Aug;43(8):729-33
9304783
Genome Res. 2008 May;18(5):821-9
18349386
BMC Bioinformatics. 2007 Nov 22;8:460
18034891
Chemosphere. 2010 Aug;80(8):951-6
20537678
Bioinformatics. 2009 Aug 15;25(16):2078-9
19505943
J Bacteriol. 2010 May;192(9):2463-4
20207761
Bioinformatics. 2014 May 1;30(9):1312-3
24451623
Bioinformatics. 2011 Nov 1;27(21):3070-1
21926124
Clin Infect Dis. 2000 Jan;30(1):35-40
10619730
Am J Infect Control. 2014 Apr;42(4):456-8
24679578
Appl Environ Microbiol. 2003 Sep;69(9):5306-18
12957918
ISME J. 2016 Mar;10(3):707-20
26359913
J Hosp Infect. 2008 Sep;70(1):7-14
18632183
Genome Med. 2014 Nov 20;6(11):90
25422674
Nucleic Acids Res. 2015 Feb 18;43(3):e15
25414349
Clin Microbiol Infect. 2012 Mar;18(3):268-81
21793988
J Hosp Infect. 1989 Nov;14(4):277-84
2575626
Mol Cell Probes. 2003 Feb;17(1):25-32
12628591
Heredity (Edinb). 2011 Feb;106(2):383-90
20551981
Genome Biol. 2014 Mar 03;15(3):R46
24580807
BMC Evol Biol. 2007 Nov 08;7:214
17996036
J Bacteriol. 2012 Nov;194(21):5965
23045485
Microb Genom. 2016 Aug 25;2(8):e000083
28348874
Genome Announc. 2016 May 12;4(3):null
27174279
Int J Microbiol. 2016;2016:4292417
26989419
Genome Announc. 2015 Aug 06;3(4):null
26251488
Front Microbiol. 2015 May 18;6:392
26042091
Euro Surveill. 2013 Aug 01;18(31):null
23929228
PLoS One. 2013 Jun 11;8(6):e66358
23776664