title: Clonal spread and accumulation of β-lactam resistance determinants in Enterobacter aerogenes and Enterobacter cloacae complex isolates from infection and colonization in patients at a public hospital in Recife, Pernambuco, Brazil.
abstract: Enterobacter aerogenes and Enterobacter cloacae complex are the two species of this genus most involved in healthcare-associated infections that are ESBL and carbapenemase producers. This study characterized, phenotypically and genotypically, 51 isolates of E. aerogenes and E. cloacae complex originating from infection or colonization in patients admitted to a public hospital in Recife, Pernambuco, Brazil, by antimicrobial susceptibility profile, analysis of β-lactamase genes (blaTEM, blaSHV, blaCTX-M, blaKPC, blaVIM, blaIMP and blaSPM), PCR and DNA sequencing, plasmid profile and ERIC-PCR. In both species, the genes blaTEM, blaCTX-M and blaKPC were detected. The DNA sequencing confirmed the variants blaTEM-1, blaCTX-M-15 and blaKPC-2 in isolates. More than one gene conferring resistance in the isolates, including the detection of the three previously cited genes in strains isolated from infection sites, was observed. The detection of blaCTX-M was more frequent in isolates from infection sites than from colonization. The gene blaKPC predominated in E. cloacae complex isolates obtained from infections; however, in E. aerogenes isolates, it predominated in samples obtained from colonization. A clonal relationship among all of E. aerogenes isolates was detected by ERIC-PCR. The majority of E. cloacae complex isolates presented the same ERIC-PCR pattern. Despite the clonal relation presented by the isolates using ERIC-PCR, different plasmid and resistance profiles and several resistance genes were observed. The clonal dissemination and the accumulation of β-lactam resistance determinants presented by the isolates demonstrated the ability of E. aerogenes and E. cloacae complex, obtained from colonization and infection, to acquire and maintain different resistance genes.
authors.affiliation: Universidade Estadual de Ciências da Saúde de Alagoas-UNCISAL, Maceió, Alagoas 57010-300, Brazil.|Universidade Federal de Pernambuco-UFPE, Recife, Pernambuco 50732-970, Brazil.
authors.forename: Adriane Borges
authors.initials: AB
authors.lastname: Cabral
authors.affiliation: Universidade Federal de Pernambuco-UFPE, Recife, Pernambuco 50732-970, Brazil.
authors.forename: Maria Amélia Vieira
authors.initials: MAV
authors.lastname: Maciel
authors.affiliation: Hospital Agamenom Magalhães, Recife, Pernambuco 52070-230, Brazil.
authors.forename: Josineide Ferreira
authors.initials: JF
authors.lastname: Barros
authors.affiliation: Hospital Agamenom Magalhães, Recife, Pernambuco 52070-230, Brazil.
authors.forename: Marcelo Maranhão
authors.initials: MM
authors.lastname: Antunes
authors.affiliation: Universidade Federal de Pernambuco-UFPE, Recife, Pernambuco 50732-970, Brazil.
authors.forename: Célia Maria Machado
authors.initials: CMM
authors.lastname: Barbosa de Castro
authors.affiliation: Universidade Federal de Pernambuco-UFPE, Recife, Pernambuco 50732-970, Brazil.
authors.forename: Ana Catarina Souza
authors.initials: ACS
authors.lastname: Lopes
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics*; D015373:Bacterial Typing Techniques; D001938:Brazil; D003428:Cross Infection / Q000188:drug therapy / Q000382:microbiology; D004269:DNA, Bacterial / Q000235:genetics; D021902:Enterobacter aerogenes / Q000187:drug effects / Q000235:genetics*; D016972:Enterobacter cloacae / Q000187:drug effects / Q000235:genetics*; D006779:Hospitals, Public; D006801:Humans; D008826:Microbial Sensitivity Tests; D017422:Sequence Analysis, DNA; D018440:beta-Lactam Resistance / Q000235:genetics*; D001618:beta-Lactamases / Q000235:genetics; D047090:beta-Lactams / Q000494:pharmacology*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D004269:DNA, Bacterial; D047090:beta-Lactams; D001618:beta-Lactamases; C063912:carbapenemase