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PubMed1979

Bacteremia associated with Enterobacter sakazakii (yellow, pigmented Enterobacter cloacae).

A case report of bacteremia due to Enterobacter sakazakii, listed previously as yellow-pigmented Enterobacter cloacae (R. Sakazaki, in R. E. Buchanan and N. E. Gibbons, ed., Bergey's Manual of Determinative Bacteriology, 8th ed., p. 325, 1974), occurred in a 7-day-old, Caucasian male who responded successfully to ampicillin therapy. The source of the infection was not known; however, because of the time lapse between birth and the onset of symptoms, the infection was thought to have occurred postnatally.

Ampicillin↗
PubMed2004

Identification and phylogeny of Enterobacter sakazakii relative to Enterobacter and Citrobacter Species.

The phylogenetic relationships of Enterobacter sakazakii strains were investigated using 16S ribosomal DNA (rDNA) and hsp60 sequencing. Each analysis distributed E. sakazakii strains among four clusters, indicating substantial taxonomic heterogeneity. The E. sakazakii type strain 16S rDNA sequence was 97.8% similar to that of Citrobacter koseri but 97.0% similar to that of Enterobacter cloacae.

Chaperonin 60↗
PubMed1984

Enterobacter sakazakii: a tween 80 esterase-positive representative of the genus Enterobacter isolated from powdered milk specimens.

Enterobacter sakazakii is the new species name introduced in 1977 for yellow-pigmented strains originally designated as yellow Enterobacter cloacae. All of the six E.sakazakii strains isolated from powdered milk specimens were found to produce Tween 80 esterase after 7 days of incubation at 25 degrees C and 37 degrees C. From E.cloacae it is distinguishable by reactions in four, or even three, biochemical tests, i.e. by production of yellow pigment, positive production of Tween 80 esterase and by non-fermentation of sorbite and mucate; from the Serratia species it can be differentiated by the negative test for lecithinase production.

Animals↗
PubMed1998

Isolation and Identification of Two l-Azetidine-2-carboxylic Acid-Degrading Soil Microorganisms, Enterobacter agglomerans and Enterobacter amnigenus

Soil samples collected at several times during the growing season and at different locations within Convallaria majalis beds in Ann Arbor, MI, were screened for their ability to grow with the cyclic amino acid, l-azetidine-2-carboxylic acid (l-A-2-C), as their sole nitrogen source (i.e., metabolize l-A-2-C). Two different soil microorganisms were isolated, characterized, and identified using fundamental selection methods, the standard battery of biochemical characterization tests, and scanning electron microscopy. The assignment of the identity of these organisms as Enterobacter agglomerans and Enterobacter amnigenus was further verified by comparison with authentic microbial samples obtained from ATCC that were able to utilize l-A-2-C as their sole nitrogen source.

Journal Article↗
PubMed1997

Enterobacter cancerogenus ("Enterobacter taylorae") infections associated with severe trauma or crush injuries.

Five cases of Enterobacter cancerogenus infections (wound, n = 4; bacteremia, n = 1) in adults are described. All infections seemed to be community acquired and occurred after precipitating events such as multiple trauma to the head or severe crush injuries. All five strains of E cancerogenus were recovered in pure culture, and three of these were isolated on multiple occasions. The results indicate that E cancerogenus can cause wound infections and septicemia in persons environmentally exposed to these organisms during traumatic events.

Adolescent↗
PubMed1986

Comparative in vitro susceptibilities of eight Enterobacter species, with special reference to Enterobacter sakazakii.

An agar dilution method was used to measure the MICs of 29 antimicrobial agents against Enterobacter sakazakii, E. cloacae, E. aerogenes, E. agglomerans, E. amnigenus, E. gergoviae, E. intermedium, and E. taylorae (formerly Enteric Group 19). E. sakazakii was the most susceptible species. Results showing resistance to ampicillin are likely to exclude E. sakazakii.

Ampicillin↗
PubMed1980

Nosocomial spread of gentamicin-tobramycin resistance in hospital strains of Pseudomonas aeruginosa and Enterobacter sp. origin, development and transfer of R plasmids from pseudomonas to enterobacter.

In the Medical Centre of the University of Bratislava the period between 1975 and 1976 was studied with regard to a rather limited use of Gentamicin (GEN) which was then followed by a period of excessive administration thereof due to a change in the availability of the antibiotic. As a consequence, GEN-resistant (GENR) Pseudomonas appeared in two medical wards, which resistance however, was non-transmissible. A few month later, however, transfer of GENR was demonstrated as a co-transfer with other types of resistance. For the first time in 1979 strains of P. aeruginosa transferring GENR directly appeared as rather individual, dispersed strains. Later in 1979, clustered outbreaks of hospital infections caused by GENR Entrobacter sp. transferring GENR appeared as single as well as mixed infections. Interspecies transfer from P. aeruginosa to Enterobacteriaceae, and vice versa, was demonstrated in vitro. Identity or close similarity of enzyme patterns inactivating aminoglycoside antibiotics in P. aeruginosa and Enterobacter suggest that genes for GENR could be transposed from P. aeruginosa under the massive selective pressure of GEN.

Anti-Bacterial Agents↗
PubMed2006

Cloning and sequencing of the ompA gene of Enterobacter sakazakii and development of an ompA-targeted PCR for rapid detection of Enterobacter sakazakii in infant formula.

Enterobacter sakazakii is an emerging, infant formula-borne pathogen that causes severe meningitis, meningoencephalitis, sepsis, and necrotizing enterocolitis in neonates and infants, with a high fatality rate. Traditional detection methods take up to 7 days to identify E. sakazakii. The outer membrane protein A gene (ompA), along with its flanking sequences from E. sakazakii (ATCC 51329), was cloned in the pGEM-T Easy vector and sequenced. Comparison of the nucleotide and deduced amino acid sequences of the ompA gene with other sequences available in the GenBank database revealed a high degree of homology with ompA genes of other gram-negative bacteria belonging to the Enterobacteriaceae. Based on regions of the ompA gene unique to E. sakazakii, two primers were synthesized to develop and optimize an E. sakazakii-specific PCR. The PCR amplified a 469-bp DNA product from all E. sakazakii strains tested but not from other bacteria. Experiments to determine the sensitivity of the PCR indicated that it could detect as few as 10(3) CFU/ml of E. sakazakii bacteria in infant formula directly and 10(-1) CFU/ml after an 8-h enrichment step. We conclude that this PCR, combined with enrichment culturing, has the potential to be used as a rapid tool for detecting the presence of E. sakazakii in infant formula.

Amino Acid Sequence↗
PubMed2005

Enterobacter meningitis: organism susceptibilities, antimicrobial therapy and related outcomes.

BACKGROUND: Meningitis due to Enterobacter species is an uncommon infection in adults; however, when present, treatment is frequently complicated by resistance of many Enterobacter isolates to third-generation cephalosporins and poor central nervous system penetration of other antibiotics. The aim of this study was to retrospectively review cases of meningitis caused by Enterobacter species at our institution, to better characterize patient factors, pathogen characteristics, and treatment options for this infection. METHODS: We reviewed all cases of Enterobacter meningitis in a 12-year period at a tertiary care center. Data collected included patient demographics, antibiotic sensitivities of Enterobacter isolates, antimicrobial therapy, and patient outcomes. RESULTS: Nineteen cases were identified, primarily in patients with neurotrauma and in neurosurgical patients. Enterobacter cloacae was the most frequent Enterobacter species isolated followed by Enterobacter aerogenes and Enterobacter agglomerans (50%, 34%, and 16% of cultures, respectively). Overall, clinical cure/improvement was achieved in 47% of patients, and the mortality rate was 21%. Antibiotic treatment varied substantially and included third-generation cephalosporins, intravenous and intrathecal aminoglycosides, trimethoprim-sulfamethoxazole (TMP-SMX), piperacillin, ciprofloxacin, and other miscellaneous antibiotics. Treatment with TMP-SMX was associated with a high rate of clinical cure/improvement, whereas third-generation cephalosporins were less efficacious. CONCLUSIONS: Enterobacter meningitis is an infrequent complication of neurological insult. Treatment is often complicated by resistance of Enterobacter species to third-generation cephalosporins. Our results indicate that while third-generation cephalosporins are not the most appropriate choice of agents to treat Enterobacter meningitis, TMP-SMX may yield satisfactory results.

Adult↗
PubMedDate not supplied

Adult Enterobacter meningitis: a high incidence of coinfection with other pathogens and frequent association with neurosurgical procedures.

BACKGROUND: The clinical characteristics of Enterobacter infection in adult bacterial meningitis were defined. PATIENTS AND METHODS: The clinical manifestations and therapeutic outcomes of ten adult patients with Enterobacter infections in acute bacterial meningitis were analyzed. RESULTS: Enterobacter infection was found in 4.5% (10/223) of our adult patients with culture-proven bacterial meningitis. The ten patients comprised seven men and three women aged between 16-69 years (mean 47 years). Coinfections with other pathogens were found in 50% of the cases, the most common pathogen being Klebsiella pneumoniae. Nine of the ten patients had a history of neurosurgery, and seven patients contracted the infection nosocomially. Multiple antibiotic-resistant strains, including resistance to third-generation cephalosporins, were found in three patients with polymicrobial infections. These three patients received iv imipenem/cilastin therapy. The therapeutic results showed that two of the ten patients died; five of the eight surviving patients had neurological sequelae. CONCLUSION: The predominant coinfection with Enterobacteriaceae in adult Enterobacter meningitis may reflect the fact that most of the cases of polymicrobial Enterobacter infections have a potential gastrointestinal source. A postneurosurgical state was the most important predisposing factor for the development of Enterobacter infection in adult bacterial meningitis in our patients. The strains of the Enterobacter species in adult polymicrobial Enterobacter meningitis were commonly resistant to multiple antibiotics, including third-generation cephalosporins. In light of the high incidence of multiple antibiotic-resistant Enterobacter strains in adult polymicrobial Enterobacter meningitis, the choice of initial empiric antibiotics may include carbapenem (imipenem/cilastin or meropenem). Although the mortality rate was not high in this group of patients, most survivors suffered neurological sequelae.

Acute Disease↗
PubMed1992

Retrospective 6-year study of enterobacter bacteraemia in a Danish university hospital.

In order to study the epidemiology of invasive enterobacter infections, data from 53 consecutive cases of bacteraemia due to this organism were compared with data from 72 randomly selected cases of Escherichia coli bacteraemia. The cases occurred among patients admitted to a Danish University hospital over a 6-year period. Forty-eight cases were due to Enterobacter cloacae and five were due to Ent. aerogenes. Enterobacter bacteraemia was more often of nosocomial origin than E. coli bacteraemia and more often polymicrobial. Patients suffering from enterobacter bacteraemia were younger than E. coli patients, and males tended to predominate. Apart from cancer of the prostate, other malignant diseases tended to be more frequent among patients with enterobacter bacteraemia than among E. coli patients. Enterobacter bacteraemia was more often associated with a focus in central venous catheters and burns, whereas patients with E. coli bacteraemia more often showed a focus of infection in the urinary tract. Patients with enterobacter bacteraemia and a microbiologically documented focus in the respiratory tract or the urinary tract more often had an endotracheal tube or indwelling urinary catheter compared to patients with E. coli bacteraemia with a similar focus of infection. In patients with no microbiologically documented focus enterobacter bacteraemia was more often associated with the presence of central and peripheral venous catheters. During the preceding 12 weeks patients with enterobacter bacteraemia, more often than E. coli patients, had been treated with beta-lactam antibiotics, especially penicillins. The close association with devices may indicate that Enterobacter has a special affinity for foreign body material. Studies are planned to elucidate this aspect in further detail.

Aged↗
PubMed2001

Increase of Enterobacter in neonatal sepsis: a twenty-two-year study.

BACKGROUND: Data on the incidence of Enterobacter infections in neonates over prolonged periods of time are scant. We determined the epidemiology of Enterobacter sepsis and/or meningitis and the trends of infection in a neonatal unit. METHODS: Retrospective review of sepsis and/or meningitis in inborn neonates admitted to Son Dureta University Hospital during a 22-year period. Molecular study by ribotyping of the Enterobacter strains isolated from 1995 to 1997. RESULTS: There were 513 cases of culture-proved sepsis and/or meningitis in neonates. In late onset infections Klebsiella pneumoniae and Staphylococcus epidermidis were the most frequent isolates in the period 1977 through 1991. Enterobacter was the most common isolate in the period 1992 through 1998. During this latter period Candida infections also increased, and the resistance rate of Enterobacter to cefotaxime was higher (59.2%). Decrease in early onset infections and increase in late onsets (4.6/1,000 live births) were observed in the second period. From 1977 to 1998, 45 episodes of sepsis and/or meningitis by Enterobacter species were identified in 44 patients (8.7% of all neonatal bacteremias). Three patients with Enterobacter bacteremia died (6.6%, 0.03/1,000 live births). During 1995 through 1997 5 different clones causing sepsis were identified and 3 were predominant. In 1997 there was an outbreak of Enterobacter disease. After cleaning, cohort nursing and hygiene reinforcement, Enterobacter was not isolated in the next 2 years. No change in the antibiotic policy was made. CONCLUSIONS: We observed a resurgence of Enterobacter infections in our neonatal intensive care unit. The sudden disappearance of this microorganism after reinforcement of hygienic measures, without withdrawing cefotaxime, confirms the importance of patient-to-patient transmission of this nosocomial infection. Further studies are needed to establish the role of antibiotics in the emergence of microorganisms in neonatal intensive care units.

Cefotaxime↗
PubMed2005

Detection and characterization of extended-spectrum beta-lactamases among bloodstream isolates of Enterobacter spp. in Hong Kong, 2000-2002.

OBJECTIVES: A total of 139 consecutive and non-duplicate bloodstream isolates of Enterobacter spp. collected from inpatients in Hong Kong during 2000-2002 were studied for production of extended-spectrum beta-lactamases (ESBLs). METHODS: All isolates were evaluated by the modified double-disc synergy test (m-DDST), the combined disc method (CDM) and the three-dimensional (3D) test. The m-DDST and CDM were modified by the use of cefepime discs. beta-Lactamases were characterized by isoelectric focusing and PCR sequencing using specific primers. RESULTS: ESBLs were identified in nine isolates (overall 6.5%), including seven of 39 (17.9%) Enterobacter hormaechei, one of 27 (3.7%) Enterobacter aerogenes and the only Enterobacter intermedius strain. The E. intermedius strain was positive only in the 3D test but not in the other two tests. The other eight strains were positive in all three tests. No ESBL was detected in the other species, including non-hormaechei members of the Enterobacter cloacae complex (n=61), Enterobacter agglomerans (n=7), Enterobacter gergoviae (n=4) and Enterobacter sakazakii (n=1). The ESBL content included five different CTX-M enzymes (CTX-M-9, CTX-M-13, CTX-M-14, CTX-M-24 and a novel CTX-M-2-like beta-lactamase), SHV-12 (n=2) and unidentifiable ESBLs with a pI of 7.7 or 7.9 in two strains. The seven ESBL-producing E. hormaechei were genotyped by pulsed-field gel electrophoresis and were found to be unrelated to each other. In three of the CTX-M-producing strains, ISEcp1-like elements, including promoters for the beta-lactamase gene, were found. CONCLUSIONS: Our data underscore the diversity of CTX-M enzymes among Enterobacter spp. in Hong Kong.

Bacteremia↗