Molecular epidemiology of a nosocomial outbreak due to Enterobacter cloacae and Enterobacter agglomerans in Campinas, São Paulo, Brazil

Abstract

SUMMARYA total of 73 isolates (57 Enterobacter cloacae and 16 Enterobacter agglomerans), recovered during an outbreak of bacteremia in the Campinas area, São Paulo, Brazil, were studied. Of these isolates, 61 were from parenteral nutrition solutions, 9 from blood cultures, 2 from a sealed bottle of parenteral nutrition solution, and one was of unknown origin. Of the 57 E. cloacae isolates, 54 were biotype 26, two were biotype 66 and one was non-typable. Of 39 E. cloacae isolates submitted to ribotyping, 87.2% showed the same banding pattern after cleavage with EcoRI and BamHI. No important differences were observed in the antimicrobial susceptibility patterns among E. cloacae isolates exhibiting the same biotype, serotype and ribotype. All E. agglomerans isolates, irrespective of their origin, showed same patterns when cleaved with EcoRI and BamHI. The results of this investigation suggest an intrinsic contamination of parenteral nutrition solutions and incriminate these products as a vehicle of infection in this outbreak.

Nosocomial outbreak of Pantoea agglomerans in a pediatric urgent care center

“…Pantoea agglomerans, commonly found in plants, soil, water and food stuffs, although rarely recognized as an agent of endogenous nosocomial infections [5][6][7], can cause epidemics among hospitalized patients when associated with the use of contaminated intravenous products due to its ability to grow in commercial infusion fluids [8][9][10].…”

Scalp abscess due to Enterobacter agglomerans

“…Enterobacter (formerly Erwinia ) agglomerans is a gram‐negative bacillus commonly isolated from plants, soil, water and foodstuffs 1 . Rarely recognized as a human pathogen, the spectrum of disease owing to E. agglomerans includes outbreaks of bacteremia associated with the use of contaminated intravenous products, 2,3 metacarpal periostitis, 4 septic monoarthritis after thorn and wood splinter injuries, 4–6 and cellulitis 5,7 . Scalp abscess is rare in adults, unless associated with severe acne, and E. agglomerans has not been previously reported as a cause of scalp abscess.…”

Perfil epidemiológico, clínico e microbiológico de amostras de pacientes diagnosticados com pneumonia nosocomial na Clínica Médica de um Hospital Universitário em Pernambuco

“…Entre as 13 espécies reconhecidas como membros do gênero Enterobacter, E. aerogenes e E.cloacae são as espécies mais frequentemente associadas a patologias. 21 No estudo atual houve uma prevalência discreta (4,4%) desse microrganismo nos isolados de aspirado traqueal. Apresentando perfil de resistência de 100% a ampicilina, ampicilina + sulbactam e cefazolina.…”