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KMID : 1100820180080030099
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Laboratory Medicine Online
2018 Volume.8 No. 3 p.99 ~ p.106
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Biological and Genetic Characteristics of Clinically Isolated Enterobacter cloacae with Multidrug Resistance
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Kim Jae-Jung
Koo Sun-Hoe
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Abstract
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Background: From January 2014 to December 2015, 69 clones of Enterobacter cloacae showing multidrug resistance to six classes of antimicrobial agents were collected from two medical centers in Korea.
Methods: Minimum inhibitory concentrations were determined using the E-test method, and 17 genes were detected using polymerase chain reaction (PCR). The epidemiological relatedness of the strains was identified using repetitive element sequence-based PCR and multilocus sequence typing.
Results: The 69 E. cloacae clones produced extended spectrum β lactamase (ESBL) and AmpC and showed multidrug resistance to cefotaxime, ceftazidime, and aztreonam. We identified the following sequence types: ST56 of type VI for ESBL SHV (N=12, 17.4%); ST53, ST114, ST113, and ST550 of types I, IV, VI, and VII, respectively, for CTX-M (N=11, 15.9%); and ST668 of type III for the carbapenemase NDM gene (N=1, 1.5%). The AmpC DHA gene (N=2, 2.89%) was confirmed as ST134, although its type was not identified, whereas EBC (MIR/ACT; N=18, 26.1%) was identified as ST53, ST24, ST41, ST114, ST442, ST446, ST484, and ST550 of types V, I, III, IV, VII, and VI, respectively. The formed subclasses were blaCTX-M-3 and blaCTX-M-22 by CTX-M-1, blaCTX-M-9 and blaCTX-M-125 by CTX-M-9, blaDHA-1 by DHA, and blaMIR-7 and blaACT-15,17,18,25,27,28 by EBC (MIR/ACT).
Conclusions: There were no epidemiological relationships between the gene products and the occurrence of resistance among the strains.
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KEYWORD
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Enterobacter cloacae, Extended spectrum β lactamase, AmpC, Repetitive element sequence-based polymerase chain reaction, Multilocus sequence typing, Multidrug resistance
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