First Report of DHA-1 Producing Enterobacter cloacae Complex Isolate in Bulgaria

Dimitrova, Dobromira; Markovska, Rumyana; Stoeva, Temenuga; Stankova, Petya; Georgieva, Lyudmila B; Mihova, Kalina; Kaneva, Radka; Mitov, Ivan

doi:10.3897/folmed.61.e39349

Cited by 3 publications

(1 citation statement)

References 18 publications

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“…Enterobacter spp. is resistant to several antibiotics especially β-lactams [11] .A recent study demonstrated the remarkable dissemination and variety of carbapenemase genes in E. cloacae complex [12,13] . Enterobacter infections do not produce a unique enough clinical presentation to differentiate them clinically from other acute bacterial infections.…”

Section: Discussionmentioning

confidence: 99%

Corneal Infection by Enterobacter Cloacae post Penetrating Keratoplasty

Sharma¹

2020

jmscr

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A 50-year-old woman underwent Penetrating Keratoplasty (PK) for Adherent Leukoma in her left eye. Three months later she reported with complaints of decrease in visual acuity, pain, redness and photophobia. She was given pulsed intravenous (IV) methyl prednisolone. There was reduction in symptoms however visual acuity did not improve. Ocular examination revealed visual acuity of 6/6 unaided in right eye and HMCF (Hand movements close to face) with accurate PR (Projection of rays).She developed a central corneal ulceration. Scraping of the corneal lesion revealed Gram-negative bacilli. Genus level identification was achieved using standard techniques and species level identification, revealing Enterobacter Cloacae, was aided by a VITEK 2 compact system. Broad-spectrum fortified antibiotics were initially started followed by species-sensitive fortified antibiotics. This case report, for the first time, highlights Enterobacter Cloacaeas a cause of an aetiological agent of corneal ulcer following PK. Members of the genus Enterobacter are commensal organisms of the gastrointestinal tract and are considered pathogenic only for patients with lowered resistance to infection (e.g., chronic infection, cancer, or diabetes mellitus) or those with impaired immunity (congenital, acquired, or impaired immunity secondary to therapy). This organism has been implicated in endophthalmitis cases in previous case reports. However, to the best of our knowledge corneal infection caused by this organism has not been reported sofar.

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Section: Discussionmentioning

confidence: 99%

Corneal Infection by Enterobacter Cloacae post Penetrating Keratoplasty

Sharma¹

2020

jmscr

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Infectious Complications, Associated With Multi-Drug Resistant Bacteria in Patients Following Hematopoietic Stem Cell Transplantation – Resistance Mechanisms and Therapeutic Options

Niyazi

2023

TJS

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Individuals undergoing hematopoietic stem cell transplantation are a peculiar group of patients in whom the risk of developing infectious complications is very high. Various groups of antimicrobials are used for prophylaxis and therapy, but the growing resistance among bacterial isolates is about to derail all attempts to prevent severe infectious complications. The aim of this review is to briefly present the different types of multidrug-resistant bacteria causing infections in these patients, as well as to introduce the most common resistance mechanisms and treatment options for this type of infections.

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Dissemination of High-Risk Clones Enterobacterales among Bulgarian Fecal Carriage Isolates

et al. 2022

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The gastrointestinal tract is an important reservoir of high-risk Enterobacteria clones and a driver of antimicrobial resistance in hospitals. In this study, patients from six hospitals in four major Bulgarian towns were included in this study. Overall, 205 cefotaxime-resistant isolates (35.3%) of Enterobacterales order were detected in fecal samples among 580 patients during the period of 2017–2019. ESBL/carbapenemase/plasmidic AmpC producer rates were 28.8%, 2.4%, and 1.2%, respectively. A wide variety of ESBLs: CTX-M-15 (41%), CTX-M-3 (24%), CTX-M-27 (11%), and CTX-M-14 (4%) was found. The carbapenemases identified in this study were New Delhi metalo-β-lactamase (NDM)-1 (5.4%) and Klebsiella carbapenemase (KPC)-2 (1.5%). Most NDM-1 isolates also produced CTX-M-15/-3 and CMY-4 β-lactamases. They belonged to ST11 Klebsiella pneumoniae clone. The epidemiology typing revealed three main high-risk K. pneumoniae clones (26%)—ST11, ST258, and ST15 and five main Escherichia coli clones—ST131 (41.7%), ST38, ST95, ST405, and ST69. Sixty-one percent of ST131 isolates were from the highly virulent epidemic clone O25b:H4-ST131. Phylotyping revealed that 69% of E. coli isolates belonged to the virulent B2 and D groups. Almost all (15/16) Enterobacter isolates were identified as E. hormaechei and the most common ST type was ST90. Among all of the isolates, a high ESBL/carbapenemases/plasmid AmpC (32.4%) prevalence was observed. A significant proportion of the isolates (37%) were members of high-risk clones including two pan-drug-resistant K. pneumoniae ST11 NDM-1 producing isolates. Due to extensive antibiotic usage during COVID-19, the situation may worsen, so routine screenings and strict infection control measures should be widely implemented.

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First Report of DHA-1 Producing Enterobacter cloacae Complex Isolate in Bulgaria

Cited by 3 publications

References 18 publications

Corneal Infection by Enterobacter Cloacae post Penetrating Keratoplasty

Corneal Infection by Enterobacter Cloacae post Penetrating Keratoplasty

Infectious Complications, Associated With Multi-Drug Resistant Bacteria in Patients Following Hematopoietic Stem Cell Transplantation – Resistance Mechanisms and Therapeutic Options

Dissemination of High-Risk Clones Enterobacterales among Bulgarian Fecal Carriage Isolates

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