Abstract:E. cloacae infection in VLBW neonates usually presents with nonspecific symptoms and signs. Early recognition of sepsis and empirical combination of piperacillin (or piperacillin and tazobactam) and gentamicin (or amikacin) may be useful for treatment of sepsis caused by this highly virulent pathogen.
“…An outbreak of E. sakazakii in a French NICU in 1994 involved 17 cases including 7 neonates with necrotizing enterocolitis, 1 case of sepsis, and 1 case of meningitis; 8 infants were colonized, but asymptomatic; there were 3 deaths. In a review of Enterobacter sepsis in 28 neonates from Taiwan, thrombocytopenia (66%) and increased band-form neutrophils (41%) were common laboratory features, with a reported clinical outcome of 11% mortality, 14% meningitis, and 7% brain abscess [139]. In a review of Enterobacter sepsis in 28 neonates from Taiwan, thrombocytopenia (66%) and increased band-form neutrophils (41%) were common laboratory features, with a reported clinical outcome of 11% mortality, 14% meningitis, and 7% brain abscess [139].…”
“…An outbreak of E. sakazakii in a French NICU in 1994 involved 17 cases including 7 neonates with necrotizing enterocolitis, 1 case of sepsis, and 1 case of meningitis; 8 infants were colonized, but asymptomatic; there were 3 deaths. In a review of Enterobacter sepsis in 28 neonates from Taiwan, thrombocytopenia (66%) and increased band-form neutrophils (41%) were common laboratory features, with a reported clinical outcome of 11% mortality, 14% meningitis, and 7% brain abscess [139]. In a review of Enterobacter sepsis in 28 neonates from Taiwan, thrombocytopenia (66%) and increased band-form neutrophils (41%) were common laboratory features, with a reported clinical outcome of 11% mortality, 14% meningitis, and 7% brain abscess [139].…”
“…They represent a diverse group which are widely distributed in nature [2] and possess multiple mechanisms to allow survival in a variety of environmental niches [3]. In humans, they may cause a wide variety of clinical infections and are a common cause of bacteraemia [2], especially within adult and neonatal intensive care units (ICUs) [4, 5]. Fig.…”
Background
Enterobacter spp. possess chromosomal AmpC beta-lactamases that may be expressed at high levels. Previous studies have demonstrated a risk of relapsed bacteraemia following therapy with third generation cephalosporins (3GCs). What additional factors predict microbiological failure in Enterobacter bacteraemia is unclear. We aimed to determine factors associated with microbiological failure in Enterobacter bacteraemia.MethodsWe retrospectively identified cases of bacteraemia caused by Enterobacter spp. occurring in four hospitals. Using a case–control design, we determined clinical risk factors for persistence or relapse defined as repeated positive blood cultures collected between 72 hours and up to 28 days post initial positive blood culture.ResultsDuring the study period a total of 922 bacteraemia events caused by Enterobacter spp. in adults were identified. The overall risk of relapsed or persisting bacteraemia at 28 days was low (31 of 922, 3.4%), with only 2 patients experiencing emergent resistance to 3GCs. A total of 159 patients were included in the case–control study. Using multivariate logistic regression, independent predictors for relapse were a line-associated source of infection (OR 3.87; 95% CI 1.56-9.60, p = 0.004) and the presence of immunosuppression (OR 2.70; 95% CI 1.14-6.44, p = 0.02). On univariate analysis definitive therapy with a broad-spectrum beta-lactam-beta-lactamase inhibitor (BLBLI, e.g. piperacillin-tazobactam) was not associated with relapse (OR 1.83; 95% CI 0.64-5.21, p = 0.26) although the proportion of patients receiving a BLBLI as definitive therapy was relatively small (21/159, 13.2%).ConclusionsThe risk of relapsed or persistent Enterobacter bacteraemia appears to be low in Australia. A line-associated source of infection and immunocompromise were significant independent predictors for relapse. Larger, preferably randomized, studies are needed to address whether BLBLIs represent an effective carbapenem-sparing option for Enterobacter bacteraemia.Electronic supplementary materialThe online version of this article (doi:10.1186/s13756-017-0177-0) contains supplementary material, which is available to authorized users.
“…These infants are born with underdeveloped gut physiology and immunity, and have an altered gut microbiota; this increases the risk of life-threatening infections 20,21 . Principal coordinates analysis (PCoA) of faecal samples indicated three distinct clusters, driven by the presence of either beneficial Bifidobacterium breve or potentially pathogenic microbiota members Enterobacter cloacae 22 or Klebsiella pneumoniae (Extended Data Fig. 1).…”
Accurate classification of a microbial mock community using MinION sequencing. We benchmarked MinION technology by profiling a bacterial mock community using R7.3 flow cells. Reads were analysed with NanoOK 18 and produced alignments to the 20 microbial reference sequences with 82-89% identity 19. Coverage ranged from almost 0 × (8 reads) of Actinomyces odontolyticus to 13 × (7,695 reads) of Streptococcus mutans, which is consistent with expected mock concentrations (Supplementary Table 1). Benchmarking to Illumina sequencing demonstrated high correlation with expected proportions (Fig. 1a, log-transformed Pearson's r = 0.94 for MinION and 0.97 for Illumina), and with each other (log-transformed Pearson's r = 0.98). Broadly similar abundance levels across both platforms were observed, with some differences in assignment to species versus genus/family (Fig. 1b). This is probable since the longer length Nanopore reads should provide
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
