Presentation
ST114 is a common global human Enterobacter clone (18) and is also present in companion animals (19). [wwwnc.cdc.gov]
Fever is the most common presentation in this syndrome, as well as systemic inflammatory response (SIRS), hypotension, shock, and leukocytosis, as seen in many other bloodstream presentations. [ncbi.nlm.nih.gov]
High levels of drug resistance often seen and due to: AmpC β-lactamases - Ambler class C Chromosomal AmpC can be constitutive (always active) or inducible (variably active) and are not inhibited by β-lactam β-lactamase inhibitors.[19] β-lactams must be present [hopkinsguides.com]
Breast
- Agalactia
4/20 (20%) 0·78 Burkholderia cepacia 6/31 (19%) 0 0·099 Coagulase negative Staphylococcus 2/31 (6%) 2/20 (10%) 0·92 Escherichia coli 0 4/20 (20%) 0·04 Klebsiella oxytoca 1/31 (3%) 2/20 (10%) 0·68 Klebsiella pneumoniae 2/31 (6%) 0 0·67 Streptococcus agalactiae [thelancet.com]
Workup
See Workup for more detail. Management Antimicrobial therapy is indicated in virtually all Enterobacter infections. [emedicine.medscape.com]
Treatment
Further discussion regarding treatment is outside the scope of this article. [ncbi.nlm.nih.gov]
[…] antibiotic treatment in the past 30 days. [nanologix.com]
Enterobacter is a versatile bacterium able to promptly respond to the antibiotic treatment in the colonized patient. [mendeley.com]
Enterobacter species possess inducible beta-lactamases, which are undetectable in vitro but are responsible for resistance during treatment. [emedicine.medscape.com]
Prognosis
The observed phenomenon may have implications not only for antimicrobial chemotherapy, but also for the prognosis of infectious diseases and infection control. [ncbi.nlm.nih.gov]
Overall mortality was 42%; factors associated with a poor prognosis were inadequacy of antimicrobial chemotherapy, septic shock, type of underlying disease, clinical condition, and requirement of intensive care. (Arch Intern Med 1985;145:1024-1027) [jamanetwork.com]
Thus, it can be presumed that bacteremia caused by antibiotic-resistant bacteria may have a poorer prognosis because of the delay in initiating appropriate antimicrobial therapy. [cid.oxfordjournals.org]
"Analysis of clinical and molecular characteristics of laryngeal squamous cell carcinoma and their application for prediction of prognosis and treatment response", 2010-2012. [mmcbg.org]
Etiology
Objectives: Identify the etiology of Enterobacter infections. Describe the evaluation of Enterobacter infections. Outline the management options available for Enterobacter Infections. Access free multiple choice questions on this topic. [ncbi.nlm.nih.gov]
Introduction Strains of Enterobacter cloacae have been implicated as etiological agents of human intestinal and extraintestinal infections that may cause fatal bacteremia, including skin and soft tissues, intra-abdominal, the urinary tract and central [academic.oup.com]
[…] factors for infection and impact of resistance on outcomes, Clin Infect Dis, 2001, vol. 32 (pg. 1162 - 71 ) 12 CDC definitions for nosocomial infections, 1988, Am J Infect Control, 1988, vol. 16 (pg. 128 - 40 ) 13 Septic shock in critically ill patients: etiology [cid.oxfordjournals.org]
Epidemiology
Molecular epidemiology of Enterobacter aerogenes acquisition: one year prospective study in two intensive care units., 9 Arpin C Coze C Rogues AM Gachie JP Bebear C Quentin C Epidemiological study of an outbreak due to multidrug-resistant Enterobacter [clinicalmicrobiologyandinfection.com]
The epidemiology of the Algerian isolates is compared to previous epidemiological studies of E. cloacae in Algeria in Table 2. The antibiotic resistance results are summarized in Table 3. [doi.org]
Antimicrobial susceptibility and molecular epidemiology of clinical Enterobacter cloacae bloodstream isolates in Shanghai, China. PLoS ONE. 2017 Dec;12 (12): e0189713. [ PubMed ] [ Crossref ] 10. [journal-imab-bg.org]
Epidemiology of extended spectrum beta-lactamase producing Enterobacter bacteremia in a Brazilian hospital. Rev Soc Bras Med Trop, 43 (2010), pp. 452-454 [2] P. Nordmann, G. Cuzon, T. Naas. [bjid.org.br]
[…] infections in intensive care units - Annual Epidemiological Report for 2015 [ecdc.europa.eu]
Pathophysiology
This opportunistic pathogen, similar to other members of the Enterobacteriaceae family, possesses an endotoxin known to play a major role in the pathophysiology of sepsis and its complications. [tgw1916.net]
PATHOPHYSIOLOGY• These bacteria have an outer membrane that contains, among other things, lipopolysaccharides from which lipid-A plays a major role in sepsis. [de.slideshare.net]
Prevention
Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreak. [bmcinfectdis.biomedcentral.com]
Buxton, AE, Anderson, RL, Klimek, J, et al: Failure of disposable domes to prevent septicemia acquired from contaminated pressure transducers. Chest 1978; 74:508–513.CrossRefGoogle ScholarPubMed 19. [cambridge.org]
Results indicated that the use of probiotics to act directly on the TMA in the gut might be an alternative approach to reduce serum TMAO levels and to prevent the development of atherosclerosis and "fish odor syndrome" through the effect of TMA on the [ncbi.nlm.nih.gov]
Disinfectant effectiveness for prevention The necessary spectrum of activity against enterobacteria is: bactericidal Our Newsletter: Your dose of knowledge Make sure you receive: hygiene news, always up to date exclusive content new issues every 4-6 weeks [hygiene-in-practice.com]