Presentation
KPC was present in 88.6% of E. aerogenes and in all E. cloacae resistant to carbapenems. [ncbi.nlm.nih.gov]
Entire Body System
Musculoskeletal
- Short Hands
Unfortunately many articles, clinicians, and GenBank submissions misname these strains as E. cloacae perhaps as a short hand for the E. cloacae complex and possibly due to the E. hormaechei subspecies not being validly published until recently. [f1000research.com]
Workup
See Workup for more detail. Management Antimicrobial therapy is indicated in virtually all Enterobacter infections. [emedicine.medscape.com]
Treatment
[…] antibiotic treatment in the past 30 days. [nanologix.com]
Abstract Quinolones are frequently used classes of antimicrobials in hospitals, crucial for the treatment of infections caused by Gram-negative bacteria. [ncbi.nlm.nih.gov]
Enterobacter is a versatile bacterium able to promptly respond to the antibiotic treatment in the colonized patient. [mendeley.com]
Treatment is with antibiotics. Infections with Klebsiella, Enterobacter, and Serratia are often hospital-acquired and occur mainly in patients with diminished resistance. [msdmanuals.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
[PubMed] [Google Scholar] McGowan JE., Jr Changing etiology of nosocomial bacteremia and fungemia and other hospital-acquired infections. Rev Infect Dis. 1985 Jul-Aug;7 (Suppl 3):S357–S370. [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]
Strains of E. cancerogenus have been isolated predominantly from human blood and spinal fluid [15] and were found to be etiological agents of wound and urinary tract infections, sepsis and osteomyelitis [16-21]. [onlinelibrary.wiley.com]
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]
[…] 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
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]
Many Enterobacteriaceae fortify their outer membrane with cationic amine‐containing moieties to prevent CAMP binding, which can lead to cell lysis. [onlinelibrary.wiley.com]
Centers for Disease Control and Prevention. New Carbapenem-Resistant Enterobacteriaceae Warrant Additional Action by Healthcare Providers. CDC. Feb 14 2013. [Full Text]. Abbott SL, Janda JM. [medscape.com]