ArticleJournal of clinical microbiology2007
Nosocomial outbreak due to extended-spectrum-beta-lactamase- producing Enterobacter cloacae in a cardiothoracic intensive care unit.
Article in Journal of clinical microbiology, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed, 57 citations in OpenAlex.
- Epidemiology and Outcomes of Bloodstream Infections in Patients in a Burns Intensive Care Unit: An 8-Year Retrospective Study.Open forum infectious diseases · 2025Article
- Calcium Potentiated Carbapenem Effectiveness Against ResistantMicrobiology insights · 2022Article
- Drug resistance of pathogens causing nosocomial infection in orthopedics from 2012 to 2017: a 6-year retrospective study.Journal of orthopaedic surgery and research · 2021Article
- Analysis of multidrug-resistant bacteria in 3223 patients with hospital-acquired infections (HAI) from a tertiary general hospital in China.Bosnian journal of basic medical sciences · 2019Article
- A recurrent and transesophageal echocardiography-associated outbreak of extended-spectrum β-lactamase-producingAntimicrobial resistance and infection control · 2019Article
- Assessment of Airborne Bacterial and Fungal Communities in Selected Areas of Teaching Hospital, Kandy, Sri Lanka.BioMed research international · 2019Article
- Intensive care unit-acquired complicated necrotizing pneumonia caused byIntractable & rare diseases research · 2018Article
- Strain-specific transmission in an outbreak of ESBL-producing Enterobacteriaceae in the hemato-oncology care unit: a cohort study.BMC infectious diseases · 2017Article
- Risk factors for relapse or persistence of bacteraemia caused byAntimicrobial resistance and infection control · 2017Article
- Mortality factor 4 like 1 protein mediates epithelial cell death in a mouse model of pneumonia.Science translational medicine · 2015Article
- Emergence of third-generation cephalosporin-resistantAcute medicine & surgery · 2014Article
- Persistence of related bla-IMP-4 metallo-beta-lactamase producing Enterobacteriaceae from clinical and environmental specimens within a burns unit in Australia - a six-year retrospective study.Antimicrobial resistance and infection control · 2013Article
- Phenotypic characterization of ESBL producing Enterobacter cloacae among children.Pakistan journal of medical sciences · 2013Article
- Gastrointestinal colonization with ESBL-producing Klebsiella in preterm babies--is vancomycin to blame?European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2012Article
- Method for phenotypic detection of extended-spectrum beta-lactamases in enterobacter species in the routine clinical setting.Journal of clinical microbiology · 2011Article
- Emergence in Spain of a multidrug-resistant Enterobacter cloacae clinical isolate producing SFO-1 extended-spectrum beta-lactamase.Journal of clinical microbiology · 2011Article
- The continuing challenge of ESBLs.Current opinion in pharmacology · 2007Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Enterobacter cloacae has been associated with several outbreaks, usually involving strains that overproduce chromosomal beta-lactamase or, uncommonly, strains expressing extended-spectrum beta-lactamases (ESBL). Only sporadic cases of ESBL-producing E. cloacae have been identified in our hospital in recent years. We describe the epidemiology and clinical and microbiological characteristics of an outbreak caused by ESBL-producing E. cloacae in a cardiothoracic intensive care unit (CT-ICU). Prospective surveillance of patients with infection or colonization by ESBL-producing E. cloacae among patients admitted to the CT-ICU was performed during the outbreak. Production of ESBL was determined by decreased susceptibility to expanded-spectrum cephalosporins and a positive double-disk test result. Clone relatedness was determined by pulsed-field gel electrophoresis (PFGE). From July to September 2005, seven patients in the CT-ICU with ESBL-producing E. cloacae were identified (four males; median age, 73 years; range, 45 to 76 years); six patients had cardiac surgery. Four patients developed infections; three had primary bacteremia, one had ventilator-associated pneumonia, and one had tracheobronchitis. ESBL-producing E. cloacae showed resistance to quinolones and aminoglycosides. PFGE revealed two patterns. Five isolates belonged to clone A; two carried a single ESBL (pI 8.2 and a positive PCR result for the SHV type), and three carried two ESBLs (pIs 8.1 and 8.2 and positive PCR results for the SHV and CTX-M-9 types). Isolates belonging to clone B carried a single ESBL (pI 5.4 and a positive PCR result for the TEM type). Review of antibiotic consumption showed increased use of cefepime and quinolones during June and July 2005. The outbreak was stopped by the implementation of barrier measures and cephalosporin restriction. ESBL production could be increasingly common in nosocomial pathogens other than Escherichia coli or Klebsiella pneumoniae.
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