ArticleThe Journal of antimicrobial chemotherapy2015
Dynamics of MDR Enterobacter cloacae outbreaks in a neonatal unit in Nepal: insights using wider sampling frames and next-generation sequencing.
Article in The Journal of antimicrobial chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed, 48 citations in OpenAlex.
- Challenges and considerations for whole-genome-based antimicrobial resistance plasmid investigations.Antimicrobial agents and chemotherapy · 2025Review
- Genomics for antimicrobial resistance-progress and future directions.Antimicrobial agents and chemotherapy · 2025Review
- Growth of Gram-Negative Bacteria in Antiseptics, Disinfectants and Hand Hygiene Products in Two Tertiary Care Hospitals in West Africa-A Cross-Sectional Survey.Pathogens (Basel, Switzerland) · 2023Article
- Prevalence, antibiotic resistance patterns, and biofilm formation ability ofVeterinary world · 2023Article
- Threshold-free genomic cluster detection to track transmission pathways in health-care settings: a genomic epidemiology analysis.The Lancet. Microbe · 2022Article
- Contaminated Incubators: Source of a Multispecies Enterobacter Outbreak of Neonatal Sepsis.Microbiology spectrum · 2022Article
- A fatal outbreak of neonatal sepsis caused by mcr-10-carrying Enterobacter kobei in a tertiary care hospital in Nepal.The Journal of hospital infection · 2022Article
- Genomic epidemiology, antimicrobial resistance and virulence factors ofJAC-antimicrobial resistance · 2022Article
- Surveillance of Enterobacter cloacae complex colonization and comparative analysis of different typing methods on a neonatal intensive care unit in Germany.Antimicrobial resistance and infection control · 2022Article
- Whole-genome analysis of carbapenem-resistantComputational and structural biotechnology journal · 2022Article
- Emergence of Neonatal Sepsis Caused by MCR-9- and NDM-1-Co-ProducingFrontiers in cellular and infection microbiology · 2022Article
- Class I integrons among multidrug resistantCaspian journal of internal medicine · 2021Article
- Enterobacter cloacae colonisation and infection in a neonatal intensive care unit: retrospective investigation of preventive measures implemented after a multiclonal outbreak.BMC infectious diseases · 2020Article
- Integrating multiple genomic technologies to investigate an outbreak of carbapenemase-producing Enterobacter hormaechei.Nature communications · 2020Article
- Draft Genome Sequences of Citrobacter freundii and Citrobacter murliniae Strains Isolated from the Feces of Preterm Infants.Microbiology resource announcements · 2019Article
- NDM Metallo-β-Lactamases and Their Bacterial Producers in Health Care Settings.Clinical microbiology reviews · 2019Review
- Spreading Patterns of NDM-ProducingAntimicrobial agents and chemotherapy · 2019Article
- Genomic epidemiology of multidrug-resistant Gram-negative organisms.Annals of the New York Academy of Sciences · 2019Review
- Carbapenem-ResistantFrontiers in microbiology · 2018Article
- A Prolonged Outbreak of KPC-3-Producing Enterobacter cloacae and Klebsiella pneumoniae Driven by Multiple Mechanisms of Resistance Transmission at a Large Academic Burn Center.Antimicrobial agents and chemotherapy · 2017Article
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Authors and funding
11 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesThere are limited data on Enterobacter cloacae outbreaks and fewer describing these in association with NDM-1. With whole-genome sequencing, we tested the hypothesis that a cluster of 16 E. cloacae bacteraemia cases in a Nepali neonatal unit represented a single clonal outbreak, using a wider set of epidemiologically unrelated clinical E. cloacae isolates for comparison.
methodsForty-three isolates were analysed, including 23 E. cloacae and 3 Citrobacter sp. isolates obtained from blood cultures from 16 neonates over a 3 month period. These were compared with two contemporaneous community-associated drug-resistant isolates from adults, a unit soap dispenser isolate and a set of historical invasive isolates (n=14) from the same geographical locality.
resultsThere were two clear neonatal outbreaks and one isolated case in the unit. One outbreak was associated with an NDM-1 plasmid also identified in a historical community-associated strain. The smaller, second outbreak was likely associated with a contaminated soap dispenser. The two community-acquired adult cases and three sets of historical hospital-associated neonatal isolates represented four additional genetic clusters.
conclusionsE. cloacae infections in this context represent several different transmission networks, operating at the community/hospital and host strain/plasmid levels. Wide sampling frames and high-resolution typing methods are needed to describe the complex molecular epidemiology of E. cloacae outbreaks, which is not appropriately reflected by routine susceptibility phenotypes. Soap dispensers may represent a reservoir for E. cloacae and bacterial strains and plasmids may persist in hospitals and in the community for long periods, sporadically being involved in outbreaks of disease.
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