Observational studyThe Journal of infectious diseases2025
Molecular Epidemiology and Clinical Characterization of Carbapenemase-Producing Enterobacter Species From an International Cohort.
Observational study in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03646227 (Multi-Drug Resistant Organism Network - MDRO Network), which is not on this map. Cited by 5 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multi-Drug Resistant Organism Network - MDRO Network
Who cites it
5 citing papers in PubMed.
- Mobilization ofMicrobiology spectrum · 2026Article
- Genomic epidemiology of carbapenemase-producingMicrobiology spectrum · 2026Article
- Carbapenemases: epidemiology, detection and management in a changing global landscape.JAC-antimicrobial resistance · 2026Review
- Susceptibility to novel antimicrobial agents and molecular epidemiology of carbapenem-resistant enterobacterales: a 9-year study in Central China.BMC microbiology · 2026Article
- Clinical characteristics and 28-day outcomes of sepsis associated with klebsiella pneumoniae carbapenemase-producing Enterobacterales: a single-center retrospective cohort study.BMC infectious diseases · 2026Article
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Authors and funding
22 authors.
Funding
Abstract
backgroundDespite the global public health threat posed by carbapenem-resistant Enterobacter spp, clinical and molecular epidemiological studies on international isolates remain scarce. Historically, the taxonomy of Enterobacter has been challenging, limiting our understanding of the clinical characteristics and outcomes of carbapenemase-producing Enterobacter spp infections.
methodsHospitalized patients enrolled in the CRACKLE-2 study (ClinicalTrials.gov, NCT03646227) from 2016 to 2018 with cultures positive for carbapenemase-producing Enterobacter spp were included. Clinical and microbiologic data were collected from health records. Whole genome sequencing was performed, and the population structures of selected predominant clones were analyzed.
resultsWe enrolled 136 hospitalized patients with carbapenemase-producing Enterobacter spp from 30 hospitals in 7 countries. Among the 136 isolates, 11 Enterobacter spp were identified, with most isolates belonging to E xiangfangensis (n = 81 [60%]) and E hoffmannii (n = 17 [13%]) and carrying blaKPC (n = 106 [78%]) and blaNDM (n = 12 [9%]). Clinical characteristics and outcomes were similar among patients with E xiangfangensis, E hoffmannii, or the other Enterobacter spp. Thirty-day mortality was 20%, and older age at enrollment (adjusted odds ratio, 1.42 [95% confidence interval, 1.08-1.87]) was associated with increased mortality. Sequence type (ST) 171 E xiangfangensis, ST78 E hoffmannii, and ST93 E xiangfangensis were the predominant clones, and the acquisition of fluoroquinolone resistance-associated mutations and carbapenemase-encoding plasmids contributed to their formation and global dissemination.
conclusionsOur findings demonstrate that E xiangfangensis and E hoffmannii are common species among international carbapenemase-producing Enterobacter spp, potentially linked to the clonal spread of a few predominant clones that have acquired fluoroquinolone resistance and carbapenemase-encoding plasmids.
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