ArticleBMC microbiology2026
The healthy human gut as a covert reservoir for mobile antimicrobial resistance: nationwide genomic surveillance of Enterobacter cloacae complex in China.
Article in BMC microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEnterobacter cloacae complex (ECC) is a formidable opportunistic pathogen, yet its ecological niche and role as a silent reservoir for antimicrobial resistance (AMR) in the healthy human gut remain underappreciated. Herein, we aim to characterize the prevalence, genomic epidemiology, and mobile resistome of ECC in a widespread healthy demographic.
methodsIn a nationwide, cross-sectional genomic surveillance study conducted across China (2024-2025), we analyzed 10,300 fecal samples from healthy individuals across 31 provinces. High-resolution whole-genome sequencing (WGS), comparative genomics, and conjugation assays were employed to resolve species identity, delineate phylogenetic relationships, and trace the mobility of high-priority resistance determinants.
resultsWe recovered 148 non-duplicate ECC isolates, establishing a community carriage prevalence of 1.44%. Among them, Enterobacter hormaechei emerged as the predominant species (49.3%). WGS revealed a highly diverse population structure harboring critical resistance determinants, including mcr genes (4.1%), tet(X4) (3.4%), and carbapenemases (9.5%, predominantly bla
conclusionsThe healthy human gastrointestinal tract can harbor ECC isolates carrying clinically important AMR determinants, including resistance genes located within mobile genetic contexts. These findings support the integration of community-based genomic surveillance into AMR monitoring strategies to better understand asymptomatic carriage of resistant ECC.
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