Molecular Mechanisms of Carbapenem Resistance in Enterobacter cloacae Clinical Isolates from Korea and Clinical Outcome
- Authors
- Lee, Yang soon; Choi, Heekyeong; Yum, Jong Hwa; Kang, Girung; Bae, Il Kwon; Jeong, Seok Hoon; Lee, Kyungwon
- Issue Date
- Sep-2012
- Publisher
- Institute for Clinical Science
- Citation
- Annals of Clinical and Laboratory Science, v.42, no.3, pp.281 - 286
- Indexed
- SCIE
SCOPUS
- Journal Title
- Annals of Clinical and Laboratory Science
- Volume
- 42
- Number
- 3
- Start Page
- 281
- End Page
- 286
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/164663
- ISSN
- 0091-7370
- Abstract
- We investigated the molecular mechanisms of carbapenem resistance in clinical isolates of Enterobacter cloacae and their clinical characteristics. Nonreplicable E cloacae isolates were recovered from six cancer patients and one patient with liver cirrhosis at a tertiary-care hospital in Korea between 2002 and 2009. Two patients who were considered to have a true infection caused by these microorganisms have died. All isolates produced AmpC beta-lactamases, including ACT-1, ACT-2, MIR-3 and DHA-1, and CTX-M- or SHV-type extended-spectrum beta-lactamase. Two isolates produced plasmid-borne VIM-2 carbapenemase. All probes specific for bla(AmpC) genes hybridized with 1-CeuI chromosomal fragments were also recognized by a probe specific for 16S rDNA, suggesting a chromosomal location. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that a major outer membrane protein, OmpF, was absent in all isolates. PFGE of XbaI-digested DNA were considered to be unrelated. The results of our study suggest that the chromosomal AmpC beta-lactamase with impermeability in E. cloacae clinical isolates implicated in reduced carbapenem susceptibility. Although carbapenem-resistant E. cloacae isolates were isolated in a few patients in our study, the clinical outcomes were grave. Therefore, the patients colonized or infected by carbapenem-resistant E. cloacae isolates should gain attention of antibiotic therapy.
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