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<p>This study aimed to monitor the evolving antibiotic resistance patterns of carbapenem-resistant <i>Enterobacter cloacae complex</i> (CR-ECC) at the Fourth Hospital of Hebei Medical University, characterize the molecular epidemiology through resistance gene profiling and phylogenetic analysis, investigate virulence gene profiles, and establish an evidence-based framework for optimizing clinical antimicrobial therapy and infection control strategies. 32 CR-ECC isolates (2018–2022) underwent Vitek-based identification and susceptibility testing. Carbapenemase production was confirmed by mCIM, with whole-genome sequencing (Illumina) for MLST phylogeny (MEGA/iTOL). Plasmid replicons and resistance/virulence genes were analyzed using PlasmidFinder and RGI/BLAST respectively. CR-ECC emerged in 2020, reaching 32 cases by 2022 as the third most prevalent carbapenem-resistant <i>Enterobacteriaceae</i>. Isolates mainly from sputum (43.75%, 14/32) and blood (25.00%, 8/32), with 53.13% ICU origins. Universal resistance to piperacillin/tazobactam, ceftazidime, imipenem; full susceptibility to tigecycline/colistin. Molecular analysis identified 8 STs, predominantly ST171 (56.25%) carrying <i>blaNDM-1/OXA-1</i>. Plasmid analysis revealed Col(pHAD28)/IncC dominance with ST-specific distribution. Virulence genes showed near-universal <i>fimA/csgD/entB</i> (96.88%) and <i>mrkD</i> (90.63%). These findings highlight the therapeutic potential of tigecycline, colistin, and amikacin against CR-ECC, while emphasizing strain-specific aztreonam susceptibility in metallo-β-lactamase producers.</p>

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Molecular epidemiological characteristics of carbapenem-resistant Enterobacter cloacae complex

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月29日

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  • Jing He,
  • Kuo Cheng,
  • Qian Sui,
  • Junhua Feng,
  • Xiaoyu Zhang,
  • Kaixuan Zhao,
  • Wei Wang,
  • Yanli Deng

摘要

This study aimed to monitor the evolving antibiotic resistance patterns of carbapenem-resistant Enterobacter cloacae complex (CR-ECC) at the Fourth Hospital of Hebei Medical University, characterize the molecular epidemiology through resistance gene profiling and phylogenetic analysis, investigate virulence gene profiles, and establish an evidence-based framework for optimizing clinical antimicrobial therapy and infection control strategies. 32 CR-ECC isolates (2018–2022) underwent Vitek-based identification and susceptibility testing. Carbapenemase production was confirmed by mCIM, with whole-genome sequencing (Illumina) for MLST phylogeny (MEGA/iTOL). Plasmid replicons and resistance/virulence genes were analyzed using PlasmidFinder and RGI/BLAST respectively. CR-ECC emerged in 2020, reaching 32 cases by 2022 as the third most prevalent carbapenem-resistant Enterobacteriaceae. Isolates mainly from sputum (43.75%, 14/32) and blood (25.00%, 8/32), with 53.13% ICU origins. Universal resistance to piperacillin/tazobactam, ceftazidime, imipenem; full susceptibility to tigecycline/colistin. Molecular analysis identified 8 STs, predominantly ST171 (56.25%) carrying blaNDM-1/OXA-1. Plasmid analysis revealed Col(pHAD28)/IncC dominance with ST-specific distribution. Virulence genes showed near-universal fimA/csgD/entB (96.88%) and mrkD (90.63%). These findings highlight the therapeutic potential of tigecycline, colistin, and amikacin against CR-ECC, while emphasizing strain-specific aztreonam susceptibility in metallo-β-lactamase producers.