Nosocomial outbreak of extended-spectrum β-lactamase-producing Enterobacter ludwigii co-harbouring CTX-M-8, SHV-12 and TEM-15 in a neonatal intensive care unit in Venezuela.

摘要: Enterobacter spp. have emerged as an important group of pathogens linked to outbreaks in neonatal intensive care units (NICUs), usually involving strains expressing extended-spectrum β-lactamases (ESBLs). The aim this study was describe the first nosocomial bloodstream infection outbreak caused by ludwigii co-harbouring CTX-M-8, SHV-12 and TEM-15 a NICU Venezuelan hospital. Initial bacterial identification achieved VITEK®2 system matrix-assisted laser desorption/ionisation time-of-flight mass spectrometry (VITEK® MS) subsequently confirmed nucleotide sequencing 16S rDNA gene hsp60 genotyping. Antimicrobial susceptibility testing determined AST-GN-299 cards Etest strips. Isolates were typed repetitive element sequence-based PCR (rep-PCR). Detection blaESBL genes carried out molecular methods. Plasmid analysis included Southern blot restriction pattern analysis, with transferability resistance being assessed conjugation. ESBL-producing E. isolates recovered from three neonates 21-day period. rep-PCR fingerprints indistinguishable among all isolates, strongly suggesting spread clonal strain. All ca. 56kb conjugative plasmid harbouring blaCTX-M-8, blaSHV-12 blaTEM-15 genes. Considering that isolation remains unusual phenomenon, not previously reported Venezuela, results reveal potential role emerging pathogen highlight importance microbiological surveillance judicious antibiotic use measures curb emergence bacteria.