Novel Enterobacter Lineage as Leading Cause of Nosocomial Outbreak Involving Carbapenemase-Producing Strains

Racha Beyrouthy (1) , Marion Marion (2) , Elodie Marion (2) , Cédric Dananché (2) , Olivier Dauwalder (3) , Frédéric Robin (1) , Lauraine Gauthier (4) , Agnès Jousset (4) , Laurent Dortet (4) , François Guérin (5) , Thomas Bénet (6) , Pierre Cassier (7) , Philippe Vanhems (6) , Richard Bonnet (1) , Marion Barets (2)

1 CNR - Centre National de Référence de la Résistance aux Antibiotiques
2 Hôpital Edouard Herriot [CHU - HCL]
3 StaPath - Pathogénie des Staphylocoques – Staphylococcal Pathogenesis
4 CNRARA/Service de Microbiologie - Centre National de Référence Associé de la Résistance aux Antibiotiques [Hôpital Bicêtre AP-HP]
5 CHU Caen
6 LPE-Fondation Mérieux - Laboratoire des pathogènes émergents -- Emerging Pathogens Laboratory
7 Centre Léon Bérard [Lyon]

We investigated unusual carbapenemase-producing Enterobacter cloacae complex isolates (n = 8) in the novel sequence type (ST) 873, which caused nosocomial infections in 2 hospitals in France. Whole-genome sequence typing showed the 1-year persistence of the epidemic strain, which harbored a blaVIM-4 ST1-IncHI2 plasmid, in 1 health institution and 2 closely related strains harboring blaCTX-M-15 in the other. These isolates formed a new subgroup in the E. hormaechei metacluster, according to their hsp60 sequences and phylogenomic analysis. The average nucleotide identities, specific biochemical properties, and pangenomic and functional investigations of isolates suggested isolates of a novel species that had acquired genes associated with adhesion and mobility. The emergence of this novel Enterobacter phylogenetic lineage within hospitals should be closely monitored because of its ability to persist and spread.

Mots clés: beta-lactamase; bacteria; antimicrobial resistance; VIM-4; Enterobacteriaceae; Enterobacter cloacae complex; Carbapenemase; CPE; next-generation sequencing; nosocomial outbreak; carbapenemase-producing Enterobacteriaceae

Domaines: Biologie moléculaire; Bactériologie

Racha Beyrouthy, Marion Marion, Elodie Marion, Cédric Dananché, Olivier Dauwalder, et al.. Novel Enterobacter Lineage as Leading Cause of Nosocomial Outbreak Involving Carbapenemase-Producing Strains. Emerging Infectious Diseases, 2018, 24 (8), pp.1505-1515. ⟨10.3201/eid2408.180151⟩. ⟨hal-02064655⟩