240 enterobacteriaceae strains were maintained in EGG medium IPH for 14 years (1985-2000) or 10 years (1990-2000). Results: E.coli, Shigella spp., Salmonella spp., Klebsiella spp. and Proteus spp., survived: 88.6%; 94.44%; 90%; 100%; and 100% respectively, but only 18% of Vibrio cholerae serotype Inaba strains survived. However, 86,67% of Vibrio cholerae serotype Inaba strains survived for 10 years (1990-2000).
Bacterial Infections ; Enterobacteriaceae

Extended-spectrum beta-lactamases (ESBLs) in gram-negative organisms have been implicated as the enzymes responsible for resistance to oxyimino-cephalosporins. The incidence of ESBL- producers in Korean isolates of Escherichia coli and Klebsiella pneumoniae were in the range of 4.8 7.5% and 22.5 22.8%, respectively. The ESBL-producing isolates revealed variable levels of resistance to cefotaxime, ceftazidime and aztreonam. They also showed the elevated MIC values of non-beta-lactam antibiotics. SHV-12 and SHV-2a were the enzymes most frequently found in K. pneumoniae strains, but TEM-52 was the most prevalent in E. coli isolates. About 15% of ESBL-producing isolates of Enterobacteriaceae produced CMY-1 enzyme, which conferred resistance to cephamycins such as cefoxitin as well as oxyimino-cephalosporins. Thus, the most common types of ESBLs in Korea are TEM-52, SHV-12, SHV-2a, and CMY-1.
Drug Resistance, Microbial/physiology ; Enterobacteriaceae/isolation & purification ; Enterobacteriaceae/chemistry* ; Enterobacteriaceae Infections/microbiology ; Human ; Korea ; beta-Lactamases/analysis*

Objective: To analyze the hints role of surveillance cultures of Carbapenem-resistant Enterobacteriaceae (CRE) by perianal swabs in patients with hematological diseases, and seek risk factors of CRE bloodstream infection. Methods: The resistance of CRE from 2 914 patients with hematological diseases who cultured perianal swabs, CRE bloodstream infection and risk factors were analyzed during January 2016 to December 2017. Results: In this study, perianal swabs from 2 914 patients with hematological diseases were cultured, 74 patients were CRE positive, and bloodstream infection with CRE was found in 13 of these patients. A total of 87 CRE strains were isolated (The same patient only keep the first one for the same location), including 31 Klebsiella pheuminiae, 43 Escherichia coli, 8 Enterobacter cloacae and 6 other Enterobacteriaceae. The resistance rates to piperacillin / tazobactam, imipenem, meropenam, amikacin, levofloxacin, tigecycline were 91.9%, 74.4%, 98.8%, 17.6%, 74.4% and 8.0%, respectively. Resistance to carbapenem, aminoglycoside, quinolones and tegacycline were highly consistent between two sites from 13 patients, whose both perianal swabs and blood were positive in CRE cultures. Febrile neutropenic time, digestive tract symptoms and perianal infection were independent risk factors for bloodstream infection in patients with perianal swabs positive results, the odds ratios (OR) were 1.10 (P=0.029), 1.13 (P=0.005) and 1.23 (P=0.016), respectively. Conclusion: Perianal swabs surveillance cultures of CRE can be hints for CRE bloodstream infection in patients with hematological diseases, and also can provide suggestions for antibiotics. Long time of febrile neutropenic, digestive tract symptoms and perianal infection can be the early warning for CRE bloodstream infections.
Anti-Bacterial Agents ; Bacteremia ; Carbapenem-Resistant Enterobacteriaceae ; Carbapenems ; Enterobacteriaceae Infections ; Hematologic Diseases ; Humans

Leclercia adecarboxylata is a Gram-negative bacterium belonging to the Enterobacteriaceae family. To our knowledge, this is the first report of a carbapenem-resistant L. adecarboxylata strain isolated from a healthy newborn. The L. adecarboxylata strain isolated in this study carried four plasmids that may serve as reservoirs for antibiotic resistance genes. Plasmids 2 and 4 did not harbor any antimicrobial resistance genes. Plasmid 3 is a novel plasmid containing three resistance genes. The bla _IMP gene harbored in the strain was most similar to bla _IMP-79 at the nucleotide level, with a similarity of 99.4% (737/741). This case highlights the importance of considering L. adecarboxylata as a potential cause of infections in children.
Infant, Newborn ; Child ; Humans ; Female ; Enterobacteriaceae Infections/microbiology* ; Enterobacteriaceae/genetics* ; Anti-Bacterial Agents/therapeutic use* ; Plasmids

OBJECTIVES: To systematically assess the risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children. METHODS: PubMed, Web of Science, China National Knowledge Infrastructure Database, Wanfang Data, China Biology Medicine disc were searched to obtain the articles on risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children published up to May 31, 2021. RevMan 5.3 software was used to perform the Meta analysis. RESULTS: A total of 13 articles were included, with 1 501 samples in total. The Meta analysis showed that indwelling gastric tube (OR=4.91), tracheal intubation (OR=5.03), central venous catheterization (OR=3.75), indwelling urinary catheterization (OR=4.11), mechanical ventilation (OR=3.09), history of hospitalization in the intensive care unit (OR=2.39), history of surgical operation (OR=3.22), previous use of third-generation cephalosporins (OR=2.62), previous use of carbapenem antibiotics (OR=3.82), previous use of glycopeptide antibiotics (OR=3.48), previous use of β-lactamase inhibitors (OR=2.87), previous use of antifungal drugs (OR=2.48), previous use of aminoglycoside antibiotics (OR=2.54), and Apgar score ≤7 at 1 minute after birth (OR=2.10) were risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children (P<0.05). CONCLUSIONS Invasive operations, history of hospitalization in the intensive care unit, previous use of antibiotics such as carbapenem antibiotics, and Apgar score ≤7 at 1 minute after birth are risk factors for the colonization or infection of carbapenem-resistant Enterobacteriaceae in children.
Anti-Bacterial Agents/therapeutic use* ; Carbapenem-Resistant Enterobacteriaceae ; Carbapenems/pharmacology* ; Child ; Enterobacteriaceae Infections/microbiology* ; Humans ; Risk Factors

OBJECTIVETo characterize the time distribution of the incidence of Enterobacter cloacae nosocomial infections in children hospitalized in the pediatric intensive care unit (PICU) of the First Affiliated Hospital of Xinjiang Medical University.

METHODSThe clinical data of children with Enterobacter cloacae nosocomial infections in the PICU of the First Affiliated Hospital of Xinjiang Medical University between January 2010 and December 2013 were collected. The monthly number of cases of Enterobacter cloacae nosocomial infections was recorded, and time series analysis was performed using SPSS 21.0 software. The obtained prediction model was verified using the data from January to June in 2014.

RESULTSA total of 157 cases of Enterobacter cloacae nosocomial infections were reported in the PICU between January 2010 and December 2013, including 33 cases in 2010, 35 cases in 2011, 37 cases in 2012, and 52 cases in 2013. Time series analysis of the monthly number of cases of nosocomial infections reveals a fitted curve with a clear pattern of seasonal variation (R2=0.702, Ljung-Box Q(18)=36.021, P=0.004), with peaks in May, June, and July. The verification using the data from January to June in 2014 showed small differences between the predicted values and the actual values.

CONCLUSIONSIn the PICU of the First Affiliated Hospital of Xinjiang Medical University, the incidence of Enterobacter cloacae nosocomial infections is high in May, June, and July every year. The prediction model is accurate and can provide a reference for infection prevention.

Child ; Cross Infection ; epidemiology ; Enterobacter cloacae ; Enterobacteriaceae Infections ; epidemiology ; Hospitalization ; Humans ; Intensive Care Units, Pediatric ; Seasons

OBJECTIVEGas-containing encephalo-meningitis is very rare. There have only been a few cases reported in the literature. The majority of neonatal cases reported in literature died. We report a case of a 5-day-old neonate who developed diffuse pneumocephalus from Enterobacter cloacae septicemia and intracranial infection.

METHODThis neonate was initially treated with penicillin and mezlocillin. He also received phototherapy, intravenous infusion, correction of acidosis and other supportive therapy. Complete blood count, C-Reactive protein, cranial CT scan, blood culture, cerebrospinal fluid culture and biochemistry were tested repeatedly.

RESULTSThis neonate's condition deteriorated after admission. He developed respiratory distress, increased muscle tone and decreased level of consciousness. His WBC and C-reactive protein were elevated, while blood gas, electrolytes, liver enzymes and renal function were within normal range initially. Cranial CT scan was done which demonstrated diffuse pneumocephalus. He was transferred to a higher level hospital for further management at the request of the family. Blood culture done in our hospital subsequently showed growth of Enterobacter cloacae. The infant developed seizures and further deterioration in level of consciousness after transfer. Antibiotics were switched to penicillin and ceftizoxime. Cranial CT scan repeated 2 days after transfer showed hydrocephalus and some resolution of pneumocephalus. Cerebrospinal fluid (CSF) was aspirated from the lateral ventricles two weeks after admission. CSF culture also showed growth of Enterobacter cloacae. Antibiotic was switched to imipenem according to antibiotic sensitivity. His general condition was improved. Blood and CSF cultures were negative 1 month after admission. His head circumference at discharge was 34.6 cm. Repeat cranial CT scan at 4 month of age demonstrated severe hydrocephalus, diffuse leukomalacia and calcification. This infant suffered significant neurodevelopmental deficit. Muscle tone was diffusely increased. Head circumference at 9 month of age was 48.4 cm.

CONCLUSIONThis case suggests the importance of Enterobacter cloacae infection in the newborns. Our analysis of 34 cases of Enterobacter cloacae infection showed that 93.75% - 100% were sensitive to quinolones, 94.12% were sensitive to imipenem, 73.33% were sensitive to gentamicin, 50% were sensitive to piperacillin-tazobactam. Enterobacter cloacae is generally not sensitive to penicillin, first and second generation cephalosporins (0 - 21.4%). Enterobacter cloacae septicemia and intracranial infection in neonates have a high mortality rate and can result in severe neurodevelopmental deficit in survivors.

Enterobacter cloacae ; Enterobacteriaceae Infections ; pathology ; Humans ; Infant, Newborn ; Male ; Meningitis ; microbiology ; Pneumocephalus ; microbiology

This study was performed for the assessing the distribution, drug resistance and its transferability, and cell agglutinating ability of Enterobacteriaceae isolated from urine of patients with urinary tract infection. Total 164 strains of Strains of Enterobacteriaceae including, 91 strains of E. coli, 35 strains of klebsiella, 23 strains of Proteus, 6 strains of Serratia, 6 strains of Citrobacter, 3 strains of Enterobacteriaceae were isolated from urine. In the cell agglutinating test, most organisms, except Proteus, showed mannose resistant agglutination. Among organisms tested more than 20 strains, E. coli showed highest frequency of cell agglutination. In the comparison of cell agglutinating characteristics of E. coli and Klebsiella isolated from urine and other sources urinary isolates of E. coli showed higher frequency of agglutination and greater agglutinating potency than isolates from other sources, but Klebsiella showed little difference between isolates of urine and other sources. Urinary isolates usually showed high frequency of resistance to penicillin(90%), ampicillin(89%). sulfamethoxazole(69%), tetracycline(66%), chloramphenicol(53%), but showed low frequency of resistance to moxalactam(1%), amikacin(2%), and nalidixic acid (9%), and these resistance were highly transferable resistance mediated by R plasmid.
Agglutination ; Citrobacter ; Drug Resistance* ; Enterobacteriaceae ; Humans ; Klebsiella ; Mannose ; Nalidixic Acid ; Plasmids ; Proteus ; Serratia ; Urinary Tract Infections

Salmonella are motile, gram-negative, non-spore-forming members of the family Enterobacteriaceae. Among nontyphoid Salmonella serotypes, Salmonella choleraesuis shows a high predilection to cause systemic infections in humans. Thoracic infection is a rare complication of Salmonella infection. So far, most of reported cases of empyema caused by Salmonella spp. have involved immunocompromised patients. Herein, as we had experienced one case of thoracic empyema due to Salmonella choleraesuis related thymoma, we report it with review of literature.
Empyema ; Empyema, Pleural* ; Enterobacteriaceae ; Humans ; Immunocompromised Host ; Salmonella Infections ; Salmonella* ; Thymoma

Salmonella are motile, gram-negative, non-spore-forming members of the family Enterobacteriaceae. Among nontyphoid Salmonella serotypes, Salmonella choleraesuis shows a high predilection to cause systemic infections in humans. Thoracic infection is a rare complication of Salmonella infection. So far, most of reported cases of empyema caused by Salmonella spp. have involved immunocompromised patients. Herein, as we had experienced one case of thoracic empyema due to Salmonella choleraesuis related thymoma, we report it with review of literature.
Empyema ; Empyema, Pleural* ; Enterobacteriaceae ; Humans ; Immunocompromised Host ; Salmonella Infections ; Salmonella* ; Thymoma