Emergence of a carbapenem-resistant and colistin-heteroresistant Enterobacter cloacae clinical isolate in Japan. Issue 4 (April 2019)

• Record Type: Journal Article
• Authors: Uechi, Kohei; Tada, Tatsuya; Shimada, Kayo; Nakasone, Isamu; Kirikae, Teruo; Fujita, Jiro
• Is Part Of: Journal of infection and chemotherapy. Volume 25:Issue 4(2019:Apr.)
• Page Start: 285
• Page End: 288
• Publication Date: 2019-04
• Subjects: Carbapenem resistance -- Class C β-lactamase ACT-2 -- Colistin heteroresistance -- Enterobacter cloacae; Chemotherapy -- Periodicals; Infection -- Periodicals; Communicable diseases -- Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1016/j.jiac.2018.09.004
• Languages: English
• ISSNs: 1341-321X

Abstract

Abstract: A carbapenem-resistant and colistin-heteroresistant clinical isolate of Enterobacter cloacae was obtained from an inpatient in Okinawa, Japan. The minimum inhibitory concentrations of both imipenem and meropenem were 32 μg/mL. The isolate showed heteroresistance to colistin using the Etest method and resistance to colistin using the broth microdilution method. It had a disrupted ompC and a mutation in the promoter region of bla ACT-2, but did not harbor any genes encoding carbapenemase. The disruption of ompC and the mutation in bla ACT-2 was associated with the carbapenem resistance of this isolate. This isolate also had mutations in pmrAB and phoPQ encoding two-component regulatory systems, which may be associated with colistin heteroresistance.