From the Research
Enterobacter is a genus of gram-negative, rod-shaped bacteria belonging to the family Enterobacteriaceae, commonly found in the human gastrointestinal tract, soil, water, and sewage, and can cause various infections, particularly in healthcare settings and immunocompromised individuals, with the most clinically significant species including Enterobacter cloacae and Enterobacter aerogenes (now reclassified as Klebsiella aerogenes) 1.
Key Characteristics of Enterobacter
- Gram-negative, rod-shaped bacteria
- Belong to the family Enterobacteriaceae
- Commonly found in the human gastrointestinal tract, soil, water, and sewage
- Can exist as normal gut flora, but also opportunistic pathogens
- Can cause urinary tract infections, pneumonia, bloodstream infections, and surgical site infections
Concerns and Challenges
- Often carry resistance to multiple antibiotics, including third-generation cephalosporins due to inducible AmpC beta-lactamases
- Treatment typically requires carbapenems (like meropenem or imipenem), fluoroquinolones, or aminoglycosides, depending on susceptibility testing
- Infection control measures in healthcare settings are crucial to prevent Enterobacter outbreaks, including proper hand hygiene, contact precautions, and environmental cleaning
- Ability to rapidly develop resistance during treatment makes them a significant challenge in clinical practice 2
Recent Guidance and Recommendations
- The Infectious Diseases Society of America provides guidance on the treatment of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-E), carbapenem-resistant Enterobacterales (CRE), and Pseudomonas aeruginosa with difficult-to-treat resistance (DTR-P. aeruginosa) 1
- New antimicrobials like ceftazidime-avibactam, meropenem-vaborbactam, imipenem-relebactam, cefiderocol, and plazomicin have the potential to overcome resistance mechanisms in Enterobacterales, including different classes of carbapenemases 2