Clinical Characteristics and Risk Factors for Multidrug-Resistant Enterobacter cloacae Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013–2022)

Mei Han,1,2,* Miaomiao Hua,3,* Hui Xie,1 Jia Li,1 Yijun Wang,2,4 Han Shen,1 Xiaoli Cao1 1Department of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China; 2Nanjing Field Epidemio...

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Main Authors: Han M, Hua M, Xie H, Li J, Wang Y, Shen H, Cao X
Format: Article
Language:English
Published: Dove Medical Press 2025-01-01
Series:Infection and Drug Resistance
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Online Access:https://www.dovepress.com/clinical-characteristics-and-risk-factors-for-multidrug-resistant-ente-peer-reviewed-fulltext-article-IDR
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author Han M
Hua M
Xie H
Li J
Wang Y
Shen H
Cao X
author_facet Han M
Hua M
Xie H
Li J
Wang Y
Shen H
Cao X
author_sort Han M
collection DOAJ
description Mei Han,1,2,&ast; Miaomiao Hua,3,&ast; Hui Xie,1 Jia Li,1 Yijun Wang,2,4 Han Shen,1 Xiaoli Cao1 1Department of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China; 2Nanjing Field Epidemiology Training Program, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, People’s Republic of China; 3Department of Laboratory Medicine, The Affiliated Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, People’s Republic of China; 4Nanjing Jiangning District Center for Disease Control and Prevention, Nanjing, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiaoli Cao; Han Shen, Email cao-xiao-li@163.com; shenhan10366@sina.comObjective: This study aimed to analyze the antimicrobial resistance profiles, clinical characteristics and risk factors of bacteremia caused by Enterobacter cloacae complex (ECC) strains.Methods: We retrospectively collected clinical data from patients diagnosed with ECC bacteremia between 2013 and 2022 in a tertiary hospital in Jiangsu. Subgroup analyses were performed based on multidrug resistance (MDR), nosocomial acquisition, polymicrobial bacteremia, and mortality.Results: Among 188 ECC strains, the highest resistance was to ceftriaxone (39.9%), followed by ceftazidime (36.7%) and aztreonam (31.2%), with low resistance to carbapenems (< 8.6%) and amikacin (1.6%). MDR ECC accounted for 30.9% (58/188). Previous antibiotic therapy was an independent risk factor for MDR ECC (OR = 3.193, P < 0.020), while appropriate antibiotic therapy significantly reduced the risk (OR = 0.279, P < 0.001). ICU admission was an independent risk factor for polymicrobial bacteremia, both endoscopy and blood transfusion were associated with mortality.Conclusion: Carbapenems and amikacin are the most effective treatments for ECC bacteremia. Previous antibiotic therapy increases the risk of MDR ECC, while appropriate antibiotic therapy reduces it. ICU admission is an independent risk factor for polymicrobial bacteremia, both endoscopy and blood transfusion are linked to higher mortality. Effective control of MDR ECC bacteremia requires comprehensive strategies, including resistance detection, risk factor identification, and infection prevention.Keywords: Enterobacter cloacae complex, bacteremia, multidrug-resistance, clinical characteristics, risk factors
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spelling doaj-art-d563cbda87764f69952b07617ed2ca392025-01-23T18:50:33ZengDove Medical PressInfection and Drug Resistance1178-69732025-01-01Volume 1842744099488Clinical Characteristics and Risk Factors for Multidrug-Resistant Enterobacter cloacae Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013&ndash;2022)Han MHua MXie HLi JWang YShen HCao XMei Han,1,2,&ast; Miaomiao Hua,3,&ast; Hui Xie,1 Jia Li,1 Yijun Wang,2,4 Han Shen,1 Xiaoli Cao1 1Department of Laboratory Medicine, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, People’s Republic of China; 2Nanjing Field Epidemiology Training Program, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, People’s Republic of China; 3Department of Laboratory Medicine, The Affiliated Fuyang Hospital of Anhui Medical University, Fuyang, Anhui, People’s Republic of China; 4Nanjing Jiangning District Center for Disease Control and Prevention, Nanjing, Jiangsu, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xiaoli Cao; Han Shen, Email cao-xiao-li@163.com; shenhan10366@sina.comObjective: This study aimed to analyze the antimicrobial resistance profiles, clinical characteristics and risk factors of bacteremia caused by Enterobacter cloacae complex (ECC) strains.Methods: We retrospectively collected clinical data from patients diagnosed with ECC bacteremia between 2013 and 2022 in a tertiary hospital in Jiangsu. Subgroup analyses were performed based on multidrug resistance (MDR), nosocomial acquisition, polymicrobial bacteremia, and mortality.Results: Among 188 ECC strains, the highest resistance was to ceftriaxone (39.9%), followed by ceftazidime (36.7%) and aztreonam (31.2%), with low resistance to carbapenems (< 8.6%) and amikacin (1.6%). MDR ECC accounted for 30.9% (58/188). Previous antibiotic therapy was an independent risk factor for MDR ECC (OR = 3.193, P < 0.020), while appropriate antibiotic therapy significantly reduced the risk (OR = 0.279, P < 0.001). ICU admission was an independent risk factor for polymicrobial bacteremia, both endoscopy and blood transfusion were associated with mortality.Conclusion: Carbapenems and amikacin are the most effective treatments for ECC bacteremia. Previous antibiotic therapy increases the risk of MDR ECC, while appropriate antibiotic therapy reduces it. ICU admission is an independent risk factor for polymicrobial bacteremia, both endoscopy and blood transfusion are linked to higher mortality. Effective control of MDR ECC bacteremia requires comprehensive strategies, including resistance detection, risk factor identification, and infection prevention.Keywords: Enterobacter cloacae complex, bacteremia, multidrug-resistance, clinical characteristics, risk factorshttps://www.dovepress.com/clinical-characteristics-and-risk-factors-for-multidrug-resistant-ente-peer-reviewed-fulltext-article-IDRenterobacter cloacae complexbacteremiamultidrug-resistanceclinical characteristicsrisk factors.
spellingShingle Han M
Hua M
Xie H
Li J
Wang Y
Shen H
Cao X
Clinical Characteristics and Risk Factors for Multidrug-Resistant Enterobacter cloacae Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013&ndash;2022)
Infection and Drug Resistance
enterobacter cloacae complex
bacteremia
multidrug-resistance
clinical characteristics
risk factors.
title Clinical Characteristics and Risk Factors for Multidrug-Resistant Enterobacter cloacae Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013&ndash;2022)
title_full Clinical Characteristics and Risk Factors for Multidrug-Resistant Enterobacter cloacae Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013&ndash;2022)
title_fullStr Clinical Characteristics and Risk Factors for Multidrug-Resistant Enterobacter cloacae Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013&ndash;2022)
title_full_unstemmed Clinical Characteristics and Risk Factors for Multidrug-Resistant Enterobacter cloacae Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013&ndash;2022)
title_short Clinical Characteristics and Risk Factors for Multidrug-Resistant Enterobacter cloacae Complex Bacteremia in a Chinese Tertiary Hospital: A Decade Review (2013&ndash;2022)
title_sort clinical characteristics and risk factors for multidrug resistant enterobacter cloacae complex bacteremia in a chinese tertiary hospital a decade review 2013 ndash 2022
topic enterobacter cloacae complex
bacteremia
multidrug-resistance
clinical characteristics
risk factors.
url https://www.dovepress.com/clinical-characteristics-and-risk-factors-for-multidrug-resistant-ente-peer-reviewed-fulltext-article-IDR
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