Clinical characteristics and outcome of bacteraemia caused by Enterobacter cloacae and Klebsiella aerogenes: more similarities than differences

• Published in: Journal of global antimicrobial resistance. Vol. 25; pp. 351 - 358
• Main Authors: Álvarez-Marín, Rocío, Lepe, José Antonio, Gasch-Blasi, Oriol, Rodríguez-Martínez, José Manuel, Calvo-Montes, Jorge, Lara-Contreras, Rosario, Martín-Gandul, Cecilia, Tubau-Quintano, Fe, Cano-García, María Eliecer, Rodríguez-López, Fernando, Rodríguez-Baño, Jesús, Pujol-Rojo, Miquel, Torre-Cisneros, Julián, Martínez-Martínez, Luis, Pascual-Hernández, Álvaro, Jiménez-Mejías, Manuel E.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.06.2021; Elsevier
• Subjects: Bacteraemia; Bacteremia - drug therapy; Case–control study; Enterobacter aerogenes; Enterobacter cloacae; Enterobacter cloacae - genetics; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - epidemiology; Humans; Klebsiella aerogenes; Prospective Studies; Quinolone resistance mechanism; Klebsiella aerogenes; Bacteraemia; Enterobacter cloacae; Enterobacter aerogenes; Quinolone resistance mechanism; Case–control study
• ISSN: 2213-7165; 2213-7173
• DOI: 10.1016/j.jgar.2021.04.008

•Enterobacter aerogenes has been reclassified as Klebsiella aerogenes.•Bacteraemia caused by K. aerogenes or Enterobacter cloacae did not show clinical differences.•Patients with E. cloacae had more co-morbidities; those with K. aerogenes received more antibiotics.•Susceptibility to antibiotics was similar for both species. The genus Enterobacter is a common cause of nosocomial infections. Historically, the most frequent Enterobacter species were those of Enterobacter cloacae complex and Enterobacter aerogenes. In 2019, E. aerogenes was re-classified as Klebsiella aerogenes owing to its higher genotypic similarity with the genus Klebsiella. Our objective was to characterise and compare the clinical profiles of bacteraemia caused by E. cloacae and K. aerogenes. This 3-year multicentre, prospective cohort study enrolled consecutive patients with bacteraemia by E. cloacae or K. aerogenes. Baseline characteristics, bacteraemia features (source, severity, treatment), antibiotic susceptibility, resistance mechanisms and mortality were analysed. The study included 285 patients with bacteraemia [196 (68.8%) E. cloacae and 89 (31.2%) K. aerogenes]. The groups showed no differences in age, sex, previous use of invasive devices, place of acquisition, sources or severity at onset. The Charlson score was higher among patients with E. cloacae bacteraemia [2 (1–4) vs. 1 (0.5–3); P = 0.018], and previous antibiotic therapy was more common in patients with K. aerogenes bacteraemia (57.3% vs. 41.3%; P = 0.01). Mortality was 19.4% for E. cloacae and 20.2% for K. aerogenes (P = 0.869). Antibiotic susceptibility was similar for both species, and the incidence of multidrug resistance or ESBL production was low (6% and 5.3%, respectively), with no differences between species. Bacteraemias caused by E. cloacae and K. aerogenes share similar patient profiles, presentation and prognosis. Patients with E. cloacae bacteraemia had more co-morbidities and those with K. aerogenes bacteraemia had received more antibiotics.