Session Type: ePosters
Session Title: ePosters
Authors(s): A.F. Wendel (1), D. Peter (1), F. Mattner (1), M. Weiss (2), M. Hoppenz (2), S. Wolf (3, 4), B. Bader (3, 4), S. Peter (3, 4), J. Liese (3, 4)
Authors Affiliations(s): (1) Institute of Hygiene, Cologne Merheim Medical Centre, University Hospital of Witten/Herdecke, Germany, (2) Department of Neonatology and Pediatric Intensive Care Medicine, Children's Hospital, Germany, (3) Institute of Medical Microbiology and Hygiene, University Hospital Tübingen, Germany, (4) German Center for Infection Research (DZIF), Partner Site Tübingen, Germany
Background:
Enterobacter cloacae complex is a common opportunistic pathogen on neonatal intensive care units. Active microbiological screening to guide antimicrobial empirical treatment or to detect transmission events is recommended in high-risk preterm neonates. A rise in colonization with E. cloacae complex was observed in a German perinatal centre. The aim of this study was to evaluate the performance of different typing techniques using whole genome sequencing (WGS) as a reference.
Methods:E. cloacae complex from clinical and screening specimens with an epidemiological link to the neonatal intensive care units were further assessed. Identification and antibiotic susceptibility testing was performed by a combination of VITEK2 (bioMérieux) and MALDI-TOF (Bruker Daltonics), followed by RAPD/rep-PCR and PFGE (XbaI). Retrospectively, all isolates were analyzed by Fourier-transform infrared (FTIR) spectroscopy (IR Biotyper; Bruker Daltonics). Whole genome sequencing with SNP-based clustering was used as the reference method. Furthermore, resistome analysis, sequence type and species identification were derived from the WGS data. Transmission analysis was based on epidemiological and typing data.
Results:Between September 2017 and March 2018 32 mostly preterm neonates were found to be colonized with E. cloacae complex and 32 isolates from 24 patients were available for further typing. RAPD/rep-PCR and PFGE showed good concordance with WGS whereas FTIR displayed mediocre results [adjusted rand index (ARI) = 0.436]. Two dominant and overlapping clonal clusters of two different E. hormaechei subspecies were detected. Genotyping confirmed third-generation resistance development in isolates of the same patient. Interestingly, four different species were identified. During the six months period several infection prevention interventions were performed and no more E. cloacae complex was observed in the following months.
Conclusions:Interpretation of the microbiological results alone to detect transmission events is often challenging and bacterial typing is of utmost importance to implement targeted infection control measures in an epidemic occurrence of E. cloacae complex. WGS is the most discriminatory method. However, traditional methods such as PFGE or RAPD/rep-PCR can provide reliable and quicker results in many settings. Furthermore, research is needed to quickly identify E. cloacae complex to the species level in the microbiological laboratory.
Keyword(s): Surveillance and outbreak, Enterobacter cloacae complex, NeonatologySession Type: ePosters
Session Title: ePosters
Authors(s): A.F. Wendel (1), D. Peter (1), F. Mattner (1), M. Weiss (2), M. Hoppenz (2), S. Wolf (3, 4), B. Bader (3, 4), S. Peter (3, 4), J. Liese (3, 4)
Authors Affiliations(s): (1) Institute of Hygiene, Cologne Merheim Medical Centre, University Hospital of Witten/Herdecke, Germany, (2) Department of Neonatology and Pediatric Intensive Care Medicine, Children's Hospital, Germany, (3) Institute of Medical Microbiology and Hygiene, University Hospital Tübingen, Germany, (4) German Center for Infection Research (DZIF), Partner Site Tübingen, Germany
Background:
Enterobacter cloacae complex is a common opportunistic pathogen on neonatal intensive care units. Active microbiological screening to guide antimicrobial empirical treatment or to detect transmission events is recommended in high-risk preterm neonates. A rise in colonization with E. cloacae complex was observed in a German perinatal centre. The aim of this study was to evaluate the performance of different typing techniques using whole genome sequencing (WGS) as a reference.
Methods:E. cloacae complex from clinical and screening specimens with an epidemiological link to the neonatal intensive care units were further assessed. Identification and antibiotic susceptibility testing was performed by a combination of VITEK2 (bioMérieux) and MALDI-TOF (Bruker Daltonics), followed by RAPD/rep-PCR and PFGE (XbaI). Retrospectively, all isolates were analyzed by Fourier-transform infrared (FTIR) spectroscopy (IR Biotyper; Bruker Daltonics). Whole genome sequencing with SNP-based clustering was used as the reference method. Furthermore, resistome analysis, sequence type and species identification were derived from the WGS data. Transmission analysis was based on epidemiological and typing data.
Results:Between September 2017 and March 2018 32 mostly preterm neonates were found to be colonized with E. cloacae complex and 32 isolates from 24 patients were available for further typing. RAPD/rep-PCR and PFGE showed good concordance with WGS whereas FTIR displayed mediocre results [adjusted rand index (ARI) = 0.436]. Two dominant and overlapping clonal clusters of two different E. hormaechei subspecies were detected. Genotyping confirmed third-generation resistance development in isolates of the same patient. Interestingly, four different species were identified. During the six months period several infection prevention interventions were performed and no more E. cloacae complex was observed in the following months.
Conclusions:Interpretation of the microbiological results alone to detect transmission events is often challenging and bacterial typing is of utmost importance to implement targeted infection control measures in an epidemic occurrence of E. cloacae complex. WGS is the most discriminatory method. However, traditional methods such as PFGE or RAPD/rep-PCR can provide reliable and quicker results in many settings. Furthermore, research is needed to quickly identify E. cloacae complex to the species level in the microbiological laboratory.
Keyword(s): Surveillance and outbreak, Enterobacter cloacae complex, Neonatology
Session Type: ePosters
Session Title: ePosters
Authors(s): A.F. Wendel (1), D. Peter (1), F. Mattner (1), M. Weiss (2), M. Hoppenz (2), S. Wolf (3, 4), B. Bader (3, 4), S. Peter (3, 4), J. Liese (3, 4)
Authors Affiliations(s): (1) Institute of Hygiene, Cologne Merheim Medical Centre, University Hospital of Witten/Herdecke, Germany, (2) Department of Neonatology and Pediatric Intensive Care Medicine, Children's Hospital, Germany, (3) Institute of Medical Microbiology and Hygiene, University Hospital Tübingen, Germany, (4) German Center for Infection Research (DZIF), Partner Site Tübingen, Germany
Background:
Enterobacter cloacae complex is a common opportunistic pathogen on neonatal intensive care units. Active microbiological screening to guide antimicrobial empirical treatment or to detect transmission events is recommended in high-risk preterm neonates. A rise in colonization with E. cloacae complex was observed in a German perinatal centre. The aim of this study was to evaluate the performance of different typing techniques using whole genome sequencing (WGS) as a reference.
Methods:E. cloacae complex from clinical and screening specimens with an epidemiological link to the neonatal intensive care units were further assessed. Identification and antibiotic susceptibility testing was performed by a combination of VITEK2 (bioMérieux) and MALDI-TOF (Bruker Daltonics), followed by RAPD/rep-PCR and PFGE (XbaI). Retrospectively, all isolates were analyzed by Fourier-transform infrared (FTIR) spectroscopy (IR Biotyper; Bruker Daltonics). Whole genome sequencing with SNP-based clustering was used as the reference method. Furthermore, resistome analysis, sequence type and species identification were derived from the WGS data. Transmission analysis was based on epidemiological and typing data.
Results:Between September 2017 and March 2018 32 mostly preterm neonates were found to be colonized with E. cloacae complex and 32 isolates from 24 patients were available for further typing. RAPD/rep-PCR and PFGE showed good concordance with WGS whereas FTIR displayed mediocre results [adjusted rand index (ARI) = 0.436]. Two dominant and overlapping clonal clusters of two different E. hormaechei subspecies were detected. Genotyping confirmed third-generation resistance development in isolates of the same patient. Interestingly, four different species were identified. During the six months period several infection prevention interventions were performed and no more E. cloacae complex was observed in the following months.
Conclusions:Interpretation of the microbiological results alone to detect transmission events is often challenging and bacterial typing is of utmost importance to implement targeted infection control measures in an epidemic occurrence of E. cloacae complex. WGS is the most discriminatory method. However, traditional methods such as PFGE or RAPD/rep-PCR can provide reliable and quicker results in many settings. Furthermore, research is needed to quickly identify E. cloacae complex to the species level in the microbiological laboratory.
Keyword(s): Surveillance and outbreak, Enterobacter cloacae complex, NeonatologySession Type: ePosters
Session Title: ePosters
Authors(s): A.F. Wendel (1), D. Peter (1), F. Mattner (1), M. Weiss (2), M. Hoppenz (2), S. Wolf (3, 4), B. Bader (3, 4), S. Peter (3, 4), J. Liese (3, 4)
Authors Affiliations(s): (1) Institute of Hygiene, Cologne Merheim Medical Centre, University Hospital of Witten/Herdecke, Germany, (2) Department of Neonatology and Pediatric Intensive Care Medicine, Children's Hospital, Germany, (3) Institute of Medical Microbiology and Hygiene, University Hospital Tübingen, Germany, (4) German Center for Infection Research (DZIF), Partner Site Tübingen, Germany
Background:
Enterobacter cloacae complex is a common opportunistic pathogen on neonatal intensive care units. Active microbiological screening to guide antimicrobial empirical treatment or to detect transmission events is recommended in high-risk preterm neonates. A rise in colonization with E. cloacae complex was observed in a German perinatal centre. The aim of this study was to evaluate the performance of different typing techniques using whole genome sequencing (WGS) as a reference.
Methods:E. cloacae complex from clinical and screening specimens with an epidemiological link to the neonatal intensive care units were further assessed. Identification and antibiotic susceptibility testing was performed by a combination of VITEK2 (bioMérieux) and MALDI-TOF (Bruker Daltonics), followed by RAPD/rep-PCR and PFGE (XbaI). Retrospectively, all isolates were analyzed by Fourier-transform infrared (FTIR) spectroscopy (IR Biotyper; Bruker Daltonics). Whole genome sequencing with SNP-based clustering was used as the reference method. Furthermore, resistome analysis, sequence type and species identification were derived from the WGS data. Transmission analysis was based on epidemiological and typing data.
Results:Between September 2017 and March 2018 32 mostly preterm neonates were found to be colonized with E. cloacae complex and 32 isolates from 24 patients were available for further typing. RAPD/rep-PCR and PFGE showed good concordance with WGS whereas FTIR displayed mediocre results [adjusted rand index (ARI) = 0.436]. Two dominant and overlapping clonal clusters of two different E. hormaechei subspecies were detected. Genotyping confirmed third-generation resistance development in isolates of the same patient. Interestingly, four different species were identified. During the six months period several infection prevention interventions were performed and no more E. cloacae complex was observed in the following months.
Conclusions:Interpretation of the microbiological results alone to detect transmission events is often challenging and bacterial typing is of utmost importance to implement targeted infection control measures in an epidemic occurrence of E. cloacae complex. WGS is the most discriminatory method. However, traditional methods such as PFGE or RAPD/rep-PCR can provide reliable and quicker results in many settings. Furthermore, research is needed to quickly identify E. cloacae complex to the species level in the microbiological laboratory.
Keyword(s): Surveillance and outbreak, Enterobacter cloacae complex, Neonatology