It is not usually a primary pathogen although it is sometimes associated with urinary and respiratory tract infection. Enterobacter cloacae can be acquired through the skin, urinary tract, or gastrointestinal tract. Nosocomial infection, meaning the contraction of the germ from being hospitalized, is the most prevalent mode of transmission for this organism.
This bacteria produces Beta-lactamases called cephalosporinases, which are chromosomally encoded. Endocarditis, intra abdominal infections, lower respitory tract infections, soft tissue infections, and bacteremia are examples of the various infections that E. High levels of SeO in water have been identified as the cause of embryonic deformities and the death of aquatic birds Enterobacter cloacae can be found on human skin and tissues as well as fruits, vegetables, and devices such as a hot water treatment tank.
Although this organism is mainly a pathogen for human and causes disease, Enterobacter cloacae have been used as a biological control for plant disease such as the seed-rotting oomycete in Pythium ultimum and used to control insect pests on mulberry leaves and suppress disease 3. Enterobacter cloacae are nosocomial pathogens that can be acquired through the skin, gastrointestinal tract, urinary tract or derived externally due to the ubiquitous nature. This organisms is an opportunistic pathogen, which means that the disease targets compromised patients such as the young, old, or those that have a severe disease such as human immunodeficiency virus 5.
Nosocomial infections are most frequent from this organism, which means it may be contracted from the result of being hospitalized, such as the ICU. Enterobacter cloacae have been isolated from hands of personnel, endoscopes, blood products, devices for intra-arterial pressure, stethoscopes, albumim, digital thermometers and many more 4.
There have been incidences of cross-contamination in the cardiovascular ward through the transoesophageal echocardiography probe in the ICU as well as the blood culturing system. With many possibilities for outbreaks due to Enterobacter cloacae , it is important to have routine environment cleaning, especially when new methods, equipments, or personnel are introduced 8.
Enterobacter cloacae are responsible for various infections such as bacteremia, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, endocarditis, intra-abdominal infections, septic arthritis, osteomyelitis, and ophthalmic infections.
These infections can cause morbidity and mortality and the infection is hard to manage due to their multiple antibiotic resistance. One recent study found that RamA and AcrAB genes are associated with the decreased susceptibility to tigecycline in Enterobacter cloacae.
Tigecycline is an antibiotic that is used against gram-positive and gram-negative bacterial pathogens including many strains of Enterobacter cloacae. Recently, few strains of Enterobacter cloacae have been found that have decreased susceptibility to tigecycline. By using the Northern blot analysis, a mutant of E. The results from this study show that the RamA-mediated over expression of the AcrAB efflux pump allow the decreased susceptibility to tigecycline. Research on other genes in Enterobacter cloacae can provide further knowledge about the antibiotic resistance this organism can obtain.
Another recent study found that after routine surveillance in a cardiovascular ward, there was an increase of Enterobacter cloacae isolates from the sputum and oropharyngeal cultures from 5. The data suggests cross-contamination through the transoesophageal echocardiography TOE probe in the ICU and was verified by using the pulsed-field gel electrophoresis and antibiogram patterns.
The TOE was disinfected with a 0. This study reveals that there needs to be improved methods in increasing the sensitivity of these outbreaks. Another recent research study investigated the chromate resistant mechanism of Enterobacter cloacae through atomic force microscopy.
The strain CYS of E. This study was done using atomic force microscopy which is used to see the morphological characteristics of the bacteria. It was shown that the length of the bacteria increased from 2. This mechanism of Enterobacter cloacae is used as a survival strategy by preventing chromate into the cells.
Another study showed that mutation in the cyaA gene, which encodes for adenylate cyclase in E. The strains revealed that E. The study shows that mutants and strains off E.
Another research study was done on Enterobacter cloacae and their ability to produce beta-lactamase, also known as cephalosporinases. A new chromosomal AmpC beta-lactamase was isolated from a blood culture and revealed its resistance to aminopenicillins, aztreonam, and broad-spectrum cephalosporins. The data revealed that the chromosomal location of this gene is closely related to the plasmid-borne MIR-1 from Klebsiella pneumoniae. Another research study recently done was on the antibiotic resistance of Enterobacter cloacae that was isolated from food animals such as ground beef cattle farm, processing facilities and clinical settings.
The ampC, ampD and ampR genes were sequenced and analyzed. The ampC gene was cloned into E. Systemic fat necrosis and septic arthritis in acute pancreatitis. Ned Tijdschr Geneeskd. Cervical spine epidural abscess in a patient with no predisposing risk factors. Ann Emerg Med. Pediatr Emerg Care. Enterobacter-cloacae vertebral infection in a heroin-addict with HIV-infection. Multiple joint infections with Enterobacter cloacae.
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Rev Bras Ortop. Download references. You can also search for this author in PubMed Google Scholar. JJH was involved in the literature review and drafting of the manuscript. QLX and HX gathered the data of the patient. JXY was the lead physician and provided critical review.
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Reprints and Permissions. Huang, J. Enterobacter cloacae infection of the shoulder in a year-old woman without apparent predisposing risk factor: a case report and literature review. BMC Infect Dis 21, 13 Download citation.
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Provided by the Springer Nature SharedIt content-sharing initiative. Skip to main content. Search all BMC articles Search. Download PDF. Abstract Background Enterobacter cloacae E. Case presentation A year-old female with a 6-year history of right shoulder pain was referred to our emergency department due to fever, acute severe shoulder pain, and swelling.
Conclusion This is a rare case of E. Background E. Case presentation A year-old female was admitted to our emergency department with fever, sore throat, acute severe right shoulder pain with a burning sensation, redness and swelling.
Posteroanterior view showing degenerative change. Full size image. MRI of the right shoulder showing supraspinatus tendon tear arrow and massive abscess. Table 1 Antimicrobial Susceptibility Testing of E. Discussion and conclusion E. Table 2 Summary of E. Availability of data and materials The main data generated or analyzed in this case report are included in the article. References 1. Article PubMed Google Scholar 6. Article PubMed Google Scholar 7.
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