Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jun 26;13(7):592.
doi: 10.3390/antibiotics13070592.

Genomic Study of High-Risk Clones of Enterobacter hormaechei Collected from Tertiary Hospitals in the United Arab Emirates

Akela Ghazawi  1 , Febin Anes  2 , Shaimaa Mouftah  3 , Mohammed Elbediwi  4   5 , Awase Baig  1 , Muna Alketbi  1 , Fatema Almazrouei  1 , Mariam Alhashmi  1 , Norah Alzarooni  1 , Ashrat Manzoor  1 , Ihab Habib  2 , Nikolaos Strepis  6 , Anju Nabi  7 , Mushtaq Khan  1
Affiliations

Genomic Study of High-Risk Clones of Enterobacter hormaechei Collected from Tertiary Hospitals in the United Arab Emirates

Akela Ghazawi et al. Antibiotics (Basel). .

Abstract

Enterobacter hormaechei has emerged as a significant pathogen within healthcare settings due to its ability to develop multidrug resistance (MDR) and survive in hospital environments. This study presents a genome-based analysis of carbapenem-resistant Enterobacter hormaechei isolates from two major hospitals in the United Arab Emirates. Eight isolates were subjected to whole-genome sequencing (WGS), revealing extensive resistance profiles including the blaNDM-1, blaOXA-48, and blaVIM-4 genes. Notably, one isolate belonging to ST171 harbored dual carbapenemase genes, while five isolates exhibited colistin resistance without mcr genes. The presence of the type VI secretion system (T6SS), various adhesins, and virulence genes contributes to the virulence and competitive advantage of the pathogen. Additionally, our isolates (87.5%) possessed ampC β-lactamase genes, predominantly blaACT genes. The genomic context of blaNDM-1, surrounded by other resistance genes and mobile genetic elements, highlights the role of horizontal gene transfer (HGT) in the spread of resistance. Our findings highlight the need for rigorous surveillance, strategic antibiotic stewardship, and hospital-based WGS to manage and mitigate the spread of these highly resistant and virulent pathogens. Accurate identification and monitoring of Enterobacter cloacae complex (ECC) species and their resistance mechanisms are crucial for effective infection control and treatment strategies.

Keywords: Enterobacter hormachei; MDR; incompatibility types; plasmids; whole-genome sequencing.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Antimicrobial resistance genes and resistome profile of Enterobacter hormaechei isolates. Orange tiles indicate the presence of the gene, blue indicates the absence of the gene.
Figure 2
Figure 2
Circular maps of plasmids isolated from Enterobacter hormaechei isolates. This figure represents the circular maps of plasmids pCRE41-NDM (A), pCRE45-OXA-48 (B), pCRE46-NDM (C), pCRE48-NDM (D), pCRE52-NDM (E), pCRE60-NDM (F), pCRE70-VIM (G), pCRE81-NDM (H), and pCRE81-OXA (I). Annotations include GC content (black), GC Skew+ (green), GC Skew- (purple), Genes (red), and tRNA (light green). The plasmids contain several resistance genes: pCRE41-NDM (A) includes blaNDM1, blaCTX-M-15, qnrS1, and aadA1; pCRE45-OXA-48 (B) includes blaOXA-48; pCRE46-NDM (C) includes blaNDM1, blaCTX-M-15, qnrS1, and aadA1; pCRE48-NDM (D), pCRE52-NDM €, and pCRE60-NDM (F) include blaNDM1, rmtC, sul1, and dfrA14; pCRE70-VIM (G) includes blaVIM-4, mphA, sul2, cmlA5, and aac(6’)-II; pCRE81-NDM (H) includes blaNDM-1, blaTEM-1, qnrS1, and aadA1; and pCRE81-OXA (I) includes blaOXA-48, blaOXA-1, and dfrA14. The outermost ring shows the annotated genes, while the inner rings display GC content and GC skew.
Figure 3
Figure 3
Genetic context and comparative analysis of resistance genes in Enterobacter hormaechei isolates. (A) Genomic context of the blaNDM-1 gene. The blaNDM-1 gene is surrounded by a cluster of genes and mobile genetic elements that may contribute to its spread and stability, including aph(3′)-VI (associated with aminoglycoside resistance), IS30 (an insertion sequence), and ble (encoding a bleomycin resistance protein), as well as putative genes for isomerase and reductase. (B) Genetic context of the blaOXA-48 gene. The blaOXA-48 gene is consistently associated with the presence of a transcriptional regulator (LysR). (C) Genetic context of the blaVIM-4 gene. The blaVIM-4 gene co-locates with the aminoglycoside resistance gene aac(6′)-lc and the trimethoprim resistance gene dfrA1.
Figure 4
Figure 4
Circular visualization of k-mer sequence comparisons (approximately 4.7–5.3 megabases) of the eight Enterobacter hormaechei isolates investigated in this study with 125 publicly available Enterobacter hormaechei genomes. The maximum-likelihood tree in the Figure describes the SNP differences. From the inner to the outer circle: the inner circle indicates publicly available genomes of Enterobacter hormaechei, with the names from the current UAE study marked in red and in a larger font size; the second circle shows the host from which the Enterobacter hormaechei was isolated; the third circle indicates the country of isolation.
See this image and copyright information in PMC

References

    1. De Oliveira D.M.P., Forde B.M., Kidd T.J., Harris P.N.A., Schembri M.A., Beatson S.A., Paterson D.L., Walker M.J. Antimicrobial Resistance in ESKAPE Pathogens. Clin. Microbiol. Rev. 2020;33:e00181-19. doi: 10.1128/CMR.00181-19. - DOI - PMC - PubMed
    1. St John A., Perault A.I., Giacometti S.I., Sommerfield A.G., DuMont A.L., Lacey K.A., Zheng X., Sproch J., Petzold C., Dancel-Manning K., et al. Capsular Polysaccharide Is Essential for the Virulence of the Antimicrobial-Resistant Pathogen Enterobacter hormaechei. mBio. 2023;14:e0259022. doi: 10.1128/mbio.02590-22. - DOI - PMC - PubMed
    1. Dong X., Zhu M., Li Y., Huang D., Wang L., Yan C., Zhang L., Dong F., Lu J., Lin X., et al. Whole-Genome Sequencing-Based Species Classification, Multilocus Sequence Typing, and Antimicrobial Resistance Mechanism Analysis of the Enterobacter cloacae Complex in Southern China. Microbiol. Spectr. 2022;10:e0216022. doi: 10.1128/spectrum.02160-22. - DOI - PMC - PubMed
    1. Wendel A.F., Peter D., Mattner F., Weiss M., Hoppenz M., Wolf S., Bader B., Peter S., Liese J. Surveillance of Enterobacter cloacae Complex Colonization and Comparative Analysis of Different Typing Methods on a Neonatal Intensive Care Unit in Germany. Antimicrob. Resist. Infect. Control. 2022;11:54. doi: 10.1186/s13756-022-01094-y. - DOI - PMC - PubMed
    1. Liu Y., Li F., Fang Y., Zhong Q., Xiao Y., Zheng Y., Zhu J., Zhao C., Cao X., Xiong J., et al. Clinical Characteristics, Prognosis and Treatment of Bloodstream Infections with Enterobacter Cloacae Complex in a Chinese Tertiary Hospital: A Retrospective Study. Infect. Drug Resist. 2024;17:1811–1825. doi: 10.2147/IDR.S460744. - DOI - PMC - PubMed

LinkOut - more resources