Risk factors and antimicrobial resistance of ESBL-positive Enterobacter cloacae complex bloodstream infections: a retrospective clinical and molecular study
Abstract
Abstract Background Bloodstream infections caused by the Enterobacter cloacae complex (ECC) are an important clinical concern in hospitalized patients. The emergence of extended-spectrum β-lactamase (ESBL)-positive ECC may further complicate antimicrobial therapy and infection control. This study aimed to investigate the clinical risk factors, antimicrobial resistance patterns, resistance and virulence gene profiles, and molecular epidemiological characteristics of ESBL-positive ECC bloodstream infections. Methods We retrospectively analyzed 64 ECC bloodstream isolates collected between 2021 and 2024 and the corresponding clinical data of the patients. Isolates were classified into ESBL-positive and ESBL-negative groups according to phenotypic testing. Clinical characteristics, underlying diseases, invasive procedures, antimicrobial exposure, and outcomes were compared between the two groups. Univariate analysis and multivariable logistic regression were used to identify risk factors associated with ESBL positivity. Antimicrobial susceptibility testing, resistance and virulence gene detection, and hsp60 -based phylogenetic analysis were performed. Results Among the 64 ECC bloodstream isolates, 21 were ESBL-positive, with a detection rate of 32.8%. Patients with ESBL-positive ECC bloodstream infections had a longer hospital stay, a higher rate of intensive care unit admission, and a higher frequency of urinary catheterization than those with ESBL-negative infections(P OR =…
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