MLST reveals potentially high-risk international clones of Enterobacter cloacae

MOSAR WP2, WP3 and WP5 Study Groups

Research output: Contribution to journalArticlepeer-review

110 Scopus citations


Objectives: To perform the first multinational Enterobacter cloacae clonality study, using the MLST scheme newly developed in Japan. Methods: The analysis included 195 rectal carriage E. cloacae isolates resistant to expanded-spectrum cephalosporins (ESCs), collected from patients in 12 hospital units across Europe and Israel. All of the isolates were typed by PFGE and 173 isolates were subjected to MLST. ESC resistance was analysed phenotypically; genes encoding ESBLs and carbapenemases were identified by PCR and sequencing. Results: MLST distinguished 88 STs, which correlated with the PFGE data. PFGE was more discriminatory, producing 129 pulsotypes (169 patterns). Numerous STs were observed in several countries each. The most widespread were ST66, ST78, ST108 and ST114, each having at least 10 isolates from three to five countries, diversified into multiple pulsotypes, with clusters of related isolates in one or more centres. Analysis of the STs against the MLST database revealed several epidemic clonal complexes, such as those with central genotypes ST74 (including ST78) or ST114 (including ST66). ESC resistance was equally related to overexpression of the AmpC cephalosporinase and to ESBL production. Among ESBL producers some spreading subclones were identified, including specific ST66, ST78 and ST114 pulsotypes, associated with CTX-M-15 production. Several isolates produced carbapenemase VIM-1 or KPC-2. Conclusions: Together with the information available in the MLST database, our results suggest that, like Escherichia coli and Klebsiella pneumoniae, E. cloacae harbours clonal lineages of increased epidemic potential that may be associated with resistance spread.

Original languageEnglish
Pages (from-to)48-56
Number of pages9
JournalJournal of Antimicrobial Chemotherapy
Issue number1
StatePublished - 1 Jan 2015
Externally publishedYes


  • Carbapenemases
  • E. cloacae
  • ESBLs
  • Population study


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