Abstract
This study aimed to monitor the evolving antibiotic resistance patterns of carbapenem-resistant Enterobacter cloacae complex (CR-ECC) at the Fourth Hospital of Hebei Medical University, characterize the molecular epidemiology through resistance gene profiling and phylogenetic analysis, investigate virulence gene profiles, and establish an evidence-based framework for optimizing clinical antimicrobial therapy and infection control strategies. 32 CR-ECC isolates (2018–2022) underwent Vitek-based identification and susceptibility testing. Carbapenemase production was confirmed by mCIM, with whole-genome sequencing (Illumina) for MLST phylogeny (MEGA/iTOL). Plasmid replicons and resistance/virulence genes were analyzed using PlasmidFinder and RGI/BLAST respectively. CR-ECC emerged in 2020, reaching 32 cases by 2022 as the third most prevalent carbapenem-resistant Enterobacteriaceae. Isolates mainly from sputum (43.75%, 14/32) and blood (25.00%, 8/32), with 53.13% ICU origins. Universal resistance to piperacillin/tazobactam, ceftazidime, imipenem; full susceptibility to tigecycline/colistin. Molecular analysis identified 8 STs, predominantly ST171 (56.25%) carrying blaNDM-1/OXA-1. Plasmid analysis revealed Col(pHAD28)/IncC dominance with ST-specific distribution. Virulence genes showed near-universal fimA/csgD/entB (96.88%) and mrkD (90.63%). These findings highlight the therapeutic potential of tigecycline, colistin, and amikacin against CR-ECC, while emphasizing strain-specific aztreonam susceptibility in metallo-β-lactamase producers.
Acknowledgements
We thank Professor Jinyan Zhang for her contribution to the study design of this paper.
Funding
This research was funded by Medical Science Research Project of Hebei (Grant Number 20241387) and S&T Program of Hebei (Grant Number 22377791D).
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He, J., Cheng, K., Sui, Q. et al. Molecular epidemiological characteristics of carbapenem-resistant Enterobacter cloacae complex. Sci Rep (2026). https://doi.org/10.1038/s41598-026-55757-6
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DOI: https://doi.org/10.1038/s41598-026-55757-6
