Clinical Microbiology of Enterobacteriaceae Infections

The family Enterobacteriaceae encompasses a diverse group of Gram-negative bacilli that colonise the human gut and environmental reservoirs. Many species act as opportunistic pathogens, causing urinary tract infections, intra-abdominal sepsis, pneumonia and bloodstream infections. Key genera include Escherichia, Klebsiella, Enterobacter, Serratia, Kluyvera and emerging taxa such as Phytobacter and Yokenella. Clinical identification relies on culture-based biochemical assays, mass spectrometry and increasingly on whole-genome sequencing to resolve closely related species and detect virulence determinants. Antimicrobial resistance mechanisms have evolved rapidly under clinical pressure, most notably the production of extended-spectrum β-lactamases and carbapenemases, which compromise first-line therapies and drive the use of last-resort agents. Plasmid-mediated gene transfer facilitates rapid dissemination of resistance across genera. Advances in molecular diagnostics now allow real-time detection of resistance markers and outbreak tracing. Globally, multidrug-resistant Enterobacteriaceae represent a critical threat to public health and heighten the urgency for novel therapeutics, stewardship and infection-control strategies. Practical applications extend from optimising empirical therapy to guiding development of targeted inhibitors and bacteriophage-based interventions. Continued integration of genomics, epidemiology and clinical microbiology is essential to anticipate emerging pathogens, unravel mechanisms of pathogenicity and curb the spread of resistance on a worldwide scale.

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Clinical Microbiology of Enterobacteriaceae Infections publication trend

The graph below shows the total number of articles in clinical microbiology of enterobacteriaceae infections across all publications each year (not limited to Nature Index journals).

Technical terms

Extended-spectrum β-lactamase (ESBL): An enzyme that hydrolyses penicillins and third-generation cephalosporins, conferring resistance to these antibiotics.

Carbapenemase: A β-lactamase capable of inactivating carbapenem antibiotics, often located on mobile genetic elements that facilitate horizontal transfer.

Phylogenomics: The application of whole-genome sequencing data to infer evolutionary relationships and species delineation.

Average Nucleotide Identity (ANI): A genomic similarity metric used to determine species boundaries by comparing the average sequence identity of orthologous genes between two genomes.

Plasmid: An extrachromosomal DNA molecule that replicates independently and can carry genes for antibiotic resistance or virulence.

References

1. Genomic insights into the evolution, pathogenicity, and extensively drug-resistance of emerging pathogens Kluyvera and Phytobacter. Frontiers in Cellular and Infection Microbiology (2024).
2. Yokenella regensburgei—Past, Present and Future. Antibiotics (2024).
3. The draft genome sequence of blaCTX-M-270-carrying Kluyvera ascorbata isolated from human sputum. Microbiology Resource Announcements (2024).