Enterobacter aerogenes

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Enterobacter aerogenes (family Enterobacteriaceae) are “gram-negative, capsulated, gas-producing rods found widely in nature (Enterobacter aerogenes, 2007). ” These bacterial species are usually found in soil, water, sewage, dairy products and in the feces of animals, including humans (Enterobacter aerogenes, 2007). Enterobacter aerogenes are known to be nosocomial pathogens, or infections originating or acquired in the hospital.

They are the common causes of various infections including “bacteremia, lower repiratory tract infections, skin and soft-tissue infections, urinary tract infections, endocarditis, intra-abdominal infections, septic arthritis, osteomyelitis, and ophthalmic infections (Fraser, 2008). ” According to Bornet et al (2000), “Enterobacter aerogenes has emerged as an important hospital pathogen since 1992… and is now the third leading cause of respiratory tract nosocomial infections by gram-negative bacteria (after Staphylococcus aureus and Pseudomonas aeruginosa.

” Moreover, E. aerogenes strains that have been isolated from the patients in hospitals are generally exhibiting high resistance to the broad-spectrum antibiotics (Bornet et al, 2000). In one journal article, Investigation and control of an outbreak of Enterobacter areogenes bloodstream infection in a neonatal intensive care unit in Fuji (Naraya, et al, 2009), Enterobacter aerogenes was the main cause of an infection hospital outbreak, due to a contaminated normal saline in the ward used by multiple patients.

To contain the infection, control practices were used — “reinforcement of strict hand hygiene policy, provision of single use vials of normal saline, and strict aseptic technique for injections (Naraya, et al, 2009). ” Also, another article concerning an infection outbreak in neonatal unit has also focused on the investigation and review of literature on Enterobacter (Dalben, 2008). For this study, however, the source was not identified but the outbreak was also controlled by “reinforcement of hygiene practices, restrictions on new admissions and the establishment of single-dose medications (Dalben, 2008).

” Another common infection caused by Enterobacter aerogenes is sepsis, or infection of the blood. From the study of Chen et al (2009) namely, Sepsis resulting from Enterobacter aerogenes resistant to carbapenems after liver transplantation, a sepsis caused by this bacteria after liver transplantation is a serious condition that could cause liver abscess. The purpose of the said study is to “relate an unusual presentation of liver transplantation to show how successive treatment can be an appropriate option in septic patients after liver transplantation (Chen et al, 2009).

” In this study, a 39-year old man who had a biliary fistula and multiple liver abscesses, acquired the infection of the carabapenem-sensitive E. aerogenes. The treatment of the patient with intravenous carabapenems was not successful, and after the five-week course of carabapenems therapy, resistant E. aerogenes was detected in bile and blood. These lead to the development of septic shock and multiple organ dysfunction syndrome. With the current antibiotic, the carabapenem-resistant E. aerogenes then leads to the uncontrolled sepsis.

Further research is needed in the immunomodulation therapy to fight against some resistant strains of aerogenes. As exemplified in the previous study, some strains of E. aerogenes are resistant to broad-agent antibiotics. This is one big problem for confined patients susceptible to infections and researches are conducted to find antibiotics for E. aerogenes. One study, Successive emergence of extended-spectrum beta-lactamase-producing and carbapenemase-producing Enterobacter aerogenes isolates in a university hospital by Biendo et al (2008), tackles this medical concern.

Also, there are automated bacterial identification and susceptibility testing systems being invented like the MicroScan Walkaway (conventional biochemical identification system) and the Vitek system. These automated identification systems are commonly used in clinical microbiology laboratories (Rhoads, 1995). The resistance of Enterobacter aerogenes to carbapenem is a medical concern that is increasing for years, and improved surveillance is vital for the distribution of resistant strains.

But a recent journal article by Gordon and Wareham (2009), Failure of the MicroScan WalkAway System to Detect HEteroresistance to Carabapenems in a Patient with Enterobacter aerogenes Bacteaemia, reported the failure of the automated MicroScan Walkaway system to detect carbapenem heteroresistance in Enterobacter aerogenes. Enterobacter aerogenes is really a pathogen that is causing medical problems word-wide. However, this bacteria are also used in other researches that has a high economic potential. This is the involvement of Enterobacter aerogenes in Bioelectricity.

Studies have proven that microorganisms can produce fuels, the bioelectricity generation through microbial fuel cells. The journal article, Mechanisms of bioelectricity generation in enterobacter aerogenes-based microbial fuel cells, proposes that “microbial fuel cells (MFCs) using hydrogen-producing bacteria (HPB) could utilize a large number of substrates to generate power (Zhang, 2009). ” References Biendo, M. et al. (2008). Successive emergence of extended-spectrum beta-lactamase-producing and carbapenemase-producing Enterobacter aerogenes isolates in a university hospital. PubMed. com. Retrieved August 5, 2009 from http://www.

ncbi. nlm. nih. gov/pubmed/18234876? dopt=Abstract Bornet, C. et al. (2000). Imipenem Resistance of Enterobacter aerogenes Mediated by Outer Membrane Permeability. Retrieved August 5, 2009 from http://jcm. asm. org/cgi/reprint/38/3/1048? maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=enterobacter+aerogenes&searchid=1&FIRSTINDEX=0&resourcetype=HWCIT Chen, H. et al. (2009). Sepsis resulting from Enterobacter aerogenes resistant to carbapenems after liver transplantation. PubMed. com. Retrieved August 5, 2009 from http://www. ncbi. nlm. nih. gov/pubmed/19502176? ordinalpos=8&itool=EntrezSystem2. PEntrez. Pubmed. Pubmed_ResultsPanel.

Pubmed_DefaultReportPanel. Pubmed_RVDocSum Dalben, M. et al. (2008). Investigation of an outbreak of Enterobacter cloacae in a neonatal unit and review of the literature. PubMed. com. Retrieved August 5, 2009 from http://www. ncbi. nlm. nih. gov/pubmed/18632183? ordinalpos=1&itool=EntrezSystem2. PEntrez. Pubmed. Pubmed_ResultsPanel. Pubmed_DiscoveryPanel. Pubmed_Discovery_RA&linkpos=4&log$=relatedreviews&logdbfrom=pubmed Enterobacter aerogenes. (2007).

Wrong Diagnosis. com. Retrieved August 5, 2009 from http://www. wrongdiagnosis. com/medical/enterobacter_aerogenes. htm. Fraser, S. L. (2008). Enterobacter Infections. Emedicine. medscape. com. Retrieved August 5, 2009 from http://emedicine. medscape. com/article/216845-overview. Gordon, N. C and Warehma D. W. (2009). Failure of the MicroScan WalkAway System to Detect HEteroresistance to Carabapenems in a Patient with Enterobacter aerogenes Bacteaemia. PubMed. com. Retrieved August 5, 2009 from http://www. ncbi. nlm. nih. gov/pubmed/19641071? ordinalpos=1&itool=EntrezSystem2. PEntrez. Pubmed. Pubmed_ResultsPanel. Pubmed_DefaultReportPanel. Pubmed_RVDocSum Naraya, S. A. et al. (2009). Investigation and control of an outbreak of Enterobacter areogenes bloodstream infection in a neonatal intensive care unit in Fuji.

PubMed. com. Retrieved August 5, 2009 from http://www. ncbi. nlm. nih. gov/pubmed/19552517? ordinalpos=4&itool=EntrezSystem2. PEntrez. Pubmed. Pubmed_ResultsPanel. Pubmed_DefaultReportPanel. Pubmed_RVDocSum Rhoades, S. (1995). Comparison of MicroScan WalkAway System and Vitek System for Identification of Gram-Negative Bacteria. Retrieved August 5, 2009 from http://jcm. asm. org/cgi/reprint/33/11/3044 Zhang, J. T. et al. (2009). Mechanisms of bioelectricity generation in enterobacter aerogenes-based microbial fuel cells. PubMed. com. Retrieved August 5, 2009 from http://www. ncbi. nlm. nih. gov/pubmed/19545032

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