Enterobacter cloacae complex is part of the Enterobacteriaceae family. E cloacae complex is a group of six closely related species with similar resistance patterns:
E. cloacae, E. asburiae, E. hormaechei, E. kobei, E. ludwigii, and E. nimipressuralis.
This gram-negative bacterium is considered dysbiotic at levels of 3+ or greater. E. cloacae complex is considered an opportunistic pathogen associated with diarrhea in children.
A Shiga-like toxin-producing E. cloacae was isolated from the feces of an infant with hemolytic-uremic syndrome. However, E. cloacae complex is most often involved in extraintestinal infections including the urinary tract, respiratory tract, and cutaneous wounds.
Widely distributed in the environment, Enterobacter spp. is commonly isolated from both human and animal feces. Environmental strains of Enterobacter spp. are capable of growth in foods at refrigeration temperature. E. cloacae complex is known to possess inducible ß-lactamases. Isolates may become resistant to all cephalosporins after initiation of therapy. Avoid ß-lactam-inhibitor drugs such as amoxicillin/ clavulanate, ampicillin/sulbactam, and piperacillin/tazobactam.
Antibiotics may be indicated in systemic infections if symptoms are prolonged.
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