Abstract
Enterobacter aerogenes is recognized as an important bacterial pathogen in hospital-acquired infections. This report describes two unusual cases of septicemia caused by E. aerogenes in immunocompetent healthcare workers. E. aerogenes was isolated from blood cultures of the two patients experiencing septicemia. The clinical isolates were initially identified as E. aerogenes using a VITEK II automated system and 16S rRNA sequence analysis, and; both isolates involved in the outbreak shared a common pulse-field gel electrophoresis pattern. The similarities between the two cases included the simultaneous development of gastroenteritis symptoms, severe sepsis and thrombocytopenia after taking intravenous injections of ketorolac tromethamine. A common source of normal saline, a 100 mL bottle, was used for diluting the analgesic in both cases. In addition to the general population, healthcare workers, especially those who are also intravenous drug abusers, should be considered subjects that could cause a transmission of Enterobacter infection.
Highlights
Enterobacter is a genus of the family Enterobacteriaceae, consisting of common Gram-negative, facultative anaerobic, rod-shaped, non-spore-forming bacteria
We examined the transmission of E. aerogenes infections in two healthcare workers; by isolating the pathogen from the blood cultures of both the patients and complete genomic sequence analysis and pulsed-field gel electrophoresis (PFGE) revealing that both the isolates were identical
After receiving the blood culture reports, which were positive for E. aerogenes in both patients, we investigated the two cases in detail, as we suspected a common source of E. aerogenes infection
Summary
Enterobacter is a genus of the family Enterobacteriaceae, consisting of common Gram-negative, facultative anaerobic, rod-shaped, non-spore-forming bacteria. E. aerogenes is recognized as an important bacterial pathogen in hospital acquired infections (Jarvis and Martone 1992). We examined the transmission of E. aerogenes infections in two healthcare workers; by isolating the pathogen from the blood cultures of both the patients and complete genomic sequence analysis and pulsed-field gel electrophoresis (PFGE) revealing that both the isolates were identical. Enterobacter is the eighth most common pathogen in healthcare-associated infections in the United States (Hidron et al 2008) and constitutes 2.9 % of healthcareassociated bloodstream infections in Korea (Son et al 2010). We encountered two patients who were otherwise
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