Background: Carbapenemase-producing Enterobacter cloacae complex (ECC) are increasingly identified in hospital-acquired infections. They usually belong to four main multilocus sequence types (STs) named ST114, ST93, ST90, and ST78. Instead, ST182 has been sporadically reported, and recently outbreaks of blaNDM-producing ST182 strains have emerged. Herein, we aimed to investigate the presence of ST182 and explore its evolution and modes of blaNDM acquisition. Methods: A phylogenetic analysis of 646 MLST STs identified among 4,685 E. hormaechei WGS assemblies deposited in public repositories was performed, as well as an in silico comparative and phylogenomic analyses for 55 WGS assemblies of ST182. blaNDM-harboring contigs were also compared to published plasmid sequences. Results: ST182 E. hormaechei strains were recovered from patients in five continents during 2011-2021. They were divided into three major genomic clusters, comprising a separate clonal complex with six other STs. In 30 out of 55 ST182 WGS assemblies, blaNDM-harboring structures were identified similar to plasmids predominant in Gram-negative bacteria, harboring resistance genes to multiple antibiotic classes and virulence genes. No associations between the genomic clusters and the country/continent of isolation, the presence and the plasmid types of the blaNDM-harboring contigs were observed. Conclusions: Our findings show that ST182 E. hormaechei strains were identified the past decade worldwide; 54.5% of them carried diverse blaNDM genetic structures, suggesting recent acquisition of the blaNDM alleles. Thus, blaNDM-producing ST182 is an emerging multidrug-resistant and virulent lineage in ECC that requires close monitoring.

This study aims to report the clinical signs, therapy, necropsy, and histopathological findings of airsacculitis caused by enterobacteria and the occurrence of the superfamily Diplotriaenoidea eggs in the feces of Megascops choliba in the Amazon Biome. A tropical screech owl nestling was rescued and admitted for hand-rearing. The animal was bred for five months. The feed was based on Zophobas morio larvae and thawed chicken breast meat with vitamin and mineral supplements. On the 37th day of hacking training for release, the owl showed weakness, lack of appetite, regurgitation, cachexia, dyspnea, ruffled feathers, dry feces in the vent and peri cloaca, and diarrhea. The parasitological examination showed eggs of the Diplotriaenoidea superfamily in the feces. The therapy was with oxytetracycline (48 mg/kg), sulfamethoxazole (48 mg/kg), mebendazole (25 mg/kg), potenay (0.5 ml/kg), sodium chloride 0.9% (50 ml /kg) and mercepton (5ml/kg). However, after five days of starting the treatment, the bird died. At necropsy, prominence of the keel, pieces of undigested food in the oral cavity and proventriculus, intestinal gas, and thickened and turbid air sacs were found. The microbiological analysis of air sacs identified Escherichia coli, Klebsiella pneumoniae, and Enterobacter aerogenes. Histopathological examination showed heterophilic bacterial airsacculitis.This study aims to report the clinical signs, therapy, necropsy, and histopathological findings of the first case of airsacculitis caused by enterobacteria and eggs of the superfamily Diplotriaenoidea in M. choliba in the Amazon Biome. The bird was admitted without clinical signs, had been hospitalized for observation for five months, and had started the rehabilitation process for release 37 days before it started to show signs of weakness, lack of appetite, cachexia, dyspnea, ruffled feathers, vomiting, and dry feces. Therapy with oxytetracycline (48 mg/kg), sulfamethoxazole (48 mg/kg), mebendazole (25 mg/kg), potenay (0.5 ml/kg), sodium chloride 0.9% (50 ml /kg) and mercepton (5ml/kg), however, after five days of starting the treatment, the bird died. At necropsy, prominence of the keel, pieces of food in the oral cavity and proventriculus, thickened air sacs, intestine with firm stools, and the presence of gas, hepatomegaly, and splenomegaly were observed. The parasitological examination showed eggs of the Diplotriaenoidea superfamily. The microbiological analysis identified Escherichia coli, Klebsiella pneumoniae, and Enterobacter aerogenes. Histopathological examination showed heterophilic bacterial airsacculitis. The diagnosis was confirmed through clinical signs, necropsy findings, and parasitological, microbiological, and histopathological examination results.

This study aims to report the clinical signs, therapy, necropsy, and histopathological findings of the first case of airsacculitis caused by enterobacteria and eggs of the superfamily Diplotriaenoidea in M. choliba in the Amazon Biome. The bird was admitted without clinical signs, had been hospitalized for observation for five months, and had started the rehabilitation process for release 37 days before it started to show signs of weakness, lack of appetite, cachexia, dyspnea, ruffled feathers, vomiting, and dry feces. Therapy with oxytetracycline (48 mg/kg), sulfamethoxazole (48 mg/kg), mebendazole (25 mg/kg), potenay (0.5 ml/kg), sodium chloride 0.9% (50 ml /kg) and mercepton (5ml/kg), however, after five days of starting the treatment, the bird died. At necropsy, prominence of the keel, pieces of food in the oral cavity and proventriculus, thickened air sacs, intestine with firm stools, and the presence of gas, hepatomegaly, and splenomegaly were observed. The parasitological examination showed eggs of the Diplotriaenoidea superfamily. The microbiological analysis identified Escherichia coli, Klebsiella pneumoniae, and Enterobacter aerogenes. Histopathological examination showed heterophilic bacterial airsacculitis. The diagnosis was confirmed through clinical signs, necropsy findings, and parasitological, microbiological, and histopathological examination results.

Carbapenemase-producing Enterobacter spp. Serratia marcescens, Citrobacter freundii, Providencia spp. and Morganella morganii (CP-ESCPM) are increasingly identified as causative agents of nosocomial infections but are still not under systematic genomic surveillance. In this study, using a combination of whole genome sequencing and conjugation experiments, we sought to elucidate the genomic characteristics and transferability of resistance genes in clinical CP-ESCPM isolates from Bulgaria. Among the 36 sequenced isolates, NDM-1 (12/36), VIM-4 (11/36), VIM-86 (8/36) and OXA-48 (7/36) carbapenemases were identified; two isolates carried both NDM-1 and VIM-86. The majority of carbapenemase genes were found on self-conjugative plasmids. IncL plasmids were responsible for the spread of OXA-48 among E. hormaechei, C. freundii and S. marcescens. IncM2 plasmids were generally associated with the spread of NDM-1 in C. freundii and S. marcescens, and also of VIM-4 in C. freundii. IncC plasmids were involved in the spread of the recently described VIM-86 in P. stuartii isolates. IncC plasmids carrying blaNDM-1 and blaVIM-86 have been observed too. blaNDM-1 was also detected on IncX3 in S. marcescens and on IncT plasmid in M. morganii. The significant resistance transfer rates highlight the role of the ESCPM group as a reservoir of resistance determinants and stress the need for strengthening the infection control measures.