The EC-COMPASS: Long-term, multi-centre surveillance of Enterobacter cloacae complex - a clinical perspective

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • M D Mauritz - , Witten/Herdecke University (Author)
  • B Claus - , Witten/Herdecke University (Author)
  • J Forster - , University of Würzburg (Author)
  • M Petzold - , Institute of Medical Microbiology and Virology (Author)
  • S Schneitler - , University Hospital of Saarland (Author)
  • A Halfmann - , University Hospital of Saarland (Author)
  • S Hauswaldt - , University of Lübeck (Author)
  • D Nurjadi - , University of Lübeck (Author)
  • N Toepfner - , Department of Paediatrics, University Hospital Carl Gustav Carus Dresden (Author)

Abstract

BACKGROUND: Enterobacter cloacae complex (ECCO) comprises closely related Enterobacterales, causing a variety of infections ranging from mild urinary tract infections to severe bloodstream infections. ECCO has emerged as a significant cause of healthcare-associated infections, particularly in neonatal and adult intensive care.

AIM: The Enterobacter Cloacae COMplex PASsive Surveillance (EC-COMPASS) aims to provide a detailed multi-centre overview of ECCO epidemiology and resistance patterns detected in routine microbiological diagnostics in four German tertiary-care hospitals.

METHODS: In a sentinel cluster of four German tertiary-care hospitals, all culture-positive ECCO results between 1st January 2020 and 31st December 2022, were analysed based on Hybase® laboratory data.

FINDINGS: Analysis of 31,193 ECCO datasets from 14,311 patients revealed a higher incidence in male patients (P<0.05), although no significant differences were observed in ECCO infection phenotypes. The most common sources of ECCO were swabs (42.7%), urine (17.5%), respiratory secretions (16.1%), blood cultures (8.9%) and tissue samples (5.6%). The annual bacteraemia rate remained steady at approximately 33 cases per hospital. Invasive ECCO infections were predominantly found in oncology and intensive care units. Incidences of nosocomial outbreaks were infrequent and limited in scope. Notably, resistance to carbapenems was consistently low.

CONCLUSION: EC-COMPASS offers a profound clinical perspective on ECCO infections in German tertiary-healthcare settings, highlighting elderly men in oncology and intensive care units as especially vulnerable to ECCO infections. Early detection strategies targeting at-risk patients could improve ECCO infection management.

Details

Original languageEnglish
Pages (from-to)11-19
Number of pages9
JournalThe Journal of hospital infection
Volume148
Early online date28 Mar 2024
Publication statusPublished - Jun 2024
Peer-reviewedYes

External IDs

Scopus 85190732540

Keywords

Keywords

  • Tertiary Care Centers/statistics & numerical data, Humans, Middle Aged, Enterobacteriaceae Infections/epidemiology, Child, Preschool, Germany/epidemiology, Infant, Male, Incidence, Young Adult, Bacteremia/epidemiology, Epidemiological Monitoring, Adolescent, Aged, 80 and over, Adult, Female, Aged, Cross Infection/epidemiology, Enterobacter cloacae/isolation & purification, Anti-Bacterial Agents/therapeutic use, Child, Infant, Newborn