Enterobacter species is a topic covered in the Johns Hopkins Antibiotic (ABX) Guide.

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MICROBIOLOGY

  • Gram-negative, aerobic, motile bacilli of the Enterobacteriaceae family.
  • Opportunistic human pathogen includes: E. cloacae (most common), E. aerogenes, E. gergoviae [8] and Pantoea agglomerans.
    • E. sakazakii now classified as Cronobacter.
  • High levels of drug resistance often seen and due to:
    • (1) Chromosomal AmpC beta-lactamases that are constitutive and inducible [12]
      • β-lactams must be present for activation of inducible beta-lactamases, so initial susceptibility reports may not detect resistance that can arise during therapy.
    • (2) Plasmid-encoded extended-spectrum β-lactamases (ESBLs)
    • (3) Carbapenemases [7]
  • Other resistance mechanisms
    • Alterations in active site of penicillin-binding protein
    • Defects in outer membrane permeability that reduce diffusion of beta-lactams into cell
    • Presence of efflux pumps that move beta-lactams out of cell

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Last updated: March 1, 2017