{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T01:19:49Z","timestamp":1784251189566,"version":"3.55.0"},"reference-count":36,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2021,7,1]],"date-time":"2021-07-01T00:00:00Z","timestamp":1625097600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2021,7]]},"abstract":"\n Carbapenemase production is constantly increasing among different\n Enterobacterales<\/jats:italic>\n species. We analyzed the microbiological characteristics and population structure of all carbapenemase-producing\n Enterobacter<\/jats:italic>\n spp. (CP-Ent) isolates recovered at the Ram\u00f3n y Cajal Hospital between 2005 and 2018. Overall, 178 CP-Ent isolates (60.7% colonization, 39.3% clinical) were recovered from 165 hospitalized patients (165\/176, 93.7%; medical [102\/165], surgical [34\/165], and intensive care unit [29\/165] areas), emergency unit (4\/176, 2.3%), and ambulatory patients (7\/176, 4.0%). In addition, three CP-Ent were found in environmental sources. Clinical samples were mainly urine (37.1%). The most frequent matrix-assisted laser desorption\/ionization time-of-flight (MALDI-TOF)-identified species were\n Enterobacter cloacae<\/jats:italic>\n (\n n<\/jats:italic>\n \u2009=\u200985) and\n Enterobacter asburiae<\/jats:italic>\n (\n n<\/jats:italic>\n \u2009=\u200949).\n hsp<\/jats:italic>\n 60 gene sequencing showed a higher species diversity than MALDI-TOF: 70\n Enterobacter hormaechei-<\/jats:italic>\n clusters\n III<\/jats:italic>\n ,\n VI<\/jats:italic>\n ,\n VIII<\/jats:italic>\n ; 69\n Enterobacter roggenkampii-IV<\/jats:italic>\n ; 15\n Enterobacter kobei-II<\/jats:italic>\n ; 9\n E. asburiae-I<\/jats:italic>\n ; 3\n Enterobacter ludwigii-V<\/jats:italic>\n ; and\n 1 E. cloacae<\/jats:italic>\n subsp.\n dissolvens-XII.<\/jats:italic>\n Nine\n Klebsiella aerogenes<\/jats:italic>\n were also identified. Overall, a high clonal diversity (Simpson Diversity Index >0.90) was found among CP-Ent-clusters. Environmental isolates were clonally related to clinical ones. Amikacin and tigecycline showed the highest susceptibility (>93%). VIM-1 (\n n<\/jats:italic>\n \u2009=\u2009133\/181, 73.5%) and OXA-48 (\n n<\/jats:italic>\n \u2009=\u200934\/181, 18.8%) carbapenemases were predominant, followed by KPC-2 (\n n<\/jats:italic>\n \u2009=\u20099\/181, 5.0%), KPC-3 (\n n<\/jats:italic>\n \u2009=\u20092\/181, 1.1%), VIM-2 (\n n<\/jats:italic>\n \u2009=\u20091\/181, 0.6%), and two coproducers (VIM-1+KPC-2 and VIM-1+KPC-3). Extended-spectrum beta-lactamase (ESBL) coproduction (14.4%) emerged in 2012, mainly associated with\n bla<\/jats:italic>\n SHV-12<\/jats:sub>\n (\n p<\/jats:italic>\n \u2009<\u20090.001),\n E. roggenkampii<\/jats:italic>\n (\n p<\/jats:italic>\n \u2009<\u20090.001), and colonization (\n p<\/jats:italic>\n \u2009=\u20090.03). VIM-1- and OXA-48-CP-Ent fecal carriers increased in our hospital, particularly between 2011 and 2018 (\n p<\/jats:italic>\n \u2009<\u20090.001). Moreover, KPC and OXA-48 producers emerged in 2010 and 2012, respectively. They superimposed over VIM producers, which were persistently recovered since first detection in 2005. These results depict increased complexity over time of CP-Ent.\n <\/jats:p>","DOI":"10.1089\/mdr.2020.0265","type":"journal-article","created":{"date-parts":[[2020,10,22]],"date-time":"2020-10-22T12:22:00Z","timestamp":1603369320000},"page":"895-903","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":17,"title":["Emergence and Persistence over Time of Carbapenemase-Producing\n Enterobacter<\/i>\n Isolates in a Spanish University Hospital in Madrid, Spain (2005\u20132018)"],"prefix":"10.1177","volume":"27","author":[{"given":"Miriam","family":"Mateos","sequence":"first","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Hern\u00e1ndez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Red Espa\u00f1ola de Investigaci\u00f3n en Patolog\u00eda Infecciosa (REIPI), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa","family":"del Campo","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Red Espa\u00f1ola de Investigaci\u00f3n en Patolog\u00eda Infecciosa (REIPI), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mart\u00ednez-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desir\u00e9e","family":"Gij\u00f3n","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Red Espa\u00f1ola de Investigaci\u00f3n en Patolog\u00eda Infecciosa (REIPI), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Isabel","family":"Morosini","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Red Espa\u00f1ola de Investigaci\u00f3n en Patolog\u00eda Infecciosa (REIPI), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Ruiz-Garbajosa","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Red Espa\u00f1ola de Investigaci\u00f3n en Patolog\u00eda Infecciosa (REIPI), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Cant\u00f3n","sequence":"additional","affiliation":[{"name":"Servicio de Microbiolog\u00eda, Hospital Universitario Ram\u00f3n y Cajal and Instituto Ram\u00f3n y Cajal de Investigaci\u00f3n Sanitaria (IRYCIS), Madrid, Spain."},{"name":"Red Espa\u00f1ola de Investigaci\u00f3n en Patolog\u00eda Infecciosa (REIPI), Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.2217\/fmb.12.61"},{"key":"e_1_3_5_3_2","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jinf.2018.05.005","article-title":"Elective distribution of resistance to beta-lactams among Enterobacter cloacae genetic clusters","volume":"77","author":"Garinet S.","year":"2018","unstructured":"Garinet S., , Fihman V., , Jacquier H., , Corvec S., , Le Monnier A., , Guillard T., , Cattoir V., , Zahar J.R, , Woerther P.L, , Carbonnelle E., , Wargnier A., , Kern\u00e9is S., , and Morand P.C.. 2018. 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