Enterobacter

Enterobactputo.png
Scientific classification
Kingdom: Bacteria Phylum: Proteobacteria Class: Gamma Proteobacteria Order: Enterobacteriales Family: Enterobacteriaceae Genus: Enterobacter Hormaeche & Edwards 1960
Species
E. aerogenes E. amnigenus E. cloacae E. gergoviae E. ludwigii E. sakazakii E. taylorae etc.

Enterobacter is a genus of common Gram-negative, facultatively-anaerobic, rod-shaped bacteria of the family Enterobacteriaceae. Several strains of the these bacteria are pathogenic and cause opportunistic infections in immunocompromised (usually hospitalized) hosts. The urinary and respiratory tract are the most common sites of infection. Enterobacter can be distinguished from other GNR by virtue of being a 'fast fermenter' of lactose (as are Escherichia coli and Klebsiella).

Two clinically-important species from this genus are E. aerogenes and E. cloacae.

Antimicrobial therapy

• Enterobacter species including E. aerogenes and E. cloacae

• 1. Empiric antimicrobial therapy pending in vitro susceptibility

• 1.1 Non–life-threatening infections or MDR-GNB prevalence < 20%

• Preferred regimen: Piperacillin-Tazobactam 3.375 g IV q6h ± Aminoglycosides
• Alternative regimen: Ciprofloxacin 400 mg IV q8–12h

• 1.2 Life-threatening infections or MDR-GNB prevalence > 20%

• Preferred regimen: Meropenem 0.5–1 g IV q8h
• Alternative regimen (1): Colistin AND Meropenem 0.5–1 g IV q8h
• Alternative regimen (2): Colistin AND Imipenem 500 mg IV q6h
• Alternative regimen (3): Colistin AND Doripenem 500 mg IV q8h
• Alternative regimen (4): Colistin AND Ertapenem 1 g IV q24h
• Alternative regimen (5): Colistin AND Fosfomycin 6 g IV q6h

• 2. In vitro susceptibility available

• 2.1 Susceptible to all tested agents

• Preferred regimen: Piperacillin-Tazobactam 3.375 g IV q6h
• Alternative regimen (1): Ciprofloxacin 400 mg IV q8–12h
• Alternative regimen (2): Cefepime 2 g IV q8h (if MIC ≤ 1 μg/mL)

• 2.2 Extended spectrum beta-lactamase (ESBL)-producing Enterobacter spp.

• Preferred regimen: Meropenem 0.5–1 g IV q8h
• Alternative regimen (1): Imipenem 500 mg IV q6h
• Alternative regimen (2): Doripenem 500 mg IV q8h
• Alternative regimen (3): Ertapenem 1 g IV q24h
• Alternative regimen (4): Cefepime 2 g IV q8h (if MIC ≤ 1 μg/mL)

• 2.3 Resistant to all tested agents

• Preferred regimen: Colistin AND Meropenem 0.5–1 g IV q8h
• Alternative regimen (1): Colistin AND Imipenem 500 mg IV q6h
• Alternative regimen (2): Colistin AND Doripenem 500 mg IV q8h
• Alternative regimen (3): Colistin AND Ertapenem 1 g IV q24h
• Alternative regimen (4): Colistin AND Minocycline 100 mg IV q12h

References

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