Whole-Genome Analysis of Extensively Drug-Resistant Enterobacter hormaechei Isolated from a Patient with Non-Hodgkin's Lymphoma.

Background: Currently, the Enterobacteriaceae species are responsible for a variety of serious infections and are already considered a global public health problem, especially in underdeveloped countries, where surveillance and monitoring programs are still scarce and limited. Analyses were performed on the complete genome of an extensively antibiotic-resistant strain of Enterobater hormaechei , which was isolated from a patient with non-Hodgkin's lymphoma, who had been admitted to a hospital in the city of Manaus, Brazil.
Methods: Phenotypical identification and susceptibility tests were performed in automated equipment. Total DNA extraction was performed using the PureLink genomic DNA mini-Kit. The genomic DNA library was prepared with Illumina Microbial Amplicon Prep and sequenced in the MiSeq Illumina Platform. The assembly of the whole-genome and individual analyses of specific resistance genes extracted were carried out using online tools and the Geneious Prime software.
Results: The analyses identified an extensively resistant ST90 clone of E. hormaechei carrying different genes, including bla _CTX-M-15 , bla _GES-2 , bla _TEM-1A , bla _ACT-15 , bla _OXA-1 and bla _NDM-1 , [ aac(3)-IIa, aac(6')-Ian, ant(2″)-Ia ], [ aac(6')-Ib-cr , (qnrB1)], dfrA25 , sul1 and sul2 , catB3 , fosA , and qnr B, in addition to resistance to chlorhexidine, which is widely used in patient antisepsis.
Conclusions: These findings highlight the need for actions to control and monitor these pathogens in the hospital environment.