Emergence of VIM-producing Enterobacter cloacae complex in France between 2015 and 2018

Objectives To genetically characterize VIM-producing Enterobacter cloacae complex (ECC) isolates recovered in France from 2015 to 2018. Methods WGS, species determination, MLST, clonal relationship and genetic characterization were performed on 149 VIM-producing ECC isolates. Results Among VIM-producing Enterobacterales, the prevalence of ECC increased drastically from 6% in 2012 to 52% in 2018. The most prevalent species were Enterobacter hormaechei subsp. hoffmannii (40.9%), E. hormaechei subsp. steigerwaltii (21.5%), E. hormaechei subsp. xiangfangensis (14.8%) and ECC clade S (17.4%). Major STs were ST-873 (17.5%), ST-66 (12.1%), ST-78 (9.4%), ST-419 (8.1%), ST-145 (4.7%), ST-50 (4.0%), ST-118 (4.0%) and ST-168 (4.0%). Finally, six different integrons were identified, with some being specific to a given bla(VIM) variant (In916 with bla(VIM-1)-aacA4 '-aphA15-aadA1-catB2 and In416 with bla(VIM-4)-aacA7-dfrA1b-aadA1b-smr2 genes). Conclusions This study demonstrated the genetic diversity among VIM-producing ECC isolates, indicating that their spread is not linked to a single clone.

Automated summary

This study genetically characterized VIM-producing Enterobacter cloacae complex (ECC) isolates recovered in France from 2015 to 2018. The prevalence of ECC among VIM-producing Enterobacterales increased significantly during this period. Various species and sequence types were identified among these isolates. Additionally, different integrons carrying specific bla(VIM) variants were identified.