Community-onset bloodstream infections (CO-BSI) due to carbapenemase producing Enterobacter cloacae complex (ECC) species are increasing internationally. This observation suggests that ECC are emerging pathogens which requires more detailed understanding of their antimicrobial resistance (AMR) profiles and transmission dynamics.. Genomic epidemiology, antimicrobial resistance and virulence factors of Enterobacter cloacae complex causing community-onset bloodstream infections in a tertiary care hospital of Nepal

Aiming to understand the molecular epidemiology of ECC causing CO-BSI, we performed whole-genome sequencing on 80 Enterobacter spp. isolated from the patients with clinically significant BSI and admitted to the emergency department of a major tertiary hospital in Kathmandu between April 2016 and October 2017. We investigated the phylogenetic relationship among the isolates and their genomic content of virulence and AMR.Our study highlights that MDR ECC clones are important pathogens of BSIs in community too. Though of low prevalence, carbapenem resistance observed in our ECC isolates raises concern about further community dissemination. This observation underscores the need for community surveillance to identify MDR ECC clones with epidemic potential and better understand their transmission dynamics.