Enterobacter Hormaechei: New Neonatal Infection in Morocco

Enterobacteria are gram-negative bacilli, found in soil, water, and especially in humans and animals gut. They include a very large number of genera and species, often involved in human clinical specimens, predominately E. cloacae and E. aerogenes. Enterobacter hormaechei was suggested in 1989 as a new member of enterobacter family, during the last twenty years they were responsible for nosocomial infection in hospitalized adult patients, some information is available on their virulence-associated properties. They are very rare in the newborn.

We report five cases of E. hormaechei's infection; first case in our department: neonatal ICU, at Mohamed VI University Hospital, Marrakesh, Morocco. Five newborns were aged between eight hours and ten days, two of them were from multiple pregnancies, and gestational age was less than 36 weeks in three cases. Clinical presentation was variable and respiratory distress was found in four patients as the most frequent sign. Multidrug-resistant E. hormaechei was isolated from the blood culture in all cases. One newborn showed on his second day of life a cutaneous necrosis, the necrosis's swab culture isolated also an E. hormaechei. Patients were treated by the combination of Tienam and Amikacine. The progress was favorable in two patients. However, three of our patients died.

We found that E. hormaechei can be responsible for nosocomial infection in vulnerable patients. It can be transferred between patients when hygiene measures are not respected.