Investigation of genetic relatedness among Enterobacter cloacae complex isolates and its association with biofilm formation and antibiotics susceptibility pattern using ERIC-PCR

This study aimed to evaluate the genetic similarity between different E. cloacae origins by utilizing ERIC-PCR fingerprinting and tracking bacterial clades based on the biofilm formation and antibiotic resistance pattern. A total of 130 specimens (50 from urine and semen and 30 from intestine biopsies) were collected from patients diagnosed with UTI, male genitourinary tract infection, and intestine illness, respectively. Twenty bacterial isolates were identified as E. cloacae, 50% of urinary isolates, and 25% of both biopsy and seminal isolates. 90% of these isolates were biofilm–producing. E. cloacae exhibited high resistance across several antibiotic categories, highly significant against β-lactams and tetracycline. Fluoroquinolones and aminoglycosides showed moderate resistance, with some isolates remained sensitive. Antifolate agents also demonstrated significant resistance. The ERIC-PCR analysis revealed the presence of three distinct Clades: Clade 1 included (urine, semen, and isolates) Clade2 (included mixed isolates), and Clade 3 (biopsy isolates) all the isolates exhibited genetic variations. The microbial species E. cloacae showed extensive genetic diversity that helped to adapt different infection areas. The obtained clustering results confirmed the possibility that hospital-created infections transfer between the urinary and reproductive tracts. The repeated genetic bands offered potential utility because they work as a biological marker for strain differentiations along with their utilization in epidemiological evaluations and antimicrobial resistance assessments.