Sputum: Enterobacter cloacae – Shipped August 09 ,2021


A simulated sputum collected from a 74 year old male in-patient with pulmonary fibrosis was sent to category A laboratories. Participants were expected to identify and report susceptibility testing of Enterobacter cloacae.


  1. Seriously ill patients in hospital require rapid and accurate identification of potential pathogens that are linked to their infectious process as was the case presented in this challenge. Reporting of spurious non-pathogens even if they have the same genus name is unhelpful for the clinical management of these patients.
  2. It was noted from the results that all the laboratories that reported either E. amnignus or Lellottia amnigena used an automated biochemical test system. Like MALDI-ToF (which was used by most laboratories that identified E. cloacae (or complex) it is important to verify species within the system (at least 5 strains) before reporting, and not simply rely on the systems database for accuracy both for the identification and the relationship of the species to specific infectious process.

Full critique (PDF)

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