Rapid emergence of ciprofloxacin-resistant enterobacteriaceae containing multiple gentamicin resistance-associated integrons in a Dutch hospital.
In a hematology unit in the Netherlands, the incidence of ciprofloxacin-resistant Enterobacter cloacae and Escherichia coli increased from from 1996 to 1999. Clonal spread of single genotypes of both ciprofloxacin-resistant E. coli and Enterobacter cloacae from patient to patient was documented by pulsed-field gel electrophoresis and random amplification of polymorphic DNA. In addition, genetically heterogeneous strains were isolated regularly. Integrons associated with gentamicin resistance were detected in Enterobacter cloacae and E. coli strains. Integron-containing E. coli were detected in all hematology wards. In contrast, in Enterobacter cloacae strains two integron types were encountered only in the isolates from one ward. Although in all patients identical antibiotic regimens were used for selective decontamination, we documented clear differences with respect to the nosocomial emergence of ciprofloxacin-resistant bacterial strains and gentamicin resistance-associated integrons.
van Belkum
A
A
Eramus University Medical Center Rotterdam, The Netherlands. vanbelkum@bacl.azr.nl
Goessens
W
W
van der Schee
C
C
Lemmens-den Toom
N
N
Vos
M C
MC
Cornelissen
J
J
Lugtenburg
E
E
de Marie
S
S
Verbrugh
H
H
Löwenberg
B
B
Endtz
H
H
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D000890:Anti-Infective Agents / Q000494:pharmacology*; D002939:Ciprofloxacin / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D016972:Enterobacter cloacae / Q000145:classification / Q000187:drug effects / Q000235:genetics; D004755:Enterobacteriaceae / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000453:epidemiology / Q000382:microbiology; D004926:Escherichia coli / Q000145:classification / Q000187:drug effects / Q000235:genetics; D005839:Gentamicins / Q000494:pharmacology*; D006405:Hematology; D006757:Hospital Units; D006801:Humans; D019426:Integrases / Q000235:genetics*; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D019105:Random Amplified Polymorphic DNA Technique
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D005839:Gentamicins; D002939:Ciprofloxacin; D019426:Integrases; C115006:integron integrase IntI1