title: Mechanisms of quinolone resistance in clinical isolates of Enterobacter cloacae.
abstract: OBJECTIVE: To study and evaluate changes in the gyrA gene and the outer-membrane protein patterns in relation to evolution of resistance against the quinolones in Enterobacter cloacae. METHODS: Strains expressing gyrA-mediated quinolone resistance become susceptible to quinolones upon insertion of the plasmid pNJR3-2. This plasmid (containing wild-type Escherichia coli quinolone-susceptible DNA gyrase A subunits) and pLA2917 (the vector) were introduced into 10 resistant or moderately susceptible clinical isolates of Enterobacter cloacae by conjugation. The transconjugants, the original isolates, the plasmid and the vector control were screened for susceptibility to ofloxacin, ciprofloxacin and sparfloxacin. Additionally, examinations of the outer-membrane proteins were performed. RESULTS: A reduction of MICs by a factor of 8--32 was found for the transconjugants of five Enterobacter cloacae isolates in the presence of the gene probe, suggesting that these isolates harbored mutations in gyrA. No discernible difference in the patterns of outer-membrane proteins of sensitive and resistant strains could be detected. CONCLUSIONS: It seems that changes in the target site such as alterations in gyrA are important factors leading to a change in the susceptibility of bacteria to the quinolones, whereas there were no evident changes in the outer-membrane proteins to account for evolution of resistance.
authors.affiliation: University Clinic for Internal Medicine I, Clinical Department for Infectious Diseases and Chemotherapy, and.
authors.forename: Apostolos
authors.initials: A
authors.lastname: Georgopoulos
authors.forename: Robert
authors.initials: R
authors.lastname: Schein
authors.forename: Astrid
authors.initials: A
authors.lastname: Buxbaum
authors.forename: Susan
authors.initials: S
authors.lastname: Tzotzos
authors.forename: Alexander
authors.initials: A
authors.lastname: Hirschl
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Graninger