title: Emergence and spread of three clonally related virulent isolates of CTX-M-15-producing Escherichia coli with variable resistance to aminoglycosides and tetracycline in a French geriatric hospital.
abstract: Three types of multidrug-resistant Escherichia coli isolates, called GEN S, GEN R, and AMG S, according to their three different aminoglycoside resistance patterns, were responsible for urinary tract colonization or infection in 87, 12, and 13 new patients, respectively, in a French 650-bed geriatric hospital over a 13-month period. The three E. coli types belonged to the same clone and phylogenetic group (group B2) and had identical transferable plasmid contents (a 120-kb plasmid), beta-lactam and fluoroquinolone resistance genotypes (bla(TEM-1B), bla(CTX-M-15), and double mutations in both the gyrA and the parC genes), and virulence factor genotypes (aer, fyuA, and irp2). They disseminated in the geriatric hospital, where the antibiotics prescribed most often were fluoroquinolones and ceftriaxone, but not in the affiliated acute-care hospital, where isolation precautions were applied to the transferred patients. Thus, E. coli isolates, both CTX-M-type beta-lactamase producers and fluoroquinolone-resistant isolates, might present a new challenge for French health care settings.
authors.affiliation: Service de Microbiologie-Hygiène, Hôpital A. Paré, 9 avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Leflon-Guibout
authors.forename: Cécile
authors.initials: C
authors.lastname: Jurand
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bonacorsi
authors.forename: Florence
authors.initials: F
authors.lastname: Espinasse
authors.forename: Marie Claude
authors.initials: MC
authors.lastname: Guelfi
authors.forename: Françoise
authors.initials: F
authors.lastname: Duportail
authors.forename: Beate
authors.initials: B
authors.lastname: Heym
authors.forename: Edouard
authors.initials: E
authors.lastname: Bingen
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Nicolas-Chanoine
mesh_terms: D000368:Aged; D000617:Aminoglycosides / Q000494:pharmacology*; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004926:Escherichia coli / Q000187:drug effects / Q000201:enzymology* / Q000235:genetics; D005602:France; D022761:Gene Transfer, Horizontal; D005798:Genes, Bacterial / Q000235:genetics; D005838:Genotype; D005853:Geriatrics; D006782:Hospitals, Special; D006801:Humans; D007525:Isoelectric Focusing; D010641:Phenotype; D010957:Plasmids / Q000235:genetics; D013752:Tetracycline / Q000494:pharmacology*; D014552:Urinary Tract Infections / Q000382:microbiology; D037521:Virulence Factors / Q000235:genetics; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000617:Aminoglycosides; D037521:Virulence Factors; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases; D013752:Tetracycline