title: Fluoroquinolone-resistant Escherichia coli, Indonesia.
abstract: In a recent, population-based survey of 3,996 persons in Indonesia, fluoroquinolone (FQ)-resistant Escherichia coli was prevalent in the fecal flora of 6% of patients at hospital admission and 23% of patients at discharge, but not among healthy relatives or patients visiting primary healthcare centers (2%). Molecular typing showed extensive genetic diversity with only limited clonality among isolates. This finding suggests that independent selection of resistant mutants occurs frequently. FQ-resistant isolates exhibited a higher rate of spontaneous mutation, but sparser virulence profiles, than FQ-susceptible isolates from the same population. The resistant isolates belonged predominantly to phylogenetic groups A (57%) and B1 (22%) but also to the moderately virulent group D (20%). Hypervirulent strains from the B2 cluster were underrepresented (1%). Because FQ-resistant E. coli can cause disease, especially nosocomial infections in immunocompromised patients, spread of such strains must be stopped.
authors.affiliation: Airlangga University, Surabaya, Indonesia.
authors.forename: Kuntaman
authors.initials: K
authors.lastname: Kuntaman
authors.forename: Endang Sri
authors.initials: ES
authors.lastname: Lestari
authors.forename: Juliëtte A
authors.initials: JA
authors.lastname: Severin
authors.forename: Irma M
authors.initials: IM
authors.lastname: Kershof
authors.forename: Ni Made
authors.initials: NM
authors.lastname: Mertaniasih
authors.forename: Marijam
authors.initials: M
authors.lastname: Purwanta
authors.forename: Usman
authors.initials: U
authors.lastname: Hadi
authors.forename: James R
authors.initials: JR
authors.lastname: Johnson
authors.forename: Alex
authors.initials: A
authors.lastname: van Belkum
authors.forename: Henri A
authors.initials: HA
authors.lastname: Verbrugh
mesh_terms: D000890:Anti-Infective Agents / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial / Q000235:genetics; D004926:Escherichia coli / Q000187:drug effects*; D024841:Fluoroquinolones / Q000494:pharmacology*; D005828:Genetics, Population; D006801:Humans; D007214:Indonesia; D008826:Microbial Sensitivity Tests; D008967:Molecular Biology; D010802:Phylogeny
chemical_list: D000890:Anti-Infective Agents; D024841:Fluoroquinolones