Enterobacter cloacae outbreak and emergence of quinolone resistance gene in Dutch hospital.
An outbreak of Enterobacter cloacae infections with variable susceptibility to fluoroquinolones occurred in the University Medical Center Utrecht in the Netherlands in 2002. Our investigation showed that a qnrA1 gene was present in 78 (94%) of 83 outbreak isolates and that a qnrA1-encoding plasmid transferred to other strains of the same species and other species. The earliest isolate carrying this same plasmid was isolated in 1999. qnrA1 was located in a complex integron consisting of the intI1, aadB, qacEDelta1, sul1, orf513, qnrA1, ampR, qacEDelta1, and sul1 genes that were not described previously. On the same plasmid, 2 other class 1 integrons were present. One was a new integron associated with the bla(CTX-M-9) extended-spectrum beta-lactamase.
Paauw
Armand
A
Eijkman-Winkler Institute for Microbiology, Infectious Diseases and Inflammation, University Medical Center Utrecht, 3508 GA Utrecht, the Netherlands. A.Paauw@umcutrecht.nl
Fluit
Ad C
AC
Verhoef
Jan
J
Leverstein-van Hall
Maurine A
MA
D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001483:Base Sequence; D016000:Cluster Analysis; D021821:Communicable Diseases, Emerging / Q000453:epidemiology / Q000235:genetics; D003227:Conjugation, Genetic; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D016972:Enterobacter cloacae / Q000145:classification / Q000187:drug effects* / Q000235:genetics*; D004756:Enterobacteriaceae Infections / Q000188:drug therapy* / Q000453:epidemiology; D005784:Gene Amplification; D005838:Genotype; D006801:Humans; D008826:Microbial Sensitivity Tests; D008969:Molecular Sequence Data; D009426:Netherlands / Q000453:epidemiology; D010802:Phylogeny; D010957:Plasmids; D015363:Quinolones / Q000494:pharmacology*; D013045:Species Specificity
D000900:Anti-Bacterial Agents; D015363:Quinolones