Rapid emergence of ciprofloxacin-resistant enterobacteriaceae containing multiple gentamicin resistance-associated integrons in a Dutch hospital

• Published in: Emerging infectious diseases Vol. 7; no. 5; pp. 862 - 871
• Main Authors: van Belkum, A, Goessens, W, van der Schee, C, Lemmens-den Toom, N, Vos, M C, Cornelissen, J, Lugtenburg, E, de Marie, S, Verbrugh, H, Löwenberg, B, Endtz, H
• Format: Journal Article
• Language: English
• Published: United States U.S. National Center for Infectious Diseases 01.09.2001; Centers for Disease Control and Prevention
• Subjects: Anti-Bacterial Agents - pharmacology; Anti-Infective Agents - pharmacology; Ciprofloxacin; Ciprofloxacin - pharmacology; Cross Infection - epidemiology; Cross Infection - microbiology; Drug resistance; Drug Resistance, Multiple, Bacterial; Electrophoresis, Gel, Pulsed-Field; Enterobacter; Enterobacter cloacae - classification; Enterobacter cloacae - drug effects; Enterobacter cloacae - genetics; Enterobacteriaceae; Enterobacteriaceae - classification; Enterobacteriaceae - drug effects; Enterobacteriaceae - genetics; Enterobacteriaceae Infections - epidemiology; Enterobacteriaceae Infections - microbiology; Escherichia coli; Escherichia coli - classification; Escherichia coli - drug effects; Escherichia coli - genetics; Evaluation; Genetic aspects; Gentamicins - pharmacology; Hematology; Hospital Units; Humans; Integrases - genetics; Netherlands - epidemiology; Neutropenia; Prevalence; Random Amplified Polymorphic DNA Technique; Netherlands
• ISSN: 1080-6040; 1080-6059
• DOI: 10.3201/eid0705.017515

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.