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.

Anti-Bacterial Agents/*pharmacology, Anti-Infective Agents/*pharmacology, Ciprofloxacin/*pharmacology, Cross Infection/epidemiology/microbiology, Drug Resistance, Multiple, Bacterial, Electrophoresis, Gel, Pulsed-Field, Enterobacter cloacae/classification/drug effects/genetics, Enterobacteriaceae Infections/epidemiology/microbiology, Enterobacteriaceae/classification/*drug effects/genetics, Escherichia coli/classification/drug effects/genetics, Gentamicins/*pharmacology, Hematology, Hospital Units, Humans, Integrases/*genetics, Netherlands/epidemiology, Prevalence, Random Amplified Polymorphic DNA Technique
hdl.handle.net/1765/9804
Emerging Infectious Diseases - (Open Access)
Erasmus MC: University Medical Center Rotterdam

van der Schee, C, Lemmens-den Toom, N, Vos, M.C, Lugtenburg, P.J, de Marie, S, Verbrugh, H.A, … Endtz, H.P. (2001). Rapid emergence of ciprofloxacin-resistant enterobacteriaceae containing multiple gentamicin resistance-associated integrons in a Dutch hospital. Emerging Infectious Diseases - (Open Access). Retrieved from http://hdl.handle.net/1765/9804