A. Van Belkum et al., Rapid emergence of ciprofloxacin-resistant enterobacteriaceae containing multiple gentamicin resistance-associated integrons in a Dutch hospital, EM INFECT D, 7(5), 2001, pp. 862-871
In a hematology unit in the Netherlands, the incidence of ciprofloxacin-res
istant Enterobacter cloacae and Escherichia coli increased from <0.5% to 20
.7% and <0.5% to 64%, respectively, from 1996 to 1999. Clonal spread of sin
gle genotypes of both ciprofloxacin-resistant E. coli and Enterobacter cloa
cae from patient to patient was documented by pulsed-field gel electrophore
sis and random amplification of polymorphic DNA. In addition, genetically h
eterogeneous strains were isolated regularly. Integrons associated with gen
tamicin resistance were detected in Enterobacter cloacae and E. coli strain
s. Integron-containing E. coli were detected in all hematology wards. In co
ntrast, in Enterobacter cloacae strains two integron types were encountered
only in the isolates from one ward. Although in all patients identical ant
ibiotic regimens were used for selective decontamination, we documented cle
ar differences with respect to the nosocomial emergence of ciprofloxacin-re
sistant bacterial strains and gentamicin resistance-associated integrons.