TY - JOUR AU - van Belkum, Alex AU - Goessens, Wil AU - van der Schee, Cindy AU - Lemmens-den Toom, Nicole AU - Vos, Margreet AU - Cornelissen, Jan AU - Lugtenburg, Elly AU - de Marie, Siem AU - Verbrugh, Henri AU - Löwenberg, Bob AU - Endtz, Hubert T1 - Rapid Emergence of Ciprofloxacin-Resistant Enterobacteriaceae Containing Multiple Gentamicin Resistance-Associated Integrons, the Netherlands T2 - Emerging Infectious Disease journal PY - 2001 VL - 7 IS - 5 SP - 862 SN - 1080-6059 AB - In a hematology unit in the Netherlands, the incidence of ciprofloxacin-resistant 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 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. KW - Escherichia coli KW - Enterobacter cloacae KW - gentamicin resistance KW - ciprofloxacin resistance KW - hematology KW - pulsed-field gel electrophoresis KW - random amplification of polymorphic DNA KW - integron KW - restriction fragment length polymorphism KW - epidemiology KW - the Netherlands DO - 10.3201/eid0705.017515 UR - https://wwwnc.cdc.gov/eid/article/7/5/01-7515_article ER - End of Reference