Journal of Antimicrobial Chemotherapy, Vol 42, 689-696, Copyright © 1998 by The British Society for Antimicrobial Chemotherapy
P Martinez-Freijo, AC Fluit, FJ Schmitz, VS Grek, J Verhoef and ME Jones
Class I integrons are associated with carriage of genes encoding resistance
to antibiotics. Expression of inserted resistance genes within these
structures can be poor and, as such, the clinical relevance in terms of the
effect of integron carriage on susceptibility has not been investigated. Of
163 unrelated Gram-negative isolates randomly selected from the intensive
care and surgical units of 14 different hospitals in nine European
countries, 43.0% (70/163) of isolates were shown to be integron-positive,
with inserted gene cassettes of various sizes. Integrons were detected in
isolates from all hospitals with no particular geographical variations.
Integron- positive isolates were statistically more likely to be resistant
to aminoglycoside, quinolone and beta8-lactam compounds, including third-
generation cephalosporins and monobactams, than integron-negative isolates.
Integron-positive isolates were also more likely to be multi- resistant
than integron-negative isolates. This association implicates integrons in
multi-drug resistance either directly through carriage of specific
resistance genes, or indirectly by virtue of linkage to other resistance
determinants such as extended-spectrum beta-lactamase genes. As such their
widespread presence is a cause for concern. There was no association
between the presence of integrons and susceptibility to cefepime, amikacin
and the carbapenems, to which at least 97% of isolates were fully
susceptible.
Class I integrons in Gram-negative isolates from different European hospitals and association with decreased susceptibility to multiple antibiotic compounds [In Process Citation]
Eijkman-Winkler Institute for Clinical Microbiology, Infectious Diseases and Inflammation, University Hospital Utrecht, The Netherlands.
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