JAC Advance Access originally published online on August 13, 2003
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Journal of Antimicrobial Chemotherapy (2003) 52, 711-714
© 2003 The British Society for Antimicrobial Chemotherapy
Two widely disseminated strains of Enterococcus faecalis highly resistant to gentamicin and ciprofloxacin from bacteraemias in the UK and Ireland
1 Antibiotic Resistance Monitoring and Reference Laboratory and 3 Laboratory of HealthCare Associated Infection, Specialist and Reference Microbiology Division, Health Protection Agency—Colindale, London NW9 5HT; 2 British Society for Antimicrobial Chemotherapy, Birmingham B1 2JS, UK
Received 29 May 2003; returned 30 June 2003; revised 3 July 2003; accepted 9 July 2003
A strong association was observed between high-level resistance to ciprofloxacin and gentamicin for isolates of Enterococcus faecalis collected in the UK and Ireland as part of the BSAC Bacteraemia Resistance Surveillance Programme, 2001. Thus, 60 of 66 E. faecalis isolates with gentamicin MICs 
512 mg/L were highly resistant to ciprofloxacin (MICs 32 mg/L), compared with only three of 83 E. faecalis isolates with normal gentamicin susceptibility (MICs 
128 mg/L) (P < 0.0001). Pulsed-field gel electrophoresis of SmaI-digested genomic DNA was used to investigate 38 representative E. faecalis isolates with the double resistance from 18 hospitals. Based on the criterion of 80% banding pattern similarity, two large clusters were observed: cluster 1 included 14 isolates, from seven hospitals, that were related at 84.8% similarity; cluster 2 included 10 isolates, from six hospitals, that were related at 83.3% similarity. Sporadic isolates and small clusters with the double resistance were also observed, but were not closely related to those in clusters 1 and 2. Further work is needed to characterize these two ‘epidemic’ E. faecalis strains and to investigate the presence of virulence genes.
Keywords: E. faecalis, epidemic strains, resistance
* Corresponding author. Tel: +44-20-8200-4400; Fax: +44-20-8358-3292; E-mail: neil.woodford{at}hpa.org.uk
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