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JAC Advance Access originally published online on June 23, 2009
Journal of Antimicrobial Chemotherapy 2009 64(3):653-654; doi:10.1093/jac/dkp222
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© The Author 2009. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Research letters

Nosocomial spread of ESBL-positive Enterobacter cloacae co-expressing plasmid-mediated quinolone resistance Qnr determinants in one hospital in France

Anaïs Potron1, Laurent Poirel1, Sandrine Bernabeu1, Xavier Monnet2, Christian Richard2 and Patrice Nordmann1,*

1 Service de Bactériologie–Virologie, INSERM U914 ‘Emerging Resistance to Antibiotics’, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine et Université Paris-Sud, 78 rue du Général Leclerc, 94275 K.-Bicêtre cedex, France 2 Service de Réanimation Médicale, Hôpital de Bicêtre, Assistance Publique/Hôpitaux de Paris, Faculté de Médecine et Université Paris-Sud, 78 rue du Général Leclerc, 94275 K.-Bicêtre cedex, France

* Corresponding author. Service de Bactériologie–Virologie, Hôpital de Bicêtre, 78 rue du Général Leclerc, 94275 Le Kremlin-Bicêtre cedex, France. Tel: +33-1-45-21-36-32; Fax: +33-1-45-21-63-40; E-mail: nordmann.patrice@bct.aphp.fr

Keywords: dissemination , Enterobacteriaceae , E. cloacae

The first 10% of the full text of this article appears below.

Sir,

Although resistance to quinolones is mainly due to chromosome-encoded mechanisms, it may also result from the expression of plasmid-mediated determinants such as aac(6')-Ib-cr encoding an aminoglycoside acetyltransferase that is also capable of acetylating some fluoroquinolones, qepA encoding an efflux pump and qnr genes. Qnr proteins protect target enzymes (DNA gyrase and type IV topoisomerases) from quinolone inhibition. Five types of Qnr have been reported: QnrA, QnrB, QnrC, QnrD and QnrS.1 In addition, the co-expression of extended-spectrum β-lactamases (ESBLs) and Qnr determinants has been frequently observed.2 To date, two nosocomial outbreaks of Qnr- . . . [Full Text of this Article]


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