JAC Advance Access published online on August 13, 2003
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkg408
© 2003 by The British Society for Antimicrobial Chemotherapy
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Brief report
1 Antibiotic Resistance
Monitoring and Reference Laboratory, Specialist
and Reference Microbiology Division, Health Protection Agency--Colindale,
London NW9 5HT
* Corresponding author. E-mail: neil.woodford{at}hpa.org.uk.
Received 29 May 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
Keywords: E. faecalis, epidemic strains,
resistance
Two widely disseminated strains of Enterococcus
faecalis highly resistant to gentamicin and ciprofloxacin from
bacteraemias in the
UK and Ireland
2 British Society
for Antimicrobial Chemotherapy, Birmingham B1 2JS, UK
3 Laboratory of HealthCare Associated Infection, Specialist
and Reference Microbiology Division, Health Protection Agency--Colindale,
London NW9 5HT
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.
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