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Antimicrobial Agents and Chemotherapy, October 2004, p. 3736-3742, Vol. 48, No. 10
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.10.3736-3742.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

Emergence and Spread of Three Clonally Related Virulent Isolates of CTX-M-15-Producing Escherichia coli with Variable Resistance to Aminoglycosides and Tetracycline in a French Geriatric Hospital

Véronique Leflon-Guibout,1 Cécile Jurand,1,2 Stéphane Bonacorsi,3 Florence Espinasse,4 Marie Claude Guelfi,5 Françoise Duportail,6 Beate Heym,1,2 Edouard Bingen,3 and Marie-Hélène Nicolas-Chanoine1,2*

Service de Microbiologie-Hygiène,1 Hygiene Department Hôpital A. Paré, Boulogne,4 Faculté de Médecine Paris Ile de France Ouest, Université Saint-Quentin-en-Yvelines, Versailles,2 Service de Microbiologie, Hôpital R. Debré,3 Pharmacie,5 Medical Information Department, Hôpital Sainte Périne-Chardon Lagache, Paris, France6

Received 20 February 2004/ Returned for modification 10 May 2004/ Accepted 6 June 2004

Three types of multidrug-resistant Escherichia coli isolates, called GEN S, GEN R, and AMG S, according to their three different aminoglycoside resistance patterns, were responsible for urinary tract colonization or infection in 87, 12, and 13 new patients, respectively, in a French 650-bed geriatric hospital over a 13-month period. The three E. coli types belonged to the same clone and phylogenetic group (group B2) and had identical transferable plasmid contents (a 120-kb plasmid), ß-lactam and fluoroquinolone resistance genotypes (blaTEM-1B, blaCTX-M-15, and double mutations in both the gyrA and the parC genes), and virulence factor genotypes (aer, fyuA, and irp2). They disseminated in the geriatric hospital, where the antibiotics prescribed most often were fluoroquinolones and ceftriaxone, but not in the affiliated acute-care hospital, where isolation precautions were applied to the transferred patients. Thus, E. coli isolates, both CTX-M-type ß-lactamase producers and fluoroquinolone-resistant isolates, might present a new challenge for French health care settings.

* Corresponding author. Mailing address: Service de Microbiologie-Hygiène, Hôpital A. Paré, 9 avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France. Phone: 33-1-49 09 55 40. Fax: 33-1-49 09 59 21. E-mail: marie-helene.nicolas-chanoine{at}apr.ap-hop-paris.fr.

Antimicrobial Agents and Chemotherapy, October 2004, p. 3736-3742, Vol. 48, No. 10
0066-4804/04/$08.00+0     DOI: 10.1128/AAC.48.10.3736-3742.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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