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Journal of Clinical Microbiology, October 2000, p. 3636-3645, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Molecular Surveillance of European Quinolone-Resistant Clinical Isolates of Pseudomonas aeruginosa and Acinetobacter spp. Using Automated Ribotyping

Sylvain Brisse,1,* Dana Milatovic,1 A. C. Fluit,1 Karlijn Kusters,1 Annet Toelstra,1 Jan Verhoef,1 and Franz-Josef Schmitz1,2

Eijkman-Winkler Institute, Utrecht University, 3584 CX Utrecht, The Netherlands,1 and Institute for Medical Microbiology and Virology, University Hospital Düsseldorf, D-40225 Düsseldorf, Germany2

Received 28 March 2000/Returned for modification 1 July 2000/Accepted 11 August 2000

Nosocomial isolates of Pseudomonas aeruginosa and Acinetobacter spp. exhibit high rates of resistance to antibiotics and are often multidrug resistant. In a previous study (D. Milatovic, A. Fluit, S. Brisse, J. Verhoef, and F. J. Schmitz, Antimicrob. Agents Chemother. 44:1102-1107, 2000), isolates of these species that were resistant to sitafloxacin, a new advanced-generation fluoroquinolone with a high potency and a broad spectrum of antimicrobial activity, were found in high proportion in 23 European hospitals. Here, we investigate the clonal diversity of the 155 P. aeruginosa and 145 Acinetobacter spp. sitafloxacin-resistant isolates from that study by automated ribotyping. Numerous ribogroups (sets of isolates with indistinguishable ribotypes) were found among isolates of P. aeruginosa (n = 34) and Acinetobacter spp. (n = 16), but the majority of the isolates belonged to a limited number of major ribogroups. Sitafloxacin-resistant isolates (MICs > 2 mg/liter, used as a provisional breakpoint) showed increased concomitant resistance to piperacillin, piperacillin-tazobactam, ceftriaxone, ceftazidime, amikacin, gentamicin, and imipenem. The major ribogroups were repeatedly found in isolates from several European hospitals; these isolates showed higher levels of resistance to gentamicin and imipenem, and some of them appeared to correspond to previously described multidrug-resistant international clones of P. aeruginosa (serotype O:12) and Acinetobacter baumannii (clones I and II). Automated ribotyping, when used in combination with more discriminatory typing methods, may be a convenient library typing system for monitoring future epidemiological dynamics of geographically widespread multidrug-resistant bacterial clones.


* Corresponding author. Mailing address: Eijkman-Winkler Institute, Utrecht University, AZU G04.614, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. Phone: 31 30 250-7625. Fax: 31 30 254-1770. E-mail: sbrisse{at}lab.azu.nl.


Journal of Clinical Microbiology, October 2000, p. 3636-3645, Vol. 38, No. 10
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.



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