failure to control an outbreak of qnra1-positive multidrug-resistant enterobacter cloacae infection despite adequate implementation of recommended infection control measures.a large outbreak with an aminoglycoside-resistant enterobacter cloacae (arec) clone occurred at the university medical center utrecht beginning in 2001 and continued up through the time that this study was completed. this clone (genotype i) contains a conjugative r plasmid carrying the qnra1, bla(ctx-m-9), and aadb genes, encoding resistance to quinolones, extended-spectrum beta-lactamases, and aminoglycosides, respectively. the aim of this study was to determine whether this clone was more tran ...200717314218
enterobacter cloacae outbreak and emergence of quinolone resistance gene in dutch outbreak of enterobacter cloacae infections with variable susceptibility to fluoroquinolones occurred in the university medical center utrecht in the netherlands in 2002. our investigation showed that a qnra1 gene was present in 78 (94%) of 83 outbreak isolates and that a qnra1-encoding plasmid transferred to other strains of the same species and other species. the earliest isolate carrying this same plasmid was isolated in 1999. qnra1 was located in a complex integron consisting of the inti1 ...200616704842
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