Fernández, Javier Montero, Ignacio Martínez, Óscar Fleites, Ana Poirel, Laurent Nordmann, Patrice Rodicio, M. Rosario 2015-08-07 Twenty-one multiresistant <em>Enterobacter cloacae</em> isolates producing OXA-48 (<em>n</em> = 10), CTX-M-15 (<em>n</em> = 7) or both (<em>n</em> = 4) β-lactamases were detected in a Spanish hospital during a 1-year period (June 2013 to June 2014). The isolates were also resistant to non-β-lactam antimicrobials, further complicating the therapeutic options. Genotyping of the isolates identified two major clones (ST74 and ST66) that caused prolonged outbreaks in different buildings of the hospital as well as some sporadic isolates (ST78, ST45 and ST295). Isolates belonging to clone 1 (<em>n</em> = 7) were carbapenem-resistant and carried the <em>bla</em>_OXA-48 gene on a conjugative IncL/M plasmid of ca. 65 kb. Clone 2 isolates (<em>n</em> = 11) were resistant to cefepime and harboured the <em>bla</em>_CTX-M-15 gene on an ca. 150-kb, non-conjugative plasmid of the IncF group, co-harbouring the <em>qnrB</em> and <em>aac(6′)-Ib</em>-cr genes encoding quinolone resistance. Four clone 2 isolates were also resistant to carbapenems owing to the co-production of OXA-48. Most of the isolates were recovered from critically ill patients and were admitted to intensive care units; a single patient was transferred from another Spanish hospital. Intrahospital and interhospital dissemination of multiresistant <em>E. cloacae</em> isolates is of major clinical concern as it could lead to endemic nosocomial situations. application/pdf https://folia.unifr.ch/global/documents/304718 https://folia.unifr.ch/documents/304718/files/nor_dme.pdf eng info:eu-repo/semantics/altIdentifier/doi/10.1016/j.ijantimicag.2015.07.003 info:eu-repo/semantics/openAccess License undefined International Journal of Antimicrobial Agents. - 2015, vol. 46, no. 4, p. 469–474 Enterobacter cloacae Carbapenemase OXA 48 CTX M 15 Plasmid mediated quinolone resistance Nosocomial outbreak info:eu-repo/classification/udc/57 Dissemination of multiresistant Enterobacter cloacae isolates producing OXA-48 and CTX-M-15 in a Spanish hospital http://purl.org/coar/resource_type/c_6501