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All lineages displayed resistance to multiple antimicrobial classes, and only the new oxazolidinone linezolid was active against all strains.
However, ST131 was more likely to be non-susceptible to multiple antimicrobial classes than non-ST131, as 61.7 % of ST131 isolates were non-susceptible to ≥ 3 antimicrobial classes other than penicillin and cephalosporin, versus 36.8%% (7/19) of S405 isolates and 33.3 % (5/15) of ST38 isolates.
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All isolates tested demonstrated resistance to multiple antimicrobial drug classes (Table).
Most resistant isolates now demonstrate reduced susceptibility to multiple antimicrobial drug classes, including β-lactams, macrolides, and tetracyclines.
The spread of blaNDM-1 among bacterial pathogens is of concern not only because of resistance to carbapenems but also because such pathogens typically are resistant to multiple antimicrobial drug classes, which leaves few treatment choices available (3 – 5 ).
Furthermore, KPC-producing organisms can confer resistance to multiple different antimicrobial classes, including all available β-lactams, fluoroquinolones, and aminoglycosides [ 4, 5].
Thirty-two unique susceptibility profiles were identified among the S. aureus isolates, with many resistant to multiple clinically important antimicrobial classes.
The 32 isolates identified as multiple antimicrobial resistant were assayed by PCR amplification for class 1 and class 2 integrase genes.
After adjusting for multiple risk factors, including exposure to other antimicrobial classes, exposures to levofloxacin (OR 3.4; p < 0.0001) and to somewhat lesser degree ciprofloxacin (OR 2.5; p = 0.0049) were significantly associated with MRSA.
Recently, class 1 integrons carrying multiple antimicrobial resistance genes were identified in 6.5% of L. hongkongensis isolates from aquatic products in Guangzhou city, China [ 110].
Hence, linking resistance genes with resistance phenotypes will be more and more important for the understanding of why some isolates are extremely resistant and why some contain multiple resistance genes encoding resistance to the same antimicrobial classes.
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