Fluoroquinolone-resistant Escherichia coli, Indonesia

Kuntaman Kuntaman, Endang Sri Lestari, Juliëtte A. Severin, Irma M. Kershof, Ni Made Mertaniasih, Marijam Purwanta, Usman Hadi, James R. Johnson, Alex Van Belkum, Henri A. Verbrugh

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20 Scopus citations


In a recent, population-based survey of 3,996 persons in Indonesia, fluoroquinolone (FQ)-resistant Escherichia coli was prevalent in the fecal flora of 6% of patients at hospital admission and 23% of patients at discharge, but not among healthy relatives or patients visiting primary healthcare centers (2%). Molecular typing showed extensive genetic diversity with only limited clonality among isolates. This finding suggests that independent selection of resistant mutants occurs frequently. FQ-resistant isolates exhibited a higher rate of spontaneous mutation, but sparser virulence profiles, than FQ-susceptible isolates from the same population. The resistant isolates belonged predominantly to phylogenetic groups A (57%) and B1 (22%) but also to the moderately virulent group D (20%). Hypervirulent strains from the B2 cluster were underrepresented (1%). Because FQ-resistant E. coli can cause disease, especially nosocomial infections in immunocompromised patients, spread of such strains must be stopped.

Original languageEnglish (US)
Pages (from-to)1363-1369
Number of pages7
JournalEmerging infectious diseases
Issue number9
StatePublished - Sep 2005


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