Emergence of SHV-2a producing enterobacter cloacae in hungary.

We report an investigation on a collection of multidrug-resistant Enterobacter cloacae isolates from a Hungarian neonatal intensive care unit. All the isolates (n=142) were examined by antimicrobial susceptibility testing and ERIC-PCR. The seven ESBL positive isolates (derived from six patients) made up a separated group with regard to their patterns by antimicrobial susceptibility testing and ERIC-PCR and were further tested by class-1-integron PCR and plasmid electrophoresis. The ESBL isolates were found indistinguishable in each of these laboratory tests, one genetic clone were revealed in the background of ESBL cases by PFGE. The ESBL positive isolates were proven to harbour a approximately 62 Md plasmid and two class-1 integrons (0.9 kb, 1.875 kb). With respect to their clinical relatedness and our laboratory findings there was a small outbreak caused by the ESBL clone. PCR-sequencing were performed on the outbreak strain and has revealed a blaSHV gene that encodes for an SHV-2a type ESBL enzyme. This is the first description of SHV-2a positive E. cloacae strains isolated in Hungary.