Characterization of two clinical, multiple-drug-resistant isolates of Enterobacter cloacae.

Two multiple drug resistant Enterobacter cloacae isolates (Nos. 460 and 493) varied phenotypically in bacteriocin susceptibility in the absence of significant O antigen variation. Both isolates were susceptible to chloramphenicol, nitrofurantoin, polymyxin B, nalidixic acid, norfloxacin, and enoxacin only. One isolate carried a non-conjugative resistance (R) plasmid, whereas the other isolate contained a conjugative, 'curable' R plasmid and a cryptic plasmid. Both wild-type isolates constitutively produced a chromosomal cephalosporinase (nitrocefin hydrolysis); 'cured' variants of E. cloacae isolate No. 493, which had become susceptible for lamoxactam, produced a cefazolin-inducible beta-lactamase. The two E. cloacae isolates, including their 'cured' variants, were of low-grade virulence for outbred NMRI mice. Both isolates differed somewhat in susceptibility to defibrinated human blood. Inhibitory (0.25 microgram/ml), but not subinhibitory (0.125 microgram/ml) concentrations of norfloxacin and enoxacin combined with human blood yielded additive effects against both E. cloacae isolates.