• Title/Summary/Keyword: fluoroquinolone resistance

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Impact of Anti-Tuberculosis Drug Use on Treatment Outcomes in Patients with Pulmonary Fluoroquinolone-Resistant Multidrug-Resistant Tuberculosis: A Nationwide Retrospective Cohort Study with Propensity Score Matching

  • Hongjo Choi;Dawoon Jeong;Young Ae Kang;Doosoo Jeon;Hee-Yeon Kang;Hee Jin Kim;Hee-Sun Kim;Jeongha Mok
    • Tuberculosis and Respiratory Diseases
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    • v.86 no.3
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    • pp.234-244
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    • 2023
  • Background: Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting. Methods: The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included. Results: The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success). Conclusion: A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options.

TopoisomeraseII and Topoisomerase IV Gene Mutations Fluoroquinolone Resistance of Pseudomonas aeruginosa

  • Kim Yuntae;Baik Heongseok
    • Biomedical Science Letters
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    • v.10 no.4
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    • pp.507-514
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    • 2004
  • The Pseudomonas aeruginosa isolated from the clinical specimens has a mutation on the QRDR (quinolone resistance determining region). There were obvious mutations in both gyrA and parC gene which are major targets of quinolone. Simultaneous mutations were found two sites or more on these genes in all of ten strains. GyrB or parE gene had only silent mutation without converted amino acids. We confirmed that P. aeruginosa from clinical specimens exhibited decreased sensitivity to fluroquiolone due to changed Thr-83→lle and Asp-87→Asn types on gyrA and altered Ser-87→Leu type on parC. This is the first finding that a new Met-93→Thr type on parC as well as mutations on gyrB or parE genes differed from existing patterns. This study showed more mutations of gyrA rather than parC, suggesting that change of Type Ⅳ topoisomerase is more serious than that of type Ⅱ (DNA gyrase).

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Ofloxacin Resistance Mechanism in PA150 and PA300-Clinical Isolates of Pseudomonas aeruginosa in Korea

  • Lee, Soon-Deuk;Lee, Yeon-Hee
    • Archives of Pharmacal Research
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    • v.21 no.6
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    • pp.671-676
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    • 1998
  • Five hundred and seventy clinical strains of Pseudomonas aeruginosa were isolated from August 1993 to August 1994 in Korea and screened for their resistance to ciprofloxacin, norfloxacin, and ofloxacin. Among these, two P. aeruginosa strains (PA150 and PA300) were selected based on their strong resistance (MICs > 50mcg/ml) to all three quinolones. The susceptible strain as well as two resistant strains had proton gradient-dependent efflux system. Efflux system in PA300 showed different specificities to ofloxacin and ciprofloxacin while PA150 had less permeability for ofloxacin. Ofloxacin had a less inhibitory action on DNA synthesis in permeabilized cells of PA150 and PA300 than 1771M. When quinolone resistance determining region (QRDR) in gyrA was sequenced, PA300 had one missense mutation, Asn 116Tyr, which was newly reported in this work. The results showed that PA150 became ofloxacin resistant by reduced ofloxacin accumulation due to the existence of efflux system and low permeability, while resistance of PA300 was due to the efflux system and a mutation in QRDR of gyrA -the target site of quinolone.

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Genotypic characterization of fluoroquinolone-resistant Escherichia coli isolates from edible offal

  • Son, Se Hyun;Seo, Kwang Won;Kim, Yeong Bin;Noh, Eun Bi;Lee, Keun-Woo;Oh, Tae-Ho;Kim, Seung-Joon;Song, Jae-Chan;Kim, Tae-Wan;Lee, Young Ju
    • Korean Journal of Veterinary Research
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    • v.60 no.3
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    • pp.173-177
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    • 2020
  • Edible offal is easily contaminated by Escherichia coli (E. coli) and fluoroquinolone (FQ)-resistant E. coli is considered a serious public health problem, thus, this study investigated the genetic characteristics of FQ-resistant E. coli from edible offal. A total of 22 FQ-resistant E. coli isolates were tested. A double mutation in each gyrA and parC led the highest MIC. Four (18.2%) isolates carried plasmid-mediated quinolone resistance genes. The fimH, eaeA, escV, astA, and iucC genes were confirmed. Seventeen isolates (77.3%) were positive for plasmid replicons. The isolates showed high genetic heterogeneity based on pulsed-field gel electrophoresis patterns.

Mutations in the GyrA Subunit of DNA Gyrase and the ParC Subunit of Topoisomerase IV in Clinical Strains of Fluoroquinolone-Resistant Shigella in Anhui, China

  • Hu, Li-Fen;Li, Jia-Bin;Ye, Ying;Li, Xu
    • Journal of Microbiology
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    • v.45 no.2
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    • pp.168-170
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    • 2007
  • In this research 26 Shigella isolates were examined by PCR and direct nucleotide sequencing for genetic alterations in the quinolone-resistance determining regions (QRDRs). We tested for the presence of qnr genes by PCR in 91 strains, but no qnr genes were found. The results did show, however, some novel mutations at codon 83 of gyrA ($Ser{\rightarrow}Ile$) and codon 64 of parC ($Ala64{\rightarrow}Cys,\;Ala64{\rightarrow}Asp$), which were related to fluroquinolone resistance.

Resistance Mechanism of Acinetobacter spp. Strains Resistant to DW-116, a New Quinolone

  • Choi, Keum-Hwa;Baek, Moon-Chang;Kim, Byong-Kak;Choi, Eung-Chil
    • Archives of Pharmacal Research
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    • v.21 no.3
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    • pp.310-314
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    • 1998
  • DW-116 is a new fluoroquinolone antimicrobial agent with a broad spectrum. In order to elucidate the resistance mechanism to DW-116 in Acinetobacter spp. bacteria, total chromosomal DNA was isolated from 10 strains of Acinetobacter spp. resistant to DW-116. Quinolone resistance determinant region (QRDR) of DNA gyrase gene was amplified by PCR. The 345 bp nucleotide fragment yielded was inserted into pKF 3 which was used as the vector. Comparisons of the DNA sequences of 8 strains with that of the wild type strain revealed a Ser-83 to Leu mutation in mutants and all ten strains contained one silent mutation$(T{\rightarrow}G)$in QRDR. From Acinetobacter MB4-8 strain, DNA gyrase was isolated and purified, through novobiocin-sepharose, heparin-sepharose affinity column chromatography. The enzyme was composed of two subunits and the molecular mass of subunits A and B were 75.6 and 51.9 kDa, respectively. The supercoiling activity of the reconstituted DNA gyrase composed of subunit A from Acinetobacter MB4-8 and subunit B from E. coli was not inhibited by $128{\mu}\textrm{g}$ml of ciprofloxacin. It might be said that one of the resistance mechanisms to DW-116 in Acinetohacter MB4-8 was subunit A alteration of DNA gyrase.

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In Vitro Selection of MRSA Strains Resistant to Some New Fluoroquinolone Antibiotics and Characterization of their Resistance Mechanisms (새로운 플루오로 퀴놀론계 항균제에 대한 내성 MRSA 균주의 In Vitro 선발과 그 내성 기전 분석)

  • Yoon, Eun-Jeong;Kim, Hyun-Jee;Lee, Chun-Yeong;Choi, Eung-Chil;Shim, Mi-Ja
    • YAKHAK HOEJI
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    • v.52 no.3
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    • pp.219-224
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    • 2008
  • Clinically isolated methicillin-resistant Staphylococcus aureus strains were exposed to subinhibitory concentration of DW286, DW-224a, gemifloxacin, trovafloxacin, sparfloxacin and ciprofloxacin during 26- to 39-days period. Subculturing led to resistance development, and most of the selected mutants were above susceptible breakpoints. Selected mutants had broad cross resistance to other quinolone antibiotics and only one mutant was completely susceptible to all fluoroquinolones. Twenty five among 42 mutants revealed mutations on DNA gyrase and topoisomerase IV by sequencing. Also 16 mutants had fluoroquinolones MICs that were 4-32 times lower in the presence of reserpine. In conclusion, alterations in DNA gyrase or topoisomerase IV and action of efflux pumping out system are the resistance mechanisms of DW-224a.

Distribution of Tetracycline-Resistance Genes detected from isolates of cultured fishes in Gyeonggi-do (경기도 내 양식어류에서 분리한 병원성 세균의 Tetracycline 내성 유전자 분포)

  • Cho, Ki-Taek;Hwang, Yun-Jeong;Lee, Sang-Woo;Kim, Kwang-Il;Jeong, Hyun-Do
    • Journal of fish pathology
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    • v.34 no.1
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    • pp.39-46
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    • 2021
  • Tetracycline (TC) is one of the antibiotics used for treatment of bacterial infection in Korea. Inadequate usage and abuse cause the resistance to antibiotics, like Tetracycline, Erythromycin, and Fluoroquinolone. It can also affect severe economic loss in aquaculture field in Korea. We isolated 101 bacterial samples from diseased fish at aquaculture sites in Gyeonggi-do during 2015~2018. Minimum inhibitory concentration (MIC) method has been used to determine distribution and to identify bacterial isolates resistant to antibiotics including Oxytetracycline (OTC), Ampicillin (AMP), Clindamycin (CLI), Enrofloxacin (ENRO), Gentamycin (GEN). TC resistant isolates were confirmed antibiotic resistant genes by conventional PCR. Bacterial isolates were identified as Aeromonas spp. (43.5%), Pseudomonas spp. (4.0%) and Vibrio spp. (5.0%). It was confirmed that multi-resistant isolates (77.2%) were predominant over single-resistant one (22.8%). TC resistant genes like tet(A), tet(D), tet(E), tet(G), tet(M), and tet(S) were detected and tet(A) was the most prevalent. Aeromonas spp. is a dominant strain in bacterial infections in fishes of aquaculture sites, and further investigation on various antibiotic resistance genes will be needed for clear understanding of aquaculture sites in Gyeonggi-do.

Listeria Species in Broiler Poultry Farms: Potential Public Health Hazards

  • Dahshan, Hesham;Merwad, Abdallah Mohamed Amin;Mohamed, Taisir Saber
    • Journal of Microbiology and Biotechnology
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    • v.26 no.9
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    • pp.1551-1556
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    • 2016
  • Broiler meat production worldwide has been plagued by lethal food-poisoning bacteria diseases, including listeriosis. A fatality rate of 15.6% was recorded in human beings in the EU in 2015. During 2013, a total of 200 poultry farm samples, including litter, chicken breast, farm feed, and drinking water, were collected to generate baseline data for the characterization of the genus Listeria in broiler poultry farms. Listeria spp. were detected in a total of 95 (47.5%) poultry farm samples. The isolates of Listeria spp. included L. innocua (28.5%), L. ivanovii (12.5%), L. welshimeri (4.5%), and L. monocytogenes and L. seeligeri (1% each). Listeria spp. contamination rates were higher in farm feed (70%), followed by litter (52.5%), chicken breasts (42.2%), and drinking water (10%). Almost all Listeria spp. isolates were resistant to more than three classes of antibiotics (multidrug resistant). Besides this, we observed a significant resistance level to penicillin and fluoroquinolone drugs. However, lower resistance levels were recorded for broad-spectrum cephalosporins. The inlA, inlC, and inlJ virulence genes were detected in almost all of the L. monocytogenes isolates. Thus, food safety management approaches and interventions at all stages of the broiler rearing cycle were needed to control cross-contamination and the zoonotic potential of listeriosis.

Treatment of pigs with enrofloxacin via different oral dosage forms - environmental contaminations and resistance development of Escherichia coli

  • Janssen, Paula;Barton, Gesine;Kietzmann, Manfred;Meissner, Jessica
    • Journal of Veterinary Science
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    • v.23 no.2
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    • pp.23.1-23.15
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    • 2022
  • Background: Antibacterial agents play important roles in the treatment of bacterial infections. However, the development of antimicrobial resistance (AMR) and carry-over of substances into the environment are several problems arising during oral treatment of bacterial infections. We assessed AMR development in commensal Escherichia coli (E. coli) in enrofloxacin treated and untreated animals. In addition, we examined fluoroquinolone in the plasma and urine of treated and untreated animals, and in sedimentation dust and aerosol. Methods: In each trial, six pigs were treated with enrofloxacin via powder, granulate or pellet forms in two time periods (days 1-5 and 22-26). Four pigs served as untreated controls. The minimum inhibitory concentration (MIC) was determined to evaluate AMR development. Analysis of enro- and ciprofloxacin was performed with high performance liquid chromatography. Results: Non-wildtype E. coli (MIC > 0.125 ㎍/mL) was detected in the pellet treated group after the first treatment period, whereas in the other groups, non-wildtype isolates were found after the second treatment period. E. coli with MIC > 4 ㎍/mL was found in only the pellet trial. Untreated animals showed similar susceptibility shifts several days later. Bioavailability differed among the treatment forms (granulate > pellet > powder). Enro- and ciprofloxacin were detected in aerosols and sedimentation dust (granulate, powder > pellet). Conclusions: This study indicates that the kind of the oral dosage form of antibiotics affects environmental contamination and AMR development in commensal E. coli in treated and untreated pigs.