Rising fluoroquinolone resistance rates in corneal isolates: implications for the wider use of antibiotics within the community

2015 ◽  
Vol 20 (3-4) ◽  
pp. 128-133 ◽  
Author(s):  
Chameen Samarawickrama ◽  
Elsie Chan ◽  
Mark Daniell
Keyword(s):  
Fluoroquinolone Resistance ◽  
Resistance Rates

scholarly journals Global Fluoroquinolone Resistance Epidemiology and Implictions for Clinical Use

2012 ◽  
Vol 2012 ◽  
pp. 1-37 ◽  
Author(s):  
Axel Dalhoff
Keyword(s):  
Urinary Tract ◽  
Rural Areas ◽  
Methicillin Resistance ◽  
Bacterial Species ◽  
Fluoroquinolone Resistance ◽  
Sexually Transmitted ◽  
Tract Infections ◽  
Almost All ◽  
Healthcare Associated ◽  
Resistance Rates

This paper on the fluoroquinolone resistance epidemiology stratifies the data according to the different prescription patterns by either primary or tertiary caregivers and by indication. Global surveillance studies demonstrate that fluoroquinolone resistance rates increased in the past years in almost all bacterial species exceptS. pneumoniaeandH. influenzae, causing community-acquired respiratory tract infections. However, 10 to 30% of these isolates harbored first-step mutations conferring low level fluoroquinolone resistance. Fluoroquinolone resistance increased in Enterobacteriaceae causing community acquired or healthcare associated urinary tract infections and intraabdominal infections, exceeding 50% in some parts of the world, particularly in Asia. One to two-thirds of Enterobacteriaceae producing extended spectrum -lactamases were fluoroquinolone resistant too. Furthermore, fluoroquinolones select for methicillin resistance inStaphylococci.Neisseria gonorrhoeaeacquired fluoroquinolone resistance rapidly; actual resistance rates are highly variable and can be as high as almost 100%, particularly in Asia, whereas resistance rates in Europe and North America range from <10% in rural areas to >30% in established sexual networks. In general, the continued increase in fluoroquinolone resistance affects patient management and necessitates changes in some guidelines, for example, treatment of urinary tract, intra-abdominal, skin and skin structure infections, and traveller’s diarrhea, or even precludes the use in indications like sexually transmitted diseases and enteric fever.

scholarly journals 2049. Trends in Antibiotic Use and Antibiotic Resistance among Veterans Affairs Community Living Centers from 2011 to 2017

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S690-S691
Author(s):  
Haley Appaneal ◽  
Aisling Caffrey ◽  
Stephanie Hughes ◽  
Vrishali Lopes ◽  
Robin L Jump ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Pseudomonas Aeruginosa ◽  
Antibiotic Resistance ◽  
Antibiotic Use ◽  
Veterans Affairs ◽  
Fluoroquinolone Resistance ◽  
Antibiotic Overuse ◽  
Community Living Centers ◽  
Resistance Rates ◽  
Klebsiella Spp

Abstract Background Antibiotic resistance is a global public health crisis, with antibiotic overuse contributing to selection pressure, and thus driving antibiotic resistance. Strategies to reduce antibiotic overuse may slow the development of resistance, but large-scale studies assessing trends in antibiotic use and resistance among nursing homes at the national level are limited. We describe trends in antibiotic use and resistance nationally among Veterans Affairs (VA) Community Living Centers (CLCs). Methods We assessed antibiotic use and microbiological cultures among VA CLC residents from 2011 to 2017. Antibiotics were grouped into eight drug classes and annual days of antibiotic therapy per 1,000 bed-days were calculated. Facility-weighted annual antibiotic resistance rates were calculated. Joinpoint Software was used for regression analyses of trends over time and to estimate annual average percent changes (AAPC) with 95% confidence intervals (CI). Results Over 7 years and among 146 CLCs, several significant trends in decreasing antibiotic use and corresponding reductions in resistance were identified. Fluoroquinolone use decreased by 9.9% annually (95% CI −11.6 to −8.2%) and fluoroquinolone resistance decreased by 2.3% per year for Escherichia coli, 5.1% for Klebsiella spp., 1.8% for Proteus mirabilis, 4.9% for Pseudomonas aeruginosa, 12.6% for Enterobacter spp., and 3.2% for Enterococcus spp. Anti-pseudomonal penicillin use decreased by 6.6% annually (95% CI −10.6 to −2.4%) and anti-pseudomonal penicillin resistance rates decreased each year by 7.9% for Escherichia coli, 8.9% for Klebsiella spp., 15.2% for Proteus mirabilis and 4.2% for Pseudomonas aeruginosa. Anti-staphylococcal penicillin use decreased by 5.4% annually (95% CI −10.0 to −0.5%) and resistance in Staphylococcus aureus decreased 1.7% per year. Conclusion Nationally among VA CLCs, we observed significant reductions in the use of several classes of antibiotics with corresponding reductions in antibiotic resistance, including an impressive decline in fluoroquinolone use and corresponding decreases in fluoroquinolone resistance among six organisms. Future research should assess whether reductions in antibiotic use predict later reductions in antibiotic resistance and improvements in resident outcomes. Disclosures All authors: No reported disclosures.

scholarly journals Comparative Analysis of Quinolone Resistance in Clinical Isolates ofKlebsiella pneumoniaeandEscherichia colifrom Chinese Children and Adults

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Ying Huang ◽  
James O. Ogutu ◽  
Jiarui Gu ◽  
Fengshu Ding ◽  
Yuhong You ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Environmental Issues ◽  
Quinolone Resistance ◽  
Clinical Isolates ◽  
Fluoroquinolone Resistance ◽  
Chinese Adults ◽  
Double Mutation ◽  
History Of ◽  
Ciprofloxacin Resistance ◽  
Resistance Rates

The objective of this study was to compare quinolone resistance andgyrAmutations in clinical isolates ofKlebsiella pneumoniaeandEscherichia colifrom Chinese adults who used quinolone in the preceding month and children without any known history of quinolone administration. The antimicrobial susceptibilities of 61 isolates from children and 79 isolates from adults were determined. The mutations in the quinolone resistance-determining regions ingyrAgene were detected by PCR and DNA sequencing. Fluoroquinolone resistance and types ofgyrAmutations in isolates from children and adults were compared and statistically analyzed. No significant differences were detected in the resistance rates of ciprofloxacin and levofloxacin between children and adults among isolates of the two species (allP>0.05). The double mutation Ser83→Leu + Asp87→Asn in the ciprofloxacin-resistant isolates occurred in 73.7% isolates from the children and 67.9% from the adults, respectively (P=0.5444). Children with no known history of quinolone administration were found to carry fluoroquinolone-resistantEnterobacteriaceaeisolates. The occurrence of ciprofloxacin resistance and the major types ofgyrAmutations in the isolates from the children were similar to those from adults. The results indicate that precautions should be taken on environmental issues resulting from widespread transmission of quinolone resistance.

Macrolide and fluoroquinolone resistance of Mycoplasma genitalium in southern Spain, 2018–2019

2020 ◽  
pp. sextrans-2019-054386
Author(s):  
Adolfo de Salazar ◽  
Antonio Barrientos-Durán ◽  
Beatriz Espadafor ◽  
Ana Fuentes-López ◽  
Natalia Chueca ◽  
...  
Keyword(s):  
General Population ◽  
Mycoplasma Genitalium ◽  
Southern Spain ◽  
Fluoroquinolone Resistance ◽  
23S Rrna ◽  
Heterosexual Men ◽  
Second Line ◽  
First Line ◽  
Sex With Men ◽  
Resistance Rates

ObjectivesIn recent years, resistance in Mycoplasma genitalium (MG) to first-line (azithromycin) and second-line (moxifloxacin) treatment has been increasingly reported worldwide, however, no data regarding the south of Spain are available.MethodsTo determine resistance rates, MG-positive samples collected from June 2018 to June 2019 were analysed by sequencing the 23S rRNA and parC genes.ResultsA total of 77 patients (24 men having sex with men (MSM), 30 heterosexual men and 23 women) were included. Resistance-associated mutations against macrolide and fluoroquinolones were found in 36.4% (95% CI 25.7% to 48.1%) and 9.1% (95% CI 3.7% to 17.8%) of the patients, respectively. Being MSM and having had another STI in the last year were significantly associated with macrolide-resistant MG infection, while no associations were found with resistance to fluoroquinolones.ConclusionsTesting for resistance to first-line and second-line drugs against MG should be recommended for the general population and mandatory for the MSM population. We suggest that empiric azithromycin use for STI management should be avoided.

scholarly journals Antimicrobial Susceptibility of Streptococcus pneumoniae in Eight European Countries from 2001 to 2003

2005 ◽  
Vol 49 (7) ◽  
pp. 2903-2913 ◽  
Author(s):  
Ralf René Reinert ◽  
Susanne Reinert ◽  
Mark van der Linden ◽  
Murat Y. Cil ◽  
Adnan Al-Lahham ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
European Countries ◽  
Penicillin G ◽  
Fluoroquinolone Resistance ◽  
23S Rrna ◽  
Antibiotic Resistant ◽  
Negative Results ◽  
Resistant Strains ◽  
Resistance Rates ◽  
Sequence Types

ABSTRACT Susceptibility testing results for Streptococcus pneumoniae isolates (n = 2,279) from eight European countries, examined in the PneumoWorld Study from 2001 to 2003, are presented. Overall, 24.6% of S. pneumoniae isolates were nonsusceptible to penicillin G and 28.0% were resistant to macrolides. The prevalence of resistance varied widely between European countries, with the highest rates of penicillin G and macrolide resistance reported from Spain and France. Serotype 14 was the leading serotype among penicillin G- and macrolide-resistant S. pneumoniae isolates. One strain (PW 158) showed a combination of an efflux type of resistance with a 23S rRNA mutation (A2061G, pneumococcal numbering; A2059G, Escherichia coli numbering). Six strains which showed negative results for mef(A) and erm(B) in repeated PCR assays had mutations in 23S rRNA or alterations in the L4 ribosomal protein (two strains). Fluoroquinolone resistance rates (levofloxacin MIC ≥ 4 μg/ml) were low (Austria, 0%; Belgium, 0.7%; France, 0.9%; Germany, 0.4%; Italy, 1.3%; Portugal, 1.2%; Spain, 1.0%; and Switzerland, 0%). Analysis of quinolone resistance-determining regions showed eight strains with a Ser81 alteration in gyrA; 13 of 18 strains showed a Ser79 alteration in parC. The clonal profile, as analyzed by multilocus sequence typing (MLST), showed that the 18 fluoroquinolone-resistant strains were genetically heterogeneous. Seven of the 18 strains belonged to new sequence types not hitherto described in the MLST database. Europe-wide surveillance for monitoring of the further spread of these antibiotic-resistant S. pneumoniae clones is warranted.

scholarly journals Rates of fluoroquinolone resistance in domestically acquired Campylobacter jejuni are increasing in people living within a model study location in Canada

2021 ◽  
Vol 67 (1) ◽  
pp. 37-52
Author(s):  
G. Douglas Inglis ◽  
Eduardo N. Taboada ◽  
Valerie F. Boras
Keyword(s):  
Campylobacter Jejuni ◽  
High Rate ◽  
Fluoroquinolone Resistance ◽  
Nucleotide Polymorphism ◽  
Single Nucleotide ◽  
Infected People ◽  
Examination Period ◽  
Model Study ◽  
Resistance Rates

Antimicrobial resistance was evaluated in Campylobacter jejuni isolated from 1291 diarrheic people over a 15-year period (2004–2018) in southwestern Alberta, a model location in Canada with a high rate of campylobacteriosis. The prevalence of resistance to chloramphenicol, clindamycin, erythromycin, and gentamicin was low during the examination period (≤4.8%). Resistance to tetracycline remained consistently high (41.6%–65.1%), and resistance was primarily conferred by plasmid-borne tetO (96.2%). Resistance rates to ciprofloxacin and nalidixic acid increased substantially over the examination period, with a maximal fluoroquinolone resistance (FQR) prevalence of 28.9% in 2016. The majority of C. jejuni isolates resistant to ciprofloxacin (93.9%) contained a C257T single nucleotide polymorphism within the gyrA chromosomal gene. Follow up with infected people indicated that the observed increase in FQR was primarily due to domestically acquired infections. Moreover, the majority of FQ-resistant C. jejuni subtypes (82.6%) were endemic in Canada, primarily linked to cattle and chicken reservoirs; 18.4% of FQ-resistant isolates were assigned to three subtypes, predominantly associated with cattle. Study findings indicate the need to prioritize FQR monitoring in C. jejuni infections in Canada and to elucidate the dynamics of the emergence and transmission of resistant C. jejuni strains within and from cattle and chicken reservoirs.

scholarly journals Antimicrobial resistance in non-typhi Salmonella enterica isolated from humans and poultry in Palestine

2011 ◽  
Vol 6 (02) ◽  
pp. 132-136 ◽  
Author(s):  
Rula AL-Dawodi ◽  
Mohammad A Farraj ◽  
Tamer Essawi
Keyword(s):  
Drug Resistance ◽  
Antimicrobial Resistance ◽  
Nalidixic Acid ◽  
Gene Mutation ◽  
Direct Sequencing ◽  
Resistance Mechanism ◽  
Fluoroquinolone Resistance ◽  
Mutation Pattern ◽  
Resistance Rates ◽  
Prevalent Mutation

Introduction: The efficacy of chemotherapy can be compromised by drug resistance.  This study was undertaken to describe the resistance profiles and fluoroquinolone resistance mechanism of non-typhoidal Salmonella (NTS) isolated from humans and poultry in West Bank, Palestine. Methodology: One hundred and fifty-one isolates of NTS, obtained from humans (71) and poultry (80), collected between September 2005 and January 2007, were tested for susceptibility to ampicillin, gentamicin, tetracycline ceftriaxone, nalidixic acid and ciprofloxacin. Mutation patterns within gyrA were determined by direct sequencing or by digestion of PCR-amplified DNA fragments with the restriction enzyme HinfI. Results: Resistance rates among human and poultry isolates were respectively 59% and 51% for ampicillin, 31% and 10% for gentamicin, 59% and 80% for tetracycline, 59% and 45% for nalidixic acid, and 30% and 15% for ciprofloxacin. All the isolates were susceptible to ceftriaxone. Mutations at positions 83 and/or 87 were detected in gyrA of isolates with resistance to nalidixic acid. Isolates which were resistant to nalidixic acid but susceptible to ciprofloxacin had a single gyr A gene mutation at point 87.  This gene mutation was sufficient to induce a new phenotype (6 isolates) with decreased susceptibility to ciprofloxacin. Conclusion: Mutations in gyrA at positions 83 or 87 were the most prevalent mutation pattern of fluoroquinolone resistant NTS isolates but other unknown mechanisms are also present. Continued surveillance of antimicrobial resistance among NTS isolates is needed to mitigate the increasing prevalence of quinolone resistance.

scholarly journals Species Distribution, Antimicrobial Resistance, and Enterotoxigenicity of Non-aureus Staphylococci in Retail Chicken Meat

Antibiotics ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 809
Author(s):  
Soo In Lee ◽  
Sun Do Kim ◽  
Ji Heon Park ◽  
Soo-Jin Yang
Keyword(s):  
Antimicrobial Resistance ◽  
Opportunistic Infections ◽  
Food Poisoning ◽  
Tetracycline Resistance ◽  
Chicken Meat ◽  
Fluoroquinolone Resistance ◽  
Coagulase Negative Staphylococci ◽  
Meat Samples ◽  
Resistance Rates ◽  
Retail Chicken Meat

Non-aureus staphylococci (NAS), including coagulase-negative staphylococci, have emerged as important causes of opportunistic infections in humans and animals and a potential cause of staphylococcal food poisoning. In this study, we investigated (i) the staphylococcal species profiles of NAS in in retail chicken meat, (ii) the phenotypic and genotypic factors associated with antimicrobial resistance in the NAS isolates, and (iii) the prevalence of classical and newer staphylococcal enterotoxin (SE) genes. A total of 58 NAS of nine different species were isolated from retail raw chicken meat samples. The occurrence of multidrug resistance in the NAS, particularly S. agnetis and S. chromogenes, with high resistance rates against tetracycline or fluoroquinolones were confirmed. The tetracycline resistance was associated with the presence of tet(L) in S. chromogenes and S. hyicus or tet(K) in S. saprophyticus. The occurrence of fluoroquinolone resistance in S. agnetis and S. chromogenes was usually associated with mutations in the quinolone resistance determining regions (QRDR) of gyrA and parC. In addition, the frequent presence of SE genes, especially seh, sej, and sep, was detected in S. agnetis and S. chromogenes. Our findings suggest that NAS in raw chicken meat can have potential roles as reservoirs for antimicrobial resistance and enterotoxin genes.

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