Clinical Importance and Epidemiology of Quinolone Resistance

Kim, Eu Suk; Hooper, David C.

doi:10.3947/ic.2014.46.4.226

Cited by 85 publications

(62 citation statements)

References 127 publications

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“…FQs can also be highly effective in treating other conditions, such as urinary tract infections, skin infections, and sexually transmitted diseases, though their efficacy may be diminishing due to increasing resistance (9). Since FQ resistance can be fairly easily acquired through de novo mutation acquisition in its targets (10), FQ monotherapy can apply selective pressure that can lead to the emergence of resistant bacteria.…”

mentioning

confidence: 99%

Genomic Analysis of the Evolution of Fluoroquinolone Resistance in Mycobacterium tuberculosis Prior to Tuberculosis Diagnosis

Zhang

Chien

Haseley

et al. 2016

Antimicrob Agents Chemother

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h Fluoroquinolones (FQs) are effective second-line drugs for treating antibiotic-resistant tuberculosis (TB) and are being considered for use as first-line agents. Because FQs are used to treat a range of infections, in a setting of undiagnosed TB, there is potential to select for drug-resistant Mycobacterium tuberculosis mutants during FQ-based treatment of other infections, including pneumonia. Here we present a detailed characterization of ofloxacin-resistant M. tuberculosis samples isolated directly from patients in Taiwan, which demonstrates that selection for FQ resistance can occur within patients who have not received FQs for the treatment of TB. Several of these samples showed no mutations in gyrA or gyrB based on PCR-based molecular assays, but genome-wide next-generation sequencing (NGS) revealed minority populations of gyrA and/or gyrB mutants. In other samples with PCR-detectable gyrA mutations, NGS revealed subpopulations containing alternative resistance-associated genotypes. Isolation of individual clones from these apparently heterogeneous samples confirmed the presence of the minority drug-resistant variants suggested by the NGS data. Further NGS of these purified clones established evolutionary links between FQ-sensitive and -resistant clones derived from the same patient, suggesting de novo emergence of FQ-resistant TB. Importantly, most of these samples were isolated from patients without a history of FQ treatment for TB. Thus, selective pressure applied by FQ monotherapy in the setting of undiagnosed TB infection appears to be able to drive the full or partial emergence of FQ-resistant M. tuberculosis, which has the potential to confound diagnostic tests for antibiotic susceptibility and limit the effectiveness of FQs in TB treatment.

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confidence: 99%

Genomic Analysis of the Evolution of Fluoroquinolone Resistance in Mycobacterium tuberculosis Prior to Tuberculosis Diagnosis

Zhang

Chien

Haseley

et al. 2016

Antimicrob Agents Chemother

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“…The MICs of Pseudomonas aeruginosa typically range from 8 to 32 mg/liter, and Acinetobacter species MICs showed a broad range of values of between 0.06 and 8 mg/liter, meaning that overall there is little clinical utility against these pathogens (11). The rise of quinolone resistance (approximately 25% to 35% in recent studies) and coresistance to TMP-SMX means that patients frequently have no options for oral agents for either induction or maintenance therapy (6,11,12). This mandates the use of an injectable antibiotic, with the attendant cost, inconvenience, and infection risk of an i.v.…”

Section: Discussionmentioning

confidence: 99%

Pharmacodynamics of Tebipenem: New Options for Oral Treatment of Multidrug-Resistant Gram-Negative Infections

McEntee

Johnson

Farrington

et al. 2019

Antimicrob Agents Chemother

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Tebipenem pivoxil HBr (TBPM-PI-HBr) is a novel orally bioavailable carbapenem. The active moiety is tebipenem. Tebipenem pivoxil is licensed for use in Japan in children with ear, nose, and throat infections and respiratory infections. The HBr salt was designed to improve drug substance and drug product properties, including stability. TBPM-PI-HBr is now being developed as an agent for the treatment of complicated urinary tract infections (cUTI) in adults. The pharmacokinetics-pharmacodynamics of tebipenem were studied in a well-characterized neutropenic murine thigh infection model. Plasma drug concentrations were measured using liquid chromatography-tandem mass spectrometry. Dose fractionation experiments were performed after establishing dose-response relationships. The magnitude of drug exposure required for stasis was established using 11 strains of Enterobacteriaceae (Escherichia coli, n = 6; Klebsiella pneumoniae, n = 5) with a variety of resistance mechanisms. The relationship between drug exposure and the emergence of resistance was established in a hollow-fiber infection model (HFIM). Tebipenem exhibited time-dependent pharmacodynamics that were best described by the free drug area under the concentration-time curve (fAUC0-24)/MIC corrected for the length of the dosing interval (fAUC0–24/MIC · 1/tau). The pharmacodynamics of tebipenem versus E. coli and K. pneumoniae were comparable, as was the response of strains possessing extended-spectrum β-lactamases versus the wild type. The median fAUC0-24/MIC · 1/tau value for the achievement of stasis in the 11 strains was 23. Progressively more fractionated regimens in the HFIM resulted in the suppression of resistance. An fAUC0-24/MIC · 1/tau value of 34.58 to 51.87 resulted in logarithmic killing and the suppression of resistance. These data and analyses will be used to define the regimen for a phase III study of adult patients with cUTI.

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“…The significant difference observed in quinolones resistance between E. coli and Klebsiella spp could be related to the frequency of isolation of uropathogenic E. coli and the intensive use of quinolones (e.g. Ciprofloxacin) in the treatment of infections (Dosso et al, 2000;Kim and Hooper, 2014) involving this pathogen at Abobo-Avocatier Hospital. Imipenem has shown excellent activity against both E. coli and Klebsiella spp isolates.…”

Section: Discussionmentioning

confidence: 99%

Assessment of drugs pressure on Escherichia coli and Klebsiella spp. uropathogens in patients attending Abobo-Avocatier Hospital, North of Abidjan (Cte dIvoire)

Abe¹,

Koffi²,

Sokouri³

et al. 2019

Afr. J. Microbiol. Res.

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The problem of antibiotic resistance of uropathogens appears in Abobo municipality to be worsening because of the overuse and misuse of antibiotics. This study aims to assess the impact of drugs pressure on uropathogenic Escherichia coli and Klebsiella spp. strains isolated from patients attending Abobo-Avocatier Hospital. The study was conducted in patients suffering from urinary tract infection. Urine samples of patients were collected; culture and antibiogram using the Kirby-Bauer disc diffusion method were performed. The overall prevalence was 31.1% with a significant difference between males and females (p = 0.01). The highest susceptible age group of patients to UTI was 21-45 years (33%). E. coli and Klebsiella spp were the predominant bacteria among isolated Gram negative. Up to 70% of the isolates of both uropathogens were resistant to Penicillins, Tetracyclines and Ampicillin-Sulbactam. Imipenem was the most active antibiotic on these uropathogens. Quinolones showed a better activity on Klebisiella spp. strains than those of E. coli. The high value of the Multiple Antibiotic Resistance Index and the rate of multi-resistance from this site suggest the need for continuous monitoring of antibiotic susceptibility profile of bacteria implicated in UTI prior to antibiotic prescription in order to ensure optimal and desired treatment.

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Clinical Importance and Epidemiology of Quinolone Resistance

Cited by 85 publications

References 127 publications

Genomic Analysis of the Evolution of Fluoroquinolone Resistance in Mycobacterium tuberculosis Prior to Tuberculosis Diagnosis

Genomic Analysis of the Evolution of Fluoroquinolone Resistance in Mycobacterium tuberculosis Prior to Tuberculosis Diagnosis

Pharmacodynamics of Tebipenem: New Options for Oral Treatment of Multidrug-Resistant Gram-Negative Infections

Assessment of drugs pressure on Escherichia coli and Klebsiella spp. uropathogens in patients attending Abobo-Avocatier Hospital, North of Abidjan (Cte dIvoire)

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