High Prevalence of Cross-Resistance to Aminoglycosides in Fluoroquinolone-Resistant Escherichia coli Clinical Isolates

Tsukamoto, Naoyuki; Ohkoshi, Yasuo; Okubo, Torahiko; Sato, Toyotaka; Kuwahara, Osamu; Fujii, Nobuhiro; Tsutsumi, Yutaka; Yokota, Shinichi

doi:10.1159/000361011

Cited by 26 publications

(21 citation statements)

References 31 publications

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“…Resistance to ciprofloxacin, amikacin and tobramycin was significantly more prevalent in the LTC applicants, with the amikacin and tobramycin resistance being caused mainly by carriage of the aac(6')-Ib gene linked to bla CTX-M-15 carriage. In agreement, it was also shown that ciprofloxacin resistance is associated with aminoglycoside resistance in ESBL-producer and non-ESBL producer E. coli [46]. …”

Section: Discussionmentioning

confidence: 64%

Carriage Rates and Characteristics of<b> </b>Enterobacteriaceae Producing Extended-Spectrum Beta-Lactamases in Healthy Individuals: Comparison of Applicants for Long-Term Care and Individuals Screened for Employment Purposes

Ebrahimi

Mózes²,

Mészáros³

et al. 2014

Chemotherapy

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Aims: We compared the prevalence of extended-spectrum beta-lactamase (ESBL) producers in the faecal samples of 1,109 healthy individuals screened for employment purposes and in 531 asymptomatic individuals applying for long-term care (LTC). Methods: Eosin-methylene blue agar plates supplemented with 2 mg/l cefotaxime were used to determine which individuals were ESBL producers. ESBL phenotype was confirmed by double-disk synergy test and ESBL genes were identified by sequencing. ESBL producers were characterized by co-resistance and integron carriage. Results: ESBL producers were more frequent in the LTC applicants than in the employment screening individuals (7.2 vs. 2.0%; p < 0.0001), with 43 Escherichia coli, 18 Klebsiella pneumoniae, 1 Klebsiella oxytoca and 1 Proteus mirabilis being found. In the employment screening individuals, only E. coli was found. Most ESBL genes (79.4%, 50/63) were bla_CTX-M type; bla_CTX-M-15 was more frequent in the LTC applicants (p < 0.001). Regarding ESBL genes and integron diversity, E. coli isolates from the LTC applicants were more similar to K. pneumoniae than to E. coli from the employment screening individuals. Conclusion: These differences in the characteristics of ESBL producers may represent different sources of colonization. Most LTC applicants harboured K. pneumoniae or E. coli that were probably hospital-acquired whereas the E. coli isolates of many healthy individuals showed similarities to environmental E. coli.

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Section: Discussionmentioning

confidence: 64%

Carriage Rates and Characteristics of<b> </b>Enterobacteriaceae Producing Extended-Spectrum Beta-Lactamases in Healthy Individuals: Comparison of Applicants for Long-Term Care and Individuals Screened for Employment Purposes

Ebrahimi

Mózes²,

Mészáros³

et al. 2014

Chemotherapy

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“…E. coli ATCC 25922 was used as a reference. The MIC values for CIP, cefpodoxime, cefepime, and gentamicin were obtained from previous studies of E. coli isolates from 2008 and 2009 (4,6,43). MICs for ceftazidime (GSK Japan, Tokyo, Japan), imipenem (MSD, Tokyo, Japan), amikacin (Wako Pure Chemical, Osaka, Japan), and fosfomycin (Meiji Seika Pharma, Tokyo, Japan) were also determined using the agar plate dilution method.…”

Section: Methodsmentioning

confidence: 99%

Tigecycline Nonsusceptibility Occurs Exclusively in Fluoroquinolone-Resistant Escherichia coli Clinical Isolates, Including the Major Multidrug-Resistant Lineages O25b:H4-ST131-H 30 R and O1-ST648

Sato

Suzuki

Shiraishi

et al. 2017

Antimicrob Agents Chemother

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Tigecycline (TGC) is a last-line drug for multidrug-resistant Enterobacteriaceae. We investigated the mechanism(s) underlying TGC nonsusceptibility (TGC resistant/intermediate) in Escherichia coli clinical isolates. The MIC of TGC was determined for 277 fluoroquinolone-susceptible isolates (ciprofloxacin [CIP] MIC, Ͻ0.125 mg/liter) and 194 fluoroquinolone-resistant isolates (CIP MIC, Ͼ2 mg/liter). The MIC 50 and MIC 90 for TGC in fluoroquinolone-resistant isolates were 2-fold higher than those in fluoroquinolone-susceptible isolates (MIC 50 , 0.5 mg/liter versus 0.25 mg/liter; MIC 90 , 1 mg/liter versus 0.5 mg/liter, respectively). Two fluoroquinolone-resistant isolates (O25b:H4-ST131-H30R and O125:H37-ST48) were TGC resistant (MICs of 4 and 16 mg/liter, respectively), and four other isolates of O25b:H4-ST131-H30R and an isolate of O1-ST648 showed an intermediate interpretation (MIC, 2 mg/liter). No TGC-resistant/intermediate strains were found among the fluoroquinolone-susceptible isolates. The TGC-resistant/intermediate isolates expressed higher levels of acrA and acrB and had lower intracellular TGC concentrations than susceptible isolates, and they possessed mutations in acrR and/or marR. The MICs of acrAB-deficient mutants were markedly lower (0.25 mg/liter) than those of the parental strain. After continuous stepwise exposure to CIP in vitro, six of eight TGC-susceptible isolates had reduced TGC susceptibility. Two of them acquired TGC resistance (TGC MIC, 4 mg/liter) and exhibited expression of acrA and acrB and mutations in acrR and/or marR. In conclusion, a population of fluoroquinolone-resistant E. coli isolates, including major extraintestinal pathogenic lineages O25b:H4-ST131-H30R and O1-ST648, showed reduced susceptibility to TGC due to overexpression of the efflux pump AcrAB-TolC, leading to decreased intracellular concentrations of the antibiotics that may be associated with the development of fluoroquinolone resistance.

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“…Multidrug-resistant (MDR) isolates are resistant to at least three antibiotics ( 10 ). The evaluation of epidemiological data concerning MDR E. coli and K. pneumoniae in different parts of the world indicates their increased prevalence with noticeable varieties in many countries ( 11 - 13 ). These differences necessitate regional surveys about their resistance patterns and risk factors.…”

Section: Introductionmentioning

confidence: 99%

Multidrug-Resistant Escherichia coli and Klebsiella pneumoniae Isolated From Patients in Kashan, Iran

Moini

Soltani

Ardakani

et al. 2015

Jundishapur J Microbiol

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Background:Escherichia coli and Klebsiella pneumoniae are common human pathogens that cause a wide spectrum of infections. Antimicrobial resistance is a basic obstacle in the management of these infections which has different patterns in various regions.Objectives:In this study, the antibiotic resistance patterns and risk factors for multidrug-resistant (MDR) E. coli and K. pneumoniae were determined.Patients and Methods:In this cross-sectional study, a total of 250 isolates (134 E. coli and 116 K. pneumoniae) were collected and antimicrobial resistances to ampicillin, amoxicillin-clavulanic acid, amikacin, gentamycin, ceftriaxone, ceftazidime, ciprofloxacin and imipenem were evaluated by disc diffusion method and confirmed by E-test. Moreover, risk factors for MDR E. coli and K. pneumoniae were also detected.Results:The mean ages of the culture-positive cases of E. coli and K. pneumoniae were 33.39 ± 24.42 and 36.54 ± 24.66 years, respectively (P = 0.31); 137 (54.8%) cases were male and 113 (45.2%) were female (P = 0.53). Nineteen (14.2%) isolates of E. coli and 12 (10.3%) isolates of K. pneumoniae were sensitive to all the evaluated antibiotics. The prevalence of MDR E. coli and MDR K. pneumoniae was 50% and 46.6%, respectively (P = 0.59). The highest resistance for both strains was to ampicillin and no imipenem resistance was seen. The risk factors for MDR E. coli were admission history during the recent three months (P = 0.043) and antibiotic use in the previous month (P = 0.03); for MDR K. pneumoniae, they were admission in the pediatric ward (P = 0.016), surgical ward (P = 0.019), or gynecology ward (P = 0.12), admission duration of > seven days, and antibiotic use during the past month (P = 0.04).Conclusions:The prevalence of multidrug resistance was high compared with developed countries, and history of admission, antibiotic use, admission duration and admission wards were the risk factors for multidrug resistance.

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High Prevalence of Cross-Resistance to Aminoglycosides in Fluoroquinolone-Resistant Escherichia coli Clinical Isolates

Cited by 26 publications

References 31 publications

Carriage Rates and Characteristics of<b> </b>Enterobacteriaceae Producing Extended-Spectrum Beta-Lactamases in Healthy Individuals: Comparison of Applicants for Long-Term Care and Individuals Screened for Employment Purposes

Carriage Rates and Characteristics of<b> </b>Enterobacteriaceae Producing Extended-Spectrum Beta-Lactamases in Healthy Individuals: Comparison of Applicants for Long-Term Care and Individuals Screened for Employment Purposes

Tigecycline Nonsusceptibility Occurs Exclusively in Fluoroquinolone-Resistant Escherichia coli Clinical Isolates, Including the Major Multidrug-Resistant Lineages O25b:H4-ST131-H 30 R and O1-ST648

Multidrug-Resistant Escherichia coli and Klebsiella pneumoniae Isolated From Patients in Kashan, Iran

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