Introduction: The commonest bacterial agent involved in causation of UTIs is Escherichia coli. The emergence of FQ resistant uropathogenic E. coli is of great concern. Aim of the work: to study resistance towards urinary E. coli with various generations of fluoroquinolones. Patients & Methods:: our study was carried out in the Clinical Pathology Department, Sohag University Hospital during the period from June 2016 to May 2017. Our study included 140 participants. Isolates from the specimens were obtained and identified using; Gram staining, colony characteristics on different culture medias. VITEC 2 Compact 15 identification kits were be used to confirm the identification of the isolates Results: E.coli was isolated from 100 patients (71%) of all patients complaining of UTI with positive urinary culture (study or case group). By studying prevalence of Antibiotic resistance of E.coli isolates reveals that fluoroquinolones show sensitivities of 42-46%. Also Nitrofurantoin has the highest sensitivity of 87%. This is followed by meropenem (67%). Ampicillin shows sensitivity in only 6% of cases. Regarding drug sensitivity in out & inpatients, we find that all generations of fluoroquinolones show highly significant resistance ratios among inpatients compared to outpatients. Meropenem show resistance more in inpatients than outpatients, with significant difference, Ampicillin and Nitrofuratoin show non-significant difference. Conclusion: our study show an increased fluoroquinolone resistance among uropathogenic E. coli isolates mainly in hospital admitted patients.
Introduction: Streptococcus pneumoniae is a major Gram-positive pathogen responsible for pneumonia, bactermia, otitis media, and meningitis leading to considerable morbidity and mortality among children and elderly individuals. The primary goals of antibiotic treatment of respiratory tract infections are clinical efficacy of treatment, pathogen eradication, and prevention of resistance development. Resistance to fluoroquinolones in S. pneumoniae arises in a stepwise fashion and results from alterations in the target binding site due to the acquisition of spontaneous mutations in the quinolone resistance-determining regions (QRDRs) of the topoisomerase IV and DNA gyrase genes. Although mutations usually occur in the QRDRs of parC and gyrA, a role for mutations in the parE subunit in low-level resistance has been reported. Aim of the work: The aim of this study was to determine the prevalence of fluoroquinolone resistance Streptococcus pneumoniae (FQRSP) and to examine the genetic relatedness of pneumococcal isolates with parE and gyrA genes mutations in different specimens in Sohag University Hospital. Patients and Methods: This study was prospectively conducted over a period of 24 months between October 2015 and September 2017, at Sohag university hospital. During the study period, 78 patients hospitalized for a syndrome consistent with a diagnosis of community acquired pneumonia (CAP) included in this study with a mean age of 34.5 years (range, 2 to 67), 60% of whom were males. A CAP syndrome was defined as a newly recognized pulmonary infiltrate together with 2 of the following findings: subjective fever or documented temperature 37.4 °C, increased cough, sputum production, or shortness of breath, pleuritic chest pain, confusion, rales, leukocytosis, (according to age) (1). Patients who had taken antibiotic treatment within 3 days prior to initial visit were excluded from this study. Results: Our study illustrate the role of mutation in the gyrA&parE genes and the effect of mutations in the both genes in fluoroquinolone resistance among S. pneumoniae isolates. Conclusion: The present study provide an opportunity to view the predominant mutations conferring reduced susceptibility to FQs in clinical pneumococcal isolates. There is a strong relationship between these mutations and decrese susceptibility to the most fameous FQs to some extent, although this varies between strains and for each drug.
Resistance of Streptococcus pneumoniae to multiple antibacterial agents, including β-lactams, macrolides, tetracyclines, and co-trimoxazole, has emerged worldwide in the 1980s and 1990s and has emphasized the need for new therapeutic alternatives, such as newer fluoroquinolones. Older fluoroquinolones, such as ciprofloxacin and ofloxacin, have been widely used in the last 2 decades, but their activity against gram-positive pathogens is limited. Newer fluoroquinolones, such as levofloxacin, gatifloxacin, moxifloxacin, and gemifloxacin, have enhanced activity against most respiratory pathogens, and some are being more widely used to treat respiratory tract infections. Therefore, the emergence of fluoroquinoloneresistant S. pneumoniae strains, although worldwide prevalence is low, is a concern to clinicians who manage respiratory tract infections. Aim of the work: The aim of this study was to determine the prevalence of fluoroquinolone resistance Streptococcus pneumoniae (FQRSP) and to examine the genetic relatedness of pneumococcal isolates with parC and gyrB genes mutations in different specimens. Patients and Methods:In this study, Biometra Thermal Cyclar-T Gradient Software PCR system version 4 together with DNASIS 2.6 Sequence Analysis Programs were used to investigate the presence of mutations at quinolone resistance-determining regions of topoisomerase IV and DNA gyrase on 78 S. pneumoniae strains, Among 78 isolates 37 (47.4%) of S. pneumonia isolates were Fluroquinolones susceptible, 12 (15.4%) were with variable susceptibility and 29 (37.2%) were Fluroquinolones resistant. Results:Our study illustrate the role of mutation in the parC & gyrB genes and the effect of mutations in the both genes in fluoroquinolone resistance among S. pneumoniae isolates. Conclusion: Results indicated that there is a significant correlation between quinolone resistance development and mutations in the parC gene and in less significance in the gyrB genes .
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