Comparative In Vitro Activities of Ciprofloxacin, Clinafloxacin, Gatifloxacin, Levofloxacin, Moxifloxacin, and Trovafloxacin against Klebsiella pneumoniae , Klebsiella oxytoca , Enterobacter cloacae , and Enterobacter aerogenes Clinical Isolates with Alterations in GyrA and ParC Proteins

Abstract

The in vitro activities of ciprofloxacin, clinafloxacin, gatifloxacin, levofloxacin, moxifloxacin, and trovafloxacin were tested against 72 ciprofloxacin-resistant and 28 ciprofloxacin-susceptible isolates of Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, and Enterobacter aerogenes. Irrespective of the alterations in GyrA and ParC proteins, clinafloxacin exhibited greater activity than all other fluoroquinolones tested against K. pneumoniae and E. aerogenes.

Type II topoisomerase mutations in clinical isolates of Enterobacter cloacae and other enterobacterial species harbouring the qnrA gene

“…In this study, the types of gyrA mutations were not different from those described previously except for the Leu83 codon present in one of the K. pneumoniae isolates, which to our knowledge has not been described so far [40]. The lle83, although rare in the literature [40][41][42][43], was found in 10 strains corresponding to four clones defined previously by molecular typing [28]. Phe83 is more common in the literature and concerned seven of our strains, including a cluster of three isolates.…”

“…In the studies by Brisse et al [40] and Deguchi et al [43], ciprofloxacin MICs were 2-4 mg/L for strains harbouring two mutations, whereas the MIC was 22 mg/L in this study; it was 0.25-1 mg/L for strains harbouring one gyrA mutation whereas it was 2 mg/L in our qnrA-positive strains. In conclusion, qnrA has an additive effect whatever the number of topoisomerase mutations, raising MICs by 10-fold as shown for the gyrA Leu83 mutation [27].…”

Ecological Disturbances in Intestinal Microflora Caused by Clinafloxacin, an Extended-Spectrum Quinolone

“…Clinically troublesome strains such as vancomycin-resistant enterococci [7], pneumococci with reduced beta-lactam susceptibility [8,9] and ciprofloxacin-resistant microorganisms [2,10,11] have also shown susceptibility to clinafloxacin. Enhanced antimicrobial activity may be beneficial to the patient by eliminating the targeted pathogen.…”

In vitro activities of 11 fluoroquinolones against 816 non-typhoidal strains of Salmonella enterica isolated from Finnish patients with special reference to reduced ciprofloxacin susceptibility

“…Many previous studies have focused on in vitro efficacy of clinafloxacin and sitafloxacin on microbes other than salmonellas [23,27-29]. In these studies, the two new fluoroquinolones have had a better activity than the older preparations towards a variety of bacterial species, even including the ciprofloxacin-resistant strains.…”

“…In these studies, the two new fluoroquinolones have had a better activity than the older preparations towards a variety of bacterial species, even including the ciprofloxacin-resistant strains. For example, clinafloxacin exhibited greater activity than older fluoroquinolones against ciprofloxacin-resistant Klebsiella pneumoniae and Enterobacter aerogenes isolates [27], and sitafloxacin proved superior to the others against ciprofloxacin-resistant isolates of several enterobacterial species [23]. Moreover, a number of studies have demonstrated the clinical efficacy of clinafloxacin in the treatment of systemic infections, including severe skin and soft tissue diseases and infective endocarditis, and in empirical therapy of febrile granulocytopenic patients [30-33].…”