Fluoroquinolone Resistance in Clinical Isolates of
            <i>Streptococcus pneumoniae</i>
            : Contributions of Type II Topoisomerase Mutations and Efflux to Levels of Resistance

Bast, Darrin J.; Low, Donald E.; Duncan, Carla; Kilburn, Laurie; Mandell, Lionel A.; Davidson, Ross; Azavedo, Joyce C. S. de

doi:10.1128/aac.44.11.3049-3054.2000

Cited by 120 publications

(102 citation statements)

References 29 publications

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“…Ciprofloxacin and levofloxacin preferentially target ParC, whereas moxifloxacin and gatifloxacin target both ParC and GyrA (15). Prior to the introduction of gatifloxacin and moxifloxacin, all isolates with mutations observed in the QRDRs of S. pneumoniae had mutations in the parC gene (3,10). Since the introduction of gatifloxacin and moxifloxacin, the number of isolates with parC mutations has remained stable, but there has been an increase in the proportion of isolates with gyrA-only mutations (12,13,24).…”

Section: Discussionmentioning

confidence: 99%

Susceptibility of Streptococcus pneumoniae to Fluoroquinolones in Canada

Patel

McGeer

Melano

et al. 2011

Antimicrob Agents Chemother

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Section: Discussionmentioning

confidence: 99%

Susceptibility of Streptococcus pneumoniae to Fluoroquinolones in Canada

Patel

McGeer

Melano

et al. 2011

Antimicrob Agents Chemother

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“…Not all amino acid substitutions cause the same level of resistance: mutations in parC alone, such as Ser79-Phe, Ser79Tyr, Ser79Ala, Asp83Gly and Asp83Tyr, confer a low level of resistance to FQ. When combined with mutations in gyrA such as Glu85Lys, Ser84Tyr and Ser84Phe, some mutations confer high-level resistance [45,46]. In addition, it was confirmed that parC is the primary target for FQ, and mutations in this subunit were shown to be the crucial first step for the acquisition of a high level of resistance [45,47].…”

Section: Fluoroquinolone (Fq) Resistancementioning

confidence: 97%

Molecular mechanisms and epidemiology of resistance in Streptococcus pneumoniae in the Middle East region

Moujaber

Osman

Rafei

et al. 2017

Journal of Medical Microbiology

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Purpose. Streptococcus pneumoniae is a commensal bacterium that normally colonizes the human nasopharyngeal cavity. Once disseminated, it can cause several diseases, ranging from non-invasive infections such as acute otitis media and sinusitis through to invasive infections with higher mortality, including meningitis and septicaemia. Since the identification of the first S. pneumoniae strain with decreased susceptibility to penicillin in the 1960s, antibiotic resistance among S. pneumoniae has increased disturbingly and the mechanisms of resistance have begun to unfold.Methodology. This work briefly reviewed the available data on the molecular mechanisms underlying antimicrobial resistance and its epidemiology among pneumococcal strains in Middle Eastern countries.Key findings. Both intrinsic and acquired mechanisms (mutations, acquisition of novel mobile genetic elements and sometimes gene duplication and overexpression) affect susceptibility to a large variety of antibiotics. In Middle Eastern countries, including Lebanon, Iran, Saudi Arabia and Turkey, surveillance showed a disturbing increase in the strength and prevalence of resistance to antibiotics over the years, especially in the last decade. However, no surveillance reports were found in other Middle Eastern countries, such as Syria and Iraq.Conclusion. In order to better survey, control and prevent the emergence of multidrug-and extremely drug-resistant S. pneumoniae strains, antimicrobial stewardship, national surveillance and public awareness programmes should be developed urgently in Middle Eastern countries.

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“…Mutations in parE and gyrB have also been reported, but to a lesser extent (2,23,30). Reduced susceptibility to fluoroquinolone may also be due to altered accumulation of the drug or efflux, but this plays a less significant role (31).…”

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confidence: 99%