Molecular epidemiology and evolution of resistance to quinolones in Escherichia coli after prolonged administration of ciprofloxacin in patients with prostatitis

Horcajada, Juan Pablo; Vilà, Jordi; Moreno-Martínez, Antonio; Ruiz, Joaquı́m; Martínez, José Antonio; Sánchez, Miquel; Soriano, E; Mensa, Josep

doi:10.1093/jac/49.1.55

Cited by 41 publications

(35 citation statements)

References 9 publications

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“…These data are consistent with several studies of healthy human volunteers in the community that demonstrated that de novo emergence of resistant gram-negative bacilli may be uncommon during fluoroquinolone monotherapy regimens (8,9,21). However, frequent emergence of fluoroquinolone-resistant gram-negative bacilli has been ob-served in some community studies and in many studies in health care facilities (2,3,11,12,(14)(15)(16)(17)(18)(20)(21)(22). Factors such as repeated exposures or preexisting colonization with resistant gram-negative organisms could contribute to more frequent acquisition of resistant gram-negative bacilli in these studies.…”

supporting

confidence: 88%

“…Numerous studies have demonstrated that fluoroquinoloneresistant gram-negative bacilli may emerge during treatment with fluoroquinolone antimicrobial agents (2,3,11,12,(15)(16)(17)(18)(20)(21)(22). Because the fluoroquinolones differ significantly with regard to the amount of intestinal excretion and in vitro activity against anaerobic bacteria (8,9,21), it is plausible that they may differ in their propensity to promote colonization with fluoroquinolone-resistant gram-negative bacilli.…”

mentioning

confidence: 99%

“…Error bars indicate standard error. (12,14), recent reports suggest that fluoroquinolone-resistant K. pneumoniae isolates are common in many long-term care facilities and hospitals and are often associated with multidrug-resistant phenotypes (17,22). Third, the KPC3 test strain had high-level resistance to fluoroquinolones (ciprofloxacin MIC, 256 g/ml) and was not inhibited by the fluoroquinolone levels achieved in the intestinal tract.…”

mentioning

confidence: 99%

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Emergence and Acquisition of Fluoroquinolone-Resistant Gram-Negative Bacilli in the Intestinal Tracts of Mice Treated with Fluoroquinolone Antimicrobial Agents

Pultz

Nerandzic

Stiefel

et al. 2008

Antimicrob Agents Chemother

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After mice received orogastric administration of a fluoroquinolone-resistant Klebsiella pneumoniae strain, subcutaneous treatment with ciprofloxacin, levofloxacin, and moxifloxacin promoted persistent low-density colonization in 10% to 40% of the mice, whereas treatment with clindamycin consistently promoted highdensity colonization. No emergence of fluoroquinolone-resistant gram-negative bacilli was detected in the mice during or after treatment with the fluoroquinolone antimicrobial agents.

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supporting

confidence: 88%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Emergence and Acquisition of Fluoroquinolone-Resistant Gram-Negative Bacilli in the Intestinal Tracts of Mice Treated with Fluoroquinolone Antimicrobial Agents

Pultz

Nerandzic

Stiefel

et al. 2008

Antimicrob Agents Chemother

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“…These studies have been limited by focusing on only patients with specific chronic conditions (e.g., cancer or prostatitis) or patients who reside in long-term-care facilities (1,8,9,11), including only subjects receiving FQ therapy (1, 9, 11), and utilizing infrequent fecal sampling (i.e., Ն1-month intervals) (8, 11). Furthermore, the impact of FQ resistance phenotype and/or genotype on duration of colonization has not been studied.…”

mentioning

confidence: 99%

Duration of Outpatient Fecal Colonization Due to Escherichia coli Isolates with Decreased Susceptibility to Fluoroquinolones: Longitudinal Study of Patients Recently Discharged from the Hospital

Lautenbach

Tolomeo

Mao³

et al. 2006

Antimicrob Agents Chemother

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Among 10 subjects colonized with Escherichia coli isolates with reduced susceptibility to fluoroquinolones, the median duration of colonization following hospital discharge was 80 days (range, 8 to 172 days). Colonization was longer for isolates demonstrating organic-solvent tolerance than for isolates that were not organicsolvent tolerant (151 versus 29 days, respectively; P ‫؍‬ 0.07) but was not associated with other resistance mechanisms, demographics, or antibiotic use.Significant increases in the prevalence of fluoroquinolone (FQ) resistance in Escherichia coli isolates have been noted in recent years (6). Approximately 20% of hospitalized patients are colonized with E. coli isolates exhibiting reduced susceptibility to FQs (4). Elucidating the duration of colonization with such organisms is vital because the human gastrointestinal (GI) tract serves as a major natural reservoir for E. coli and clinical E. coli isolates are usually derived from an organism colonizing the GI tract (3). In addition, the GI tract may serve as the primary source from which E. coli can spread through the population.Few studies have addressed the duration of fecal colonization with E. coli isolates demonstrating reduced susceptibility to FQs (1,8,9,11). These studies have been limited by focusing on only patients with specific chronic conditions (e.g., cancer or prostatitis) or patients who reside in long-term-care facilities (1,8,9,11), including only subjects receiving FQ therapy (1, 9, 11), and utilizing infrequent fecal sampling (i.e., Ն1-month intervals) (8, 11). Furthermore, the impact of FQ resistance phenotype and/or genotype on duration of colonization has not been studied.The goal of this study was to identify the duration of fecal colonization due to E. coli isolates with reduced susceptibility to FQs among patients recently discharged from the hospital. Furthermore, we sought to identify variables associated with prolonged colonization and characterize changes in the FQ resistance genotype and phenotype of isolates over time.The study was performed at the Hospital of the University of Pennsylvania, a 625-bed academic tertiary-care medical center.Eligible study subjects were identified from an ongoing prospective study of patients who, while hospitalized, developed new GI tract colonization due to E. coli isolates demonstrating reduced susceptibility to FQs (4, 5). From this larger study, a convenience sample of consecutively identified colonized subjects was enrolled. Subjects were sampled using a perirectal swab technique (5), with all in-hospital swabs collected by the same research nurse. Patients whose swabs demonstrated growth of E. coli isolates with reduced susceptibility to FQs were then prospectively monitored as outpatients. Following hospital discharge, each subject continued to collect fecal samples every 2 weeks (using a swab to collect a sample of a freshly passed bowel movement). Subjects were asked to send in fecal samples for 6 months after discharge.At the time of hospital discharge, inpatient medical...

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“…There are three possible interpretations of this finding: (i) unmasking of fluoroquinolone-resistant organisms present in low numbers before therapy but undetected by the methodology; (ii) acquisition of an exogenous, resistant strain during treatment; and (iii) selection in the host of highly resistant mutations from pre-existing, intermediately susceptible organisms. 17 Second, the data from our study suggest that therapy protocols should be adequately differentiated with regard to the different ultrasound patterns observed before and after antibiotic therapy. In particular, it would be important to evaluate or to subject to a longer duration of therapy forms limited to ultrasound complications or to add other standard therapies to the antibacterial treatment; in fact, with regard to the treatment of infertility, antibiotics play a role in bacterial prostatitis, whereas in abacterial prostatitis, other treatments, such as antioxidant compounds, sacral nerve stimulation and antiinflammatory treatments, are worth being considered.…”

Section: Discussionmentioning

confidence: 78%

Persistence of ultrasound alterations after antibiotic treatment with levofloxacin in patients with male accessory gland infection

Vignera¹,

Condorelli²,

Calogero³

et al. 2012

Asian J Androl

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No studies have evaluated the ultrasound features of the male sex accessory glands in infertile patients with bacterial male accessory gland infection (MAGI) according to the microbiological outcomes of bacterial cultures (absent, partial or complete) following antibiotic therapy administration. Therefore, the aim of this study was to evaluate the ultrasound characteristics of the prostate, seminal vesicles, and epididymal tracts after treatment with levofloxacin (a common quinolone antibiotic), in patients with infections caused by Escherichia coli (a Gram-negative bacterium) according to the Naber's classification, which includes the following categories: eradication, eradication with superinfection, persistence and persistence with superinfection. The study was conducted in 100 patients aged 2568 years (range: 20-40 years) with bacterial MAGI and bacterial cultures positive only for E. coli (colony forming units o10 6 per ml). Retrospective analysis was conducted only on patients treated with oral levofloxacin (500 mg) administered once daily for 28 days who were recruited over the last 5 years. Following antibiotic treatment, patients with microbiological persistence or persistence with superinfection had a significantly higher percentage of ultrasound abnormalities suggestive of prostato-vesiculitis (PV) (30.2% and 36.0%, respectively) or prostato-vesiculo-epididymitis (PVE) (60.2% and 70.0%, respectively) compared with patients with microbiological eradication (PV510.2% and PVE58.2%, respectively) or eradication with superinfection (PV518.8% and PVE521.2%, respectively). In conclusion, patients with microbiological persistence or persistence plus superinfection showed the highest prevalence of complicated forms of MAGI (PV and PVE), compared with patients with microbiological eradication or eradication with superinfection.

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Molecular epidemiology and evolution of resistance to quinolones in Escherichia coli after prolonged administration of ciprofloxacin in patients with prostatitis

Cited by 41 publications

References 9 publications

Emergence and Acquisition of Fluoroquinolone-Resistant Gram-Negative Bacilli in the Intestinal Tracts of Mice Treated with Fluoroquinolone Antimicrobial Agents

Emergence and Acquisition of Fluoroquinolone-Resistant Gram-Negative Bacilli in the Intestinal Tracts of Mice Treated with Fluoroquinolone Antimicrobial Agents

Duration of Outpatient Fecal Colonization Due to Escherichia coli Isolates with Decreased Susceptibility to Fluoroquinolones: Longitudinal Study of Patients Recently Discharged from the Hospital

Persistence of ultrasound alterations after antibiotic treatment with levofloxacin in patients with male accessory gland infection

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