The Molecular Epidemiology of Streptococcus pneumoniae with Quinolone Resistance Mutations

Richter, Sandra; Heilmann, Kristopher P.; Beekmann, Susan E.; Miller, Norman N.; Rice, C.; Doern, G V

doi:10.1086/426817

Cited by 70 publications

(47 citation statements)

References 29 publications

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“…A conclusion that quinolone and nonquinolone agents are similar in both microbiologic and clinical cure rates was reached in a study in more than 200 children, 90 of whom were evaluated for microbiologic response e6 44 -46 Pharmacokinetic data for children 6 months and older are well defined for levofloxacin, the only currently available fluoroquinolone studied for respiratory tract infections in children. 47 49 Ciprofloxacin is currently not considered appropriate therapy for community-acquired pneumonia in adults because of its resistance profile.…”

Section: External Otitis Tympanostomy Tubeassociated Otorrheamentioning

confidence: 99%

The Use of Systemic and Topical Fluoroquinolones

Jackson¹,

Schutze²

2016

Pediatrics

138

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Appropriate prescribing practices for fluoroquinolones, as well as all antimicrobial agents, are essential as evolving resistance patterns are considered, additional treatment indications are identified, and the toxicity profile of fluoroquinolones in children has become better defined. Earlier recommendations for systemic therapy remain; expanded uses of fluoroquinolones for the treatment of certain infections are outlined in this report. Prescribing clinicians should be aware of specific adverse reactions associated with fluoroquinolones, and their use in children should continue to be limited to the treatment of infections for which no safe and effective alternative exists or in situations in which oral fluoroquinolone treatment represents a reasonable alternative to parenteral antimicrobial therapy.

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Section: External Otitis Tympanostomy Tubeassociated Otorrheamentioning

confidence: 99%

The Use of Systemic and Topical Fluoroquinolones

Jackson¹,

Schutze²

2016

Pediatrics

138

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“…The discrepancies observed in the specificity of the assay were instructive because the conventional phenotypic method failed to pick up strains which have high proportions of a single QRDR mutation. Several reports have noted that a significant number of isolates already have a single mutation but are still considered fully susceptible (7,22). Although our study lacks a collection of moderately FQ-resistant (LVX MIC of 2 g/ml or 4 g/ml) S. pneumoniae strains, Lim et al (16) reported that about 60% of S. pneumoniae isolates with an LVX MIC of 2 g/ml carry preexisting parC mutations.…”

mentioning

confidence: 83%

“…Resistance as a result of other mechanisms (such as parE or gyrB mutation and efflux) also cannot be detected. However, these mechanisms provide resistance potential but are not conclusive indicators of high-level resistance to FQs compared with parC and gyrA mutations (7,22).…”

mentioning

confidence: 99%

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Rapid Screening of Topoisomerase Gene Mutations by a Novel Melting Curve Analysis Method for Early Warning of Fluoroquinolone-Resistant Streptococcus pneumoniae Emergence

Fukushima¹,

Hirakata

Sugahara³

et al. 2006

J Clin Microbiol

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“…Multiple mutations within the QRDRs of both gyrA and parC result in high-level resistance against LVFX. 4 We hypothesized that the increase of fluoroquinolone-resistant S. pneumoniae strains might be related to the selection of resistant clones in restricted areas. Therefore, in the present study, a comparison of the drug sensitivities and genotypes of clinically isolated strains of LVFX-resistant S. pneumoniae obtained from Hong Kong, Okinawa Island and the Japanese main island (Honshu) was performed.…”

Section: Introductionmentioning

confidence: 99%

Comparison of drug sensitivity and genotypes of clinically isolated strains of levofloxacin-resistant Streptococcus pneumoniae obtained from Okinawa Island, the Japanese main island and Hong Kong

et al. 2011

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The prevalence of fluoroquinolone-resistant Streptococcus pneumoniae is increasing worldwide. In the present study, a comparison of drug sensitivity and genotypes of clinically isolated strains of levofloxacin (LVFX)-resistant S. pneumoniae obtained from Hong Kong, Okinawa Island and the Japanese main island (Honshu) was performed. MICs of quinolones (LVFX, tosufloxacin, ciprofloxacin, gatifloxacin and sitafloxacin (STFX)) and other antibiotics (penicillin G, cefcapene, cefditoren, clarithromycin and azithromycin) were determined by a microdilution broth method according to the Clinical and Laboratory Standards Institute Standards. The quinolone-resistance determining regions (QRDRs) of gyrA, gyrB, parC and parE of these strains were analyzed by PCR-based sequencing. All 40 strains tested had more than one amino-acid substitution in the QRDRs of gyrA, gyrB, parC or parE. Although there seemed to be some clonality in strains obtained from Hong Kong, there was no clonality in strains obtained from Okinawa and Japan. Strains obtained from Hong Kong, Okinawa Island and the Japanese main island were genetically different by pulsed-field gel electrophoresis analysis. The range of MIC values of STFX against isolates resistant to LVFX (MIC 4-32 mg l À1 ) was 0.12-0.5 mg l À1 , and MIC 80 values of STFX against LVFX-resistant isolates were 0.25 mg l À1 . This study suggests that LVFX-resistant S. pneumoniae is similar in all three locations and STFX is potent against LVFX-resistant S. pneumoniae with multiple mutations in QRDRs of gyrase A and topoisomerase IV.

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The Molecular Epidemiology of Streptococcus pneumoniae with Quinolone Resistance Mutations

Abstract: The population of fluoroquinolone-resistant S. pneumoniae in the United States has increased but remains genetically diverse. However, 35% of LNSP were related to widespread pneumococcal clones, increasing the potential for the rapid spread of quinolone resistance in this species.

Cited by 70 publications

References 29 publications

The Use of Systemic and Topical Fluoroquinolones

The Use of Systemic and Topical Fluoroquinolones

Rapid Screening of Topoisomerase Gene Mutations by a Novel Melting Curve Analysis Method for Early Warning of Fluoroquinolone-Resistant Streptococcus pneumoniae Emergence

Comparison of drug sensitivity and genotypes of clinically isolated strains of levofloxacin-resistant Streptococcus pneumoniae obtained from Okinawa Island, the Japanese main island and Hong Kong

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