The prevalence of fluoroquinolone resistance among clinically significant respiratory tract isolates of Streptococcus pneumoniae in the United States and Canada—1997 results from the SENTRY Antimicrobial Surveillance Program

Doern, G V; Pfaller, M. A.; Erwin, Meridithe .; Brueggemann, Angela B.; Jones, Rn

doi:10.1016/s0732-8893(98)00081-9

Cited by 51 publications

(34 citation statements)

References 16 publications

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“…Fluoroquinolone resistance in S. pneumoniae has been well documented (5,7,10,11,19) but is still less than 2% overall for ciprofloxacin in the United States according to recent surveys, despite a dramatic increase in fluoroquinolone use to treat community-acquired respiratory tract infections since the late 1990s (4,5,10,11,19,23,29). However, rapidly emerging resistance in the well-characterized Spain 23F -1 clone was apparently responsible for a fluoroquinolone resistance rate of 13.3% reported in Hong Kong during 2000 (20).…”

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confidence: 99%

Genetic Relatedness of Levofloxacin-Nonsusceptible Streptococcus pneumoniae Isolates from North America

Johnson¹,

Benjamin²,

Moser³

et al. 2003

J Clin Microbiol

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We characterized 32 levofloxacin-nonsusceptible Streptococcus pneumoniae (LNSP) isolates obtained from a broad geographic region of North America over a 5-year period by using capsular serotypes, antimicrobial susceptibility profiles, BOX-PCR, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). Sixteen international clones identified by the Pneumococcal Molecular Epidemiology Network also were included for comparison. Fifteen serotypes were represented, with serogroups 6, 9, 14, 19, and 23 accounting for 63% of isolates. Among isolates whose quinolone resistance-determining regions were sequenced, all contained gyrA and parC point mutations. Sixty-three percent were penicillin susceptible, and 84% were erythromycin susceptible. BOX-PCR analysis identified 39 different band patterns among 32 LNSP and 16 international clones and grouped 16 isolates, including 2 international clones, into seven unrelated groups of 2 to 4 isolates each. PFGE analysis identified 35 different band patterns among 32 LNSP and 16 international clones and grouped 21 isolates, including 3 international clones, into eight unrelated groups of 2 to 6 isolates each. MLST performed on 10 isolates identified five allelic profiles and separated 9 isolates into four groups of 2 to 3 isolates each. Overall, each typing method indicated that the LNSP were heterogeneous and that resistance to fluoroquinolones was not closely associated with a particular serotype or with coresistance to other antimicrobial classes and suggests that LNSP have likely arisen through independent mutational events as a result of selective pressure. However, seven LNSP were found to be related to three international clones by PFGE.

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confidence: 99%

Genetic Relatedness of Levofloxacin-Nonsusceptible Streptococcus pneumoniae Isolates from North America

Johnson¹,

Benjamin²,

Moser³

et al. 2003

J Clin Microbiol

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“…However, their activity against Grampositive pathogens, including the penicillin-resistant S. pneumoniae, is improved [5][6][7]. The activity of these new quinolones against "atypical" pathogens and against Haemophilus influenzae, including the H. influenzae strains that produce beta-lactamases, has also been enhanced [8].…”

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confidence: 99%

An open label, multicenter, non-comparative study of the efficacy and safety of oral gatifloxacin in the treatment of community-acquired pneumonia: a Brazilian study in five centers

Nicodemo¹

2003

Braz J Infect Dis

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We made an open label, multicenter, non-comparative study to assess the efficacy and safety of oral gatifloxacin, 400mg PO given once-daily during 7 to 14 days for the treatment of adult outpatients with community-acquired pneumonia at five Brazilian medical facilities. Among the 86 subjects available for clinical evaluation, 84 (98%) were cured. The bacteriological eradication and presumed eradication rate was 98% (52/53) among the 44 (51%) patients who were bacteriologically evaluated. Drug-related adverse events were reported by 27% of the patients, diarrhea being the most frequent, occurring in 12% of patients. Adverse events were considered mild (89%) or moderate (11%). We conclude that a 7-14 day course of gatifloxacin, 400mg PO given once daily is safe and effective for the treatment of community-acquired pneumonia. The drug had a favorable safety profile and a good clinical and bacteriological efficacy.

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“…Gatifloxacin contains a methoxy substituent at position 8 of the quinolone ring that has been associated in some bacteria with increased bacteriostatic and bactericidal activity as well as decreased selection of resistant mutants (7,27,53,54). Although gatifloxacin has been studied in S. pneumoniae (6,13,17,21,22,33,38) and Escherichia coli (27), there have been few studies of gatifloxacin action and resistance in S. aureus (14,15,22). We thus undertook to define the effects of established resistance mechanisms on gatifloxacin activity, to characterize gatifloxacin-selected mutants, and to compare the bactericidal activity of gatifloxacin with its desmethoxy derivative AM-1121.…”

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confidence: 99%

Mechanisms and Frequency of Resistance to Gatifloxacin in Comparison to AM-1121 and Ciprofloxacin in Staphylococcus aureus

İnce

Hooper

2001

Antimicrob Agents Chemother

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Gatifloxacin, an 8-methoxyfluoroquinolone, was found to be two-to fourfold more active against wild-type Staphylococcus aureus ISP794 than its desmethoxy derivative, AM-1121, and ciprofloxacin, another desmethoxy fluoroquinolone. Single grlBA mutations caused two-to fourfold increases in the MIC of gatifloxacin, and a single gyrase mutation was silent. Double mutations in gyrA and grlA or grlB caused a 32-fold increase in the MIC of gatifloxacin, in contrast to a 128-fold increase for ciprofloxacin and AM-1121. Overexpression of the NorA efflux pump had minimal effect on the MIC of gatifloxacin. The bactericidal activity of the three quinolones at four times the MIC differed only for a double mutant, with gatifloxacin exhibiting a killing pattern similar to that for ISP794, whereas ciprofloxacin and AM-1121 failed to show any killing. With gatifloxacin, selection of resistant mutants at twice the MIC was 100-to 1,000-fold less frequent than with the comparison quinolones, and mutants could rarely be selected at four times the MIC. The limit resistance in ISP74 was 512 times the MIC of gatifloxacin and 1,024 times the MICs of ciprofloxacin and AM-1121. Novel mutations in topoisomerase IV were selected in five of the six single-step mutants, three of which were shown to cause quinolone resistance by genetic studies. In conclusion, topoisomerase IV is the primary target of gatifloxacin. In contrast to comparison quinolones, mutations in both topoisomerase IV and gyrase are required for resistance to gatifloxacin by clinical breakpoints and do not abolish bactericidal effect, further supporting the benefit of the 8-methoxy substituent in gatifloxacin.

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The prevalence of fluoroquinolone resistance among clinically significant respiratory tract isolates of Streptococcus pneumoniae in the United States and Canada—1997 results from the SENTRY Antimicrobial Surveillance Program

Cited by 51 publications

References 16 publications

Genetic Relatedness of Levofloxacin-Nonsusceptible Streptococcus pneumoniae Isolates from North America

Genetic Relatedness of Levofloxacin-Nonsusceptible Streptococcus pneumoniae Isolates from North America

An open label, multicenter, non-comparative study of the efficacy and safety of oral gatifloxacin in the treatment of community-acquired pneumonia: a Brazilian study in five centers

Mechanisms and Frequency of Resistance to Gatifloxacin in Comparison to AM-1121 and Ciprofloxacin in Staphylococcus aureus

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