Mechanisms of fluoroquinolone resistance among Escherichia coli isolates from urinary tract infections in Thailand
Abstract
Escherichia coli is the major causative agent for urinary tract infections (UTIs), and fluoroquinolones (FQ) are commonly used in the treatment of patients with UTIs. The surge in FQ-resistant E. coli is an important public health threat worldwide. We investigated the prevalence and mechanisms of FQ resistance among FQ-resistant E. coli isolated from UTI patients. A total of 131 FQ-resistant E. coli strains were characterized and broth microdilution assay showed that 108 strains (82.4%) were highly resistant to ciprofloxacin (MIC ≥ 32 μg/mL). All strains were analyzed for plasmid-mediated quinolone resistance (PMQR) genes, with 37 (28.2%) testing positive. Among the PMQR genes detected, aac(6')-Ib-cr was the most frequent, found in 30 strains (22.9%), followed by qnrS in 10 strains (7.6%) and qnrB in 1 strain (0.8%). PCR assay showed that all carried acrA, acrB, and tolC genes, but 33 strains (25.2%) revealed at least 4-fold reduction in ciprofloxacin MIC when using PAβN and CCCP as efflux pump inhibitors, indicating the role of the AcrAB efflux pump in ciprofloxacin resistance in these strains. The 19 strains of high-level ciprofloxacin-resistant E. coli were selected to determine the target enzyme alteration by PCR assay and DNA sequencing. Genetic analysis revealed that 16 strains (84.2%) had double mutations in gyrA (S83L and D87 to N or Y) with single mutation in parC (S80I), while 3 strains (15.8%) had double mutations in gyrA (S83L and D87 to N or Y) and parC (S80I…
Read the paper
Related studies
- Association of lower urinary tract symptoms and OAB severity with quality of life and mental health in China, Taiwan and South Korea: results from a cross-sectional, population-based study
- Ten-Day Quadruple Therapy Comprising Low-Dose Rabeprazole, Bismuth, Amoxicillin, and Tetracycline Is an Effective and Safe First-Line Treatment for Helicobacter pylori Infection in a Population with High Antibiotic Resistance: a Prospective, Multicenter, Randomized, Parallel-Controlled Clinical Trial in China
- The Role of the NLR and PLR in Urinary Tract Infection
- Threat of Antimicrobial Resistance among Pilgrims with Infectious Diseases during Hajj: Lessons Learnt from COVID-19 Pandemic
- Leclercia adecarboxylata urinary tract infection in a patient with bladder cancer and recurrent hematuria
- A Case Series of Staphylococcus lugdunensis Infection in Cancer Patients at an Academic Cancer Institute in the United States
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.