151. Plasmid-mediated fluoroquinolone resistance determinants in Escherichia coli from community uncomplicated urinary tract infection in an area of high prevalence of quinolone resistance
- Author
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Lucia Pallecchi, Maria Pia Conte, Massimiliano Marazzato, Valerio Iebba, C. Gallinelli, Antonella Comanducci, Catia Longhi, Valentina Totino, Eleonora Riccobono, Serena Schippa, Floriana Santangelo, Longhi, Catia, Pia Conte, Maria, Marazzato, Massimiliano, Iebba, Valerio, Totino, Valentina, Santangelo, Floriana, Gallinelli, Carmela, Pallecchi, L., Riccobono, E., Schippa, Serena, and Comanducci, Antonella
- Subjects
Male ,Drug Resistance ,Ceftazidime ,medicine.disease_cause ,Polymerase Chain Reaction ,Plasmid ,Medical microbiology ,Ampicillin ,80 and over ,Prevalence ,Uropathogenic Escherichia coli ,Escherichia coli Infections ,Aged, 80 and over ,Bacterial ,General Medicine ,Middle Aged ,Anti-Bacterial Agents ,Ciprofloxacin ,Community-Acquired Infections ,Infectious Diseases ,Italy ,Urinary Tract Infections ,Adolescent ,Adult ,Aged ,DNA, Bacterial ,Female ,Fluoroquinolones ,Genes, Bacterial ,Humans ,Microbial Sensitivity Tests ,Plasmids ,Young Adult ,beta-Lactamases ,Drug Resistance, Bacterial ,medicine.drug ,Microbiology (medical) ,medicine.medical_specialty ,Urinary system ,Microbiology ,Antibiotic resistance ,medicine ,Escherichia coli ,business.industry ,DNA ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,Genes ,business - Abstract
In Italy fluoroquinolones (FQs) are extensively prescribed in empirical therapy of uncomplicated urinary tract infection (UTI) despite recommendations in national guidelines and widespread antibiotic resistance in community. To survey the dissemination of plasmid-mediated quinolone resistance in a peak area of FQs consumption, E. coli strains from 154 community and 41 local hospital patients were collected; low level ciprofloxacin resistance qnrA, qnrB, qnrS, and aac(6) -Ib-cr genes were screened by PCR and patterns of transferable resistances were determined. Clinical ciprofloxacin resistance in hospital doubled community value, while overall rates of FQ resistance genes were similar (31.6% and 27.8%). Prevalence of aac(6)-Ib-cr gene was 11% in outpatients (21%, inpatients) and risk of harbouring this variant was significantly associated with gentamicin resistance; linkage to ceftazidime resistance was significant (P0 0.001) and six out of eight strains produced CTX-M-15 and TEM-1 beta lactamases. In transconjugants, the unique pattern ampicillin/kanamycin- gentamicin/ ESBL + was associated with aac(6)-Ib-cr gene presence and with an increase of ciprofloxacin MIC value. Data highlight the need to monitor the resistance risk factors in the local community to provide clinicians with well-grounded guidelines for UTI therapy. © Springer-Verlag 2012.
- Published
- 2011