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Mahapatra A, Patro ARK, Khajuria A, Dhal S, Praharaj AK. Ciprofloxacin-resistant Gram-negative isolates from a tertiary care hospital in Eastern India with novel gyrA and parC gene mutations. Med J Armed Forces India 2022; 78:24-31. [PMID: 35035040 PMCID: PMC8737103 DOI: 10.1016/j.mjafi.2019.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 10/02/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Expanded-spectrum quinolones (ciprofloxacin) are highly effective against gram-negative bacteria, but significant resistance to quinolones has been increasingly reported. We sought to evaluate the prevalence of gram-negative ciprofloxacin-resistant isolates (CRIs) from our hospital and their mechanism of action. METHODS Gram-negative CRIs were identified as per standard procedures and confirmed using the Ezy MICTM Strip (HiMedia). DNA from 67 CRIs was amplified for the quinolone resistance-determining region (QRDR) and plasmid-mediated quinolone resistance genes. Thirty isolates positive for QRDR DNA were sequenced by Sanger's method to detect mutation. RESULTS Of the isolates, 42.5% were found to be CRIs, the majority (74.42%) from inpatient departments, and E scherichia coli (64.19%) was the predominant isolate. Among the CRIs, 24.55% were ESBL producers and 35.29% were multidrug resistant. The polymerase chain reaction results showed the majority were amplified by QRDR target regions of gyrA (35.4%) while 4.61% were amplified for the plasmid-mediated fluoroquinolone resistance region of the qnrB gene. Further sequencing of QRDR-positive genes showed point mutations with amino acid changes at codons Ser83 and Asp87 in the gyrA gene and Ser80, Glu84, and Leu88 positions in the parC gene. CONCLUSION Ciprofloxacin resistance observed in our study was mostly due to point mutations. Hence, strategies for rational use of ciprofloxacin and adherence to the dose and duration of treatment could be helpful to prevent selection and spread of mutant CRIs/strains.
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Affiliation(s)
- Ashoka Mahapatra
- Additional Professor (Microbiology), AIIMS Bhubaneswar, Odisha, India,Corresponding author.
| | | | - Atul Khajuria
- Former Resident (Microbiology), AIIMS Bhubaneswar, Odisha, India
| | - Sagarika Dhal
- Assistant Professor (Microbiology), S.C.B. Medical College, Cuttack, India
| | - Ashok Kumar Praharaj
- Professor (Microbiology), Kalinga Institute of Medical Sciences, Bhubaneswar, India
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Rajivgandhi G, Maruthupandy M, Manoharan N. Detection of TEM and CTX-M genes from ciprofloxacin resistant Proteus mirabilis and Escherichia coli isolated on urinary tract infections (UTIs). Microb Pathog 2018; 121:123-130. [DOI: 10.1016/j.micpath.2018.05.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 05/13/2018] [Accepted: 05/14/2018] [Indexed: 12/13/2022]
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Antibiofilm activity of zinc oxide nanosheets (ZnO NSs) using Nocardiopsis sp. GRG1 (KT235640) against MDR strains of gram negative Proteus mirabilis and Escherichia coli. Process Biochem 2018. [DOI: 10.1016/j.procbio.2018.01.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Detection of ESBL genes from ciprofloxacin resistant Gram negative bacteria isolated from urinary tract infections (UTIs). ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.flm.2018.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Kwiecinska-Pirog J, Skowron K, Bartczak W, Gospodarek-Komkowska E. The Ciprofloxacin Impact on Biofilm Formation by Proteus Mirabilis and P. Vulgaris Strains. Jundishapur J Microbiol 2016; 9:e32656. [PMID: 27303616 PMCID: PMC4903162 DOI: 10.5812/jjm.32656] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 12/23/2015] [Accepted: 01/29/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Proteus spp. bacilli belong to opportunistic human pathogens, which are primarily responsible for urinary tract and wound infections. An important virulence factor is their ability to form biofilms that greatly reduce the effectiveness of antibiotics in the site of infection. OBJECTIVES The aim of this study was to determine the value of the minimum concentration of ciprofloxacin that eradicates a biofilm of Proteus spp. strains. MATERIALS AND METHODS A biofilm formation of 20 strains of P. mirabilis and 20 strains of P. vulgaris were evaluated by a spectrophotometric method using 0.1% 2, 3, 5-Triphenyl-tetrazolium chloride solution (TTC, AVANTORTM). On the basis of the results of the absorbance of the formazan, a degree of reduction of biofilm and minimum biofilm eradication (MBE) values of MBE50 and MBE90 were determined. RESULTS All tested strains formed a biofilm. A value of 1.0 μg/mL ciprofloxacin is MBE50 for the strains of both tested species. An MBE90 value of ciprofloxacin for isolates of P. vulgaris was 2 μg/mL and for P. mirabilis was 512 μg/mL. CONCLUSIONS Minimum biofilm eradication values of ciprofloxacin obtained in the study are close to the values of the minimal inhibition concentration (MIC).
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Affiliation(s)
- Joanna Kwiecinska-Pirog
- Department of Microbiology, Faculty of Pharmacy, Nicolaus Copernicus University in Torun, Collegium Medicum of L. Rydygier in Bydgoszcz, Bydgoszcz, Poland
| | - Krzysztof Skowron
- Department of Microbiology, Faculty of Pharmacy, Nicolaus Copernicus University in Torun, Collegium Medicum of L. Rydygier in Bydgoszcz, Bydgoszcz, Poland
- Corresponding author: Krzysztof Skowron, Department of Microbiology, Faculty of Pharmacy, Nicolaus Copernicus University in Torun, Collegium Medicum of L. Rydygier in Bydgoszcz, Bydgoszcz, Poland. Tel/Fax: +48-525854047, E-mail:
| | - Wojciech Bartczak
- Department of Microbiology, Faculty of Pharmacy, Nicolaus Copernicus University in Torun, Collegium Medicum of L. Rydygier in Bydgoszcz, Bydgoszcz, Poland
| | - Eugenia Gospodarek-Komkowska
- Department of Microbiology, Faculty of Pharmacy, Nicolaus Copernicus University in Torun, Collegium Medicum of L. Rydygier in Bydgoszcz, Bydgoszcz, Poland
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The assessment of Proteus mirabilis susceptibility to ceftazidime and ciprofloxacin and the impact of these antibiotics at subinhibitory concentrations on Proteus mirabilis biofilms. BIOMED RESEARCH INTERNATIONAL 2013; 2013:930876. [PMID: 24151628 PMCID: PMC3787586 DOI: 10.1155/2013/930876] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 08/13/2013] [Indexed: 11/23/2022]
Abstract
Rods of the Proteus genus are commonly isolated from patients, especially from the urinary tracts of the catheterised patients. The infections associated with biomaterials are crucial therapeutic obstacles, due to the bactericidal resistance of the biofilm. The aim of this study was to assess the susceptibility of P. mirabilis planktonic forms to ciprofloxacin and ceftazidime, the ability to form biofilm, and the impact of chosen sub-MIC concentrations of these antibiotics on biofilm at different stages of its formation. The research included 50 P. mirabilis strains isolated from wounds and the urinary tracts from patients of the University Hospital No. 1 in Bydgoszcz. The assessment of susceptibility to ciprofloxacin and ceftazidime was conducted using micromethods. The impact of sub-MIC concentrations of the chosen antibiotics on the biofilm was measured using the TTC method. The resistance to ciprofloxacin was confirmed for 20 strains (40.0%) while to ceftazidime for 32 (64.0%) of the tested P. mirabilis strains. All of the tested strains formed biofilm: 24.0% weakly, 26.0% moderately, and 50.0% strongly. It was determined that ciprofloxacin and ceftazidime caused eradication of the biofilm. Moreover, the connection between origin of the strains, biofilm maturity level, and resistance to antibiotics was proved.
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Mokracka J, Gruszczyńska B, Kaznowski A. Integrons, β-lactamase andqnrgenes in multidrug resistant clinical isolates ofProteus mirabilisandP. vulgaris. APMIS 2012; 120:950-8. [DOI: 10.1111/j.1600-0463.2012.02923.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Accepted: 05/01/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Joanna Mokracka
- Department of Microbiology, Faculty of Biology; Adam Mickiewicz University in Poznań; Poznań; Poland
| | - Beata Gruszczyńska
- Department of Microbiology, Faculty of Biology; Adam Mickiewicz University in Poznań; Poznań; Poland
| | - Adam Kaznowski
- Department of Microbiology, Faculty of Biology; Adam Mickiewicz University in Poznań; Poznań; Poland
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Cunha BA. Multidrug-resistant Gram-negative bacilli causing urinary tract infections: clinical considerations. J Chemother 2011; 23:171-4. [PMID: 21742588 DOI: 10.1179/joc.2011.23.3.171] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- B A Cunha
- Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501, USA
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Sohn KM, Kang CI, Joo EJ, Ha YE, Chung DR, Peck KR, Lee NY, Song JH. Epidemiology of ciprofloxacin resistance and its relationship to extended-spectrum β-lactamase production in Proteus mirabilis bacteremia. Korean J Intern Med 2011; 26:89-93. [PMID: 21437168 PMCID: PMC3056262 DOI: 10.3904/kjim.2011.26.1.89] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2010] [Revised: 08/30/2010] [Accepted: 09/28/2010] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS We evaluated the clinical features of ciprofloxacin-resistant Proteus mirabilis bacteremia and risk factors for ciprofloxacin resistance. METHODS From October 2000 to July 2009, 37 patients with clinically significant P. mirabilis bacteremia were identified and data from patients with ciprofloxacin-resistant and ciprofloxacin-susceptible P. mirabilis bacteremia were compared. RESULTS The most common underlying diseases were neurologic disease (37.8%) and solid tumors (29.7%). The most common site of infection was the urinary tract (35.1%). Ten of the 37 patients (27.0%) were infected with ciprofloxacin-resistant isolates, and univariate analysis revealed a significant relationship between ciprofloxacin-resistant P. mirabilis bacteremia and neurologic disease, recent operation, L-tube insertion, percutaneous tube use, and extended-spectrum β-lactamase (ESBL) production (all p < 0.05). ESBL was detected in six of 10 (60%) ciprofloxacin-resistant isolates, while only three of 27 (11%) ciprofloxacin-susceptible isolates produced ESBL (p = 0.005). In a logistic regression analysis, ESBL production remained a significant factor associated with ciprofloxacin resistance, after adjusting for other variables. CONCLUSIONS These data indicate a close association between ciprofloxacin resistance and ESBL-production in P. mirabilis bacteremia. This association is particularly troublesome because the therapeutic options for serious infections caused by ESBL-producing P. mirabilis are severely restricted.
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Affiliation(s)
- Kyung Mok Sohn
- Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Cheol-In Kang
- Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun-Jeong Joo
- Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Young Eun Ha
- Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Doo Ryeon Chung
- Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyong Ran Peck
- Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Nam Yong Lee
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jae-Hoon Song
- Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Urinary Tract Infections Caused by Multi-Drug Resistant Proteus mirabilis: Risk Factors and Clinical Outcomes. Infection 2009; 38:41-6. [DOI: 10.1007/s15010-009-8460-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2008] [Accepted: 08/06/2009] [Indexed: 10/20/2022]
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Souza Neto JLE, Oliveira FVD, Kobaz AK, Silva MNP, Lima AR, Maciel LC. Infecção do trato urinário relacionada com a utilização do catéter vesical de demora: resultados da bacteriúria e da microbiota estudadas. Rev Col Bras Cir 2008. [DOI: 10.1590/s0100-69912008000100008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar o momento do início da bacteriúria e o germe mais freqüentemente relacionado à infecção urinária nos pacientes submetidos à sondagem vesical de demora. MÉTODO: No período de setembro de 2003 a outubro de 2004, foram avaliados os pacientes com 13 anos ou mais, submetidos à operações eletivas com cateterismo vesical de demora. Na inserção do cateter foi colhida a primeira amostra de urina, denominada Amostra 1, e outras seqüencialmente a cada 12 horas. Estas foram analisadas quanto a bacteriúria, leucocitúria, e cultura. A infecção do trato urinário foi definida como a presença de 100.000 unidades formadoras de colônias ou mais, após o isolamento da mesma bactéria ou fungo em culturas de urina de amostras distintas, desde a inserção até a remoção do cateter urinário; a leucocitúria como contagem de leucócitos igual ou superior a 10.000 leucócitos/mm³; e bacteriúria como presença de bactéria de uma única espécie na amostra analisada. RESULTADOS: A amostra foi composta de 63 pacientes, 46 sexo masculino (73%) e 17 sexo feminino (27%). Apenas três deles apresentaram leucocitúria na primeira coleta. Nas Amostras 1 houve variação de 1.000 a 20.000 leucócitos/mm³, todas com cultura negativa. O número de amostras variou de 1 a 8 (84h após a realização do cateterismo vesical). As leucocitúrias nas amostras finais variaram de 1.000 a 204.000 leucócitos/mm³, todas com urocultura e bacteriúria negativa. 62 pacientes (98,4%) utilizaram antibioticoterapia de curta duração para o sítio cirúrgico. CONCLUSÃO: Até 84h - 3,5 dias - não houve Infecção em nenhuma das amostras coletadas e cultivadas. A antibioticoterapia de curta duração pode ter contribuído para o resultado observado.
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