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Phenotypic screening for quinolone resistance in Escherichia coli
Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Heart and Medicine Center, Department of Infectious Diseases. inkoping, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Microbiology.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology, Infection and Inflammation. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Microbiology.
Not Found:Linkoping Univ, Dept Clin and Expt Med, Linkoping, Sweden; Linkoping Univ, Dept Urol, Linkoping, Sweden.
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2019 (English)In: European Journal of Clinical Microbiology and Infectious Diseases, ISSN 0934-9723, E-ISSN 1435-4373, Vol. 38, no 9, p. 1765-1771Article in journal (Refereed) Published
Abstract [en]

Recent studies show that rectal colonization with low-level ciprofloxacin-resistant Escherichia coli (ciprofloxacin minimal inhibitory concentration (MIC) above the epidemiological cutoff point, but below the clinical breakpoint for resistance), i.e., in the range amp;gt; 0.06-0.5 mg/L is an independent risk factor for febrile urinary tract infection after transrectal ultrasound-guided biopsy (TRUS-B) of the prostate, adding to the other risk posed by established ciprofloxacin resistance in E. coli (MIC amp;gt; 0.5 mg/L) as currently defined. We aimed to identify the quinolone that by disk diffusion best discriminates phenotypic wild-type isolates (ciprofloxacin MIC amp;lt;= 0.06 mg/L) of E. coli from isolates with acquired resistance, and to determine the resistance genotype of each isolate. The susceptibility of 108 E. coli isolates was evaluated by ciprofloxacin, levofloxacin, moxifloxacin, nalidixic acid, and pefloxacin disk diffusion and correlated to ciprofloxacin MIC (broth microdilution) using EUCAST methodology. Genotypic resistance was identified by PCR and DNA sequencing. The specificity was 100% for all quinolone disks. Sensitivity varied substantially, as follows: ciprofloxacin 59%, levofloxacin 46%, moxifloxacin 59%, nalidixic acid 97%, and pefloxacin 97%. We suggest that in situations where low-level quinolone resistance might be of importance, such as when screening for quinolone resistance in fecal samples pre-TRUS-B, a pefloxacin (S amp;gt;= 24 mm) or nalidixic acid (S amp;gt;= 19 mm) disk, or a combination of the two, should be used. In a setting where plasmid-mediated resistance is prevalent, pefloxacin might perform better than nalidixic acid.

Place, publisher, year, edition, pages
SPRINGER , 2019. Vol. 38, no 9, p. 1765-1771
Keywords [en]
PMQR; Susceptibility testing; E. coli; Transrectal ultrasound (TRUS)-guided biopsy
National Category
Microbiology in the medical area
Identifiers
URN: urn:nbn:se:liu:diva-160157DOI: 10.1007/s10096-019-03608-wISI: 000481757500022PubMedID: 31214796OAI: oai:DiVA.org:liu-160157DiVA, id: diva2:1349611
Note

Funding Agencies|ALF grants from Ostergotland County Council [LIO-61341, LIO-127281]; Linkoping University

Available from: 2019-09-09 Created: 2019-09-09 Last updated: 2019-11-27

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Dellgren, LinusClaesson, CarinaHögdahl, MarieHanberger, HåkanNilsson, Lennart EHällgren, Anita
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