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Occurrence of quinolone resistance in Staphylococcus aureus from nosocomial infection

Published online by Cambridge University Press:  15 May 2009

W. Witte
Affiliation:
Robert Koch Institute of the Federal Bureau of Health, Branch Wernigerode, Burgstrasse 37, D–3700 Wernigerode, Germany
H. Grimm
Affiliation:
Labor Gärtner, Weingarten, Germany
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Summary

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Among 63 Staphylococcus aureus isolates (one isolate per one patient) counted from infections (from August to November 1991) in hospital T., eight exhibited resistance to fluoroquinolones. Seven of these quinolone-resistant isolates were multiply- and methicillin-resistant S. aureus (QR-MRSA). The results of phage-, plasmid- and genotyping (pulsed field electrophoresis) revealed that six different strain-clones of these MRSA were spread in the hospital. In vitro spontaneous mutants resistant to fluoroquinolones are 1–-100-fold more frequent in MRSA than in other S. aureus when selected on isosensitest-agar containing 1 μg/ml of ciprofloxacin. However, the same mutant frequencies were found in strain 8325–4 with and without the mecA-determinant. The resistance phenotype was stable over 30 generations of subculture in nutrient broth as well in natural quinolone resistant MRSA as in mutants of other types of S.aureus selected in vitro. The phenotypic association of quinolone resistance and MRSA is rather likely due to a higher frequency of spontaneous resistant mutants which are present in natural populations of MRSA. Data of chemotherapy prior to the isolation of 8. aureus show that three of seven patients from whom QR-MRSA were isolated were treated with a quinolone. In eight cases of infections with non-MRSA and quinolone treatment the isolated S. aureus strains were in vitro sensitive to quinolones.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1992

References

REFERENCES

1.Wolfson, JS, Hooper, DC. The fluoroquinolones: structures, mechanisms of action and resistance, and spectra of activity in vitro. Antimicrob Agents Chemother 1985; 28: 581–6.CrossRefGoogle ScholarPubMed
2.Bergan, T, Thorsteinsson, SB, Kolstad, IM, Johnsen, S. Pharmacokinetics of ciprofloxacin after intravenous and increasing oral doses. Eur J Clin Microbiol 1986; 5: 187–92.CrossRefGoogle ScholarPubMed
3.Shah, PM. The role of quinolones in staphylococcal infection. J Chemother 1989; 1: 253–6.CrossRefGoogle ScholarPubMed
4.Sreedharan, S, Oram, M, Jensen, B, Peterson, LR, Fisher, LM. DNA gyrase gyr A mutations in ciprofloxacin-resistant strains of Staphylococcus aureus: close similarity with quinolone resistance mutations in Escherichia coli. J Bacteriol 1990; 7260–2.CrossRefGoogle Scholar
5.Kaatz, GW. Seo SM, Ruble CA. Mechanisms of fluoroquinolone resistance in Staphylococcus aureus. J Infect Dis 1991: 163: 1080–6.CrossRefGoogle ScholarPubMed
6.Witte, W. Wolter, E-J, Klare, I. Bakterizide Wirkung von 4-Chinolonen in vitro und Auftreten resistenter Mutanten unter besonderer Berücksichtigung von Pefloxacin. Z Klin Med. 1991; 46: 5962.Google Scholar
7.Crook, SM, Selkon, JB, McLardy-Smith, PD. Clinical resistance to long-term oral ciprofloxacin. Lancet 1985: i: 1275.CrossRefGoogle Scholar
8.Schacht, P, Arcieri, G. Branolte, J. Bruck, H, Chysky, V. Worldwide clinical data on efficacy and safety of ciprofloxacin. Infection 1988; 16: 2943.CrossRefGoogle ScholarPubMed
9.Beck, WD. Berger-Bächi, B, Kayser, FH. Additional DNA in methicillin-resistant Staphylococcus aureus and molecular cloning of mec-specific DNA. J Bacteriol 1986; 165: 373–8.CrossRefGoogle ScholarPubMed
10.Witte, W, Green, L, Misra, T, Silver, S. Resistance to mercury and to cadmium in chromosomallv resistant Staphylococcus ureus. Antimicrob Agents Chemother 1986; 28: 663–9.CrossRefGoogle Scholar
11.Blair, JE, Williams, REO. Phage typing of staphylococci. Bull WHO 1961; 24: 771–84.Google ScholarPubMed
12.Witte, W. Typing of multiresistant and methicillin resistant Staphylococcus aureus by classical and molecular methods and their use in epidemiology. In: Novick, RP, Skurray, R. eds. Molecular biology of the staphylococci. New York: VCH Verlagsgesellschaft Heidelberg, 1990: 602–15.Google Scholar
13.Goering, RV, Ruff, EA. Comparative analysis of conjugative plasmids mediating gentamicin resistance in Staphylococcus aureus. Antimicrob Agents Chemother 1983: 24: 450–2.CrossRefGoogle ScholarPubMed
14.Hartman, BJ, Tomasz, A. Low affinity penicillin-binding protein associated with beta-lactam resistance in Staphylococcus aureus. J Bacteriol 1984; 158: 513–16.CrossRefGoogle ScholarPubMed
15.Smith, SM, Eng, R, Berman, E. The effect of ciprofloxacin on methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother 1986; 17: 287–95.CrossRefGoogle ScholarPubMed
16.Pierey, EA, Barbaro, D. Luby, JP, Machowiak, PA. Ciprofloxacin for methocillin-resistant Staphylococcus aureus infections. Antimicrob Agents Chemother 1989; 33: 128–30.CrossRefGoogle Scholar
17.Smith, SM, Eng, RHK, Bais, P, Fan-Havard, P, Tecson-Tumang, F. Epidemiology of ciprofloxacin resistance among patients with methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother 1990; 26: 567–72.CrossRefGoogle ScholarPubMed
18.Schaefler, S. Methicillin-resistant of Staphylococcus aureus resistant to quinolones. J Clin Microbiol 1989; 27: 335–6.CrossRefGoogle ScholarPubMed
19.Ragnaud, JM, Roche-Bezian, MC, Dupon, M, Wone, C. Management of peritonitis related to chronic ambulatory peritoneal dialysis (CADP) using two daily intraperitoneal injections of 400 mg pefloxacin. 5th Mediterranean Congress Chemotherapy Cairo 1986, Abstract p 232.Google Scholar
20.Schalit, I, Berger, SA, Gorea, A, Frimerman, H. Widespread quinolone resistance among methicillin-resistant Staphylococcus aureus isolates in a general hospital. Antimicrob Agents Chemother 1989; 33: 593–4.CrossRefGoogle Scholar
21.Maple, P, Hamilton-Miller, J, Brumfitt, W. Ciprofioxacin-resistance in methicillin- and gentamicin-resistant Staphylococcus aureus. Eur J Microbiol Infect Dis 1989; 8: 622–4.CrossRefGoogle ScholarPubMed