Cargando…

Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use

BACKGROUND: Antibiotic resistance has necessitated fluoroquinolone use but little is known about the selective forces and resistance trajectory in malaria-endemic settings, where selection from the antimalarial chloroquine for fluoroquinolone-resistant bacteria has been proposed. METHODS: Antimicrob...

Descripción completa

Detalles Bibliográficos
Autores principales: Lamikanra, Adebayo, Crowe, Jennifer L, Lijek, Rebeccah S, Odetoyin, Babatunde W, Wain, John, Aboderin, A Oladipo, Okeke, Iruka N
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3226678/
https://www.ncbi.nlm.nih.gov/pubmed/22060770
http://dx.doi.org/10.1186/1471-2334-11-312
_version_ 1782217668426727424
author Lamikanra, Adebayo
Crowe, Jennifer L
Lijek, Rebeccah S
Odetoyin, Babatunde W
Wain, John
Aboderin, A Oladipo
Okeke, Iruka N
author_facet Lamikanra, Adebayo
Crowe, Jennifer L
Lijek, Rebeccah S
Odetoyin, Babatunde W
Wain, John
Aboderin, A Oladipo
Okeke, Iruka N
author_sort Lamikanra, Adebayo
collection PubMed
description BACKGROUND: Antibiotic resistance has necessitated fluoroquinolone use but little is known about the selective forces and resistance trajectory in malaria-endemic settings, where selection from the antimalarial chloroquine for fluoroquinolone-resistant bacteria has been proposed. METHODS: Antimicrobial resistance was studied in fecal Escherichia coli isolates in a Nigerian community. Quinolone-resistance determining regions of gyrA and parC were sequenced in nalidixic acid resistant strains and horizontally-transmitted quinolone-resistance genes were sought by PCR. Antimicrobial prescription practices were compared with antimicrobial resistance rates over a period spanning three decades. RESULTS: Before 2005, quinolone resistance was limited to low-level nalixidic acid resistance in fewer than 4% of E. coli isolates. In 2005, the proportion of isolates demonstrating low-level quinolone resistance due to elevated efflux increased and high-level quinolone resistance and resistance to the fluoroquinolones appeared. Fluoroquinolone resistance was attributable to single nucleotide polymorphisms in quinolone target genes gyrA and/or parC. By 2009, 35 (34.5%) of isolates were quinolone non-susceptible with nine carrying gyrA and parC SNPs and six bearing identical qnrS1 alleles. The antimalarial chloroquine was heavily used throughout the entire period but E. coli with quinolone-specific resistance mechanisms were only detected in the final half decade, immediately following the introduction of the fluoroquinolone antibacterial ciprofloxacin. CONCLUSIONS: Fluoroquinolones, and not chloroquine, appear to be the selective force for fluoroquinolone-resistant fecal E. coli in this setting. Rapid evolution to resistance following fluoroquinolone introduction points the need to implement resistant containment strategies when new antibacterials are introduced into resource-poor settings with high infectious disease burdens.
format Online
Article
Text
id pubmed-3226678
institution National Center for Biotechnology Information
language English
publishDate 2011
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-32266782011-11-30 Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use Lamikanra, Adebayo Crowe, Jennifer L Lijek, Rebeccah S Odetoyin, Babatunde W Wain, John Aboderin, A Oladipo Okeke, Iruka N BMC Infect Dis Research Article BACKGROUND: Antibiotic resistance has necessitated fluoroquinolone use but little is known about the selective forces and resistance trajectory in malaria-endemic settings, where selection from the antimalarial chloroquine for fluoroquinolone-resistant bacteria has been proposed. METHODS: Antimicrobial resistance was studied in fecal Escherichia coli isolates in a Nigerian community. Quinolone-resistance determining regions of gyrA and parC were sequenced in nalidixic acid resistant strains and horizontally-transmitted quinolone-resistance genes were sought by PCR. Antimicrobial prescription practices were compared with antimicrobial resistance rates over a period spanning three decades. RESULTS: Before 2005, quinolone resistance was limited to low-level nalixidic acid resistance in fewer than 4% of E. coli isolates. In 2005, the proportion of isolates demonstrating low-level quinolone resistance due to elevated efflux increased and high-level quinolone resistance and resistance to the fluoroquinolones appeared. Fluoroquinolone resistance was attributable to single nucleotide polymorphisms in quinolone target genes gyrA and/or parC. By 2009, 35 (34.5%) of isolates were quinolone non-susceptible with nine carrying gyrA and parC SNPs and six bearing identical qnrS1 alleles. The antimalarial chloroquine was heavily used throughout the entire period but E. coli with quinolone-specific resistance mechanisms were only detected in the final half decade, immediately following the introduction of the fluoroquinolone antibacterial ciprofloxacin. CONCLUSIONS: Fluoroquinolones, and not chloroquine, appear to be the selective force for fluoroquinolone-resistant fecal E. coli in this setting. Rapid evolution to resistance following fluoroquinolone introduction points the need to implement resistant containment strategies when new antibacterials are introduced into resource-poor settings with high infectious disease burdens. BioMed Central 2011-11-07 /pmc/articles/PMC3226678/ /pubmed/22060770 http://dx.doi.org/10.1186/1471-2334-11-312 Text en Copyright ©2011 Lamikanra et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Lamikanra, Adebayo
Crowe, Jennifer L
Lijek, Rebeccah S
Odetoyin, Babatunde W
Wain, John
Aboderin, A Oladipo
Okeke, Iruka N
Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use
title Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use
title_full Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use
title_fullStr Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use
title_full_unstemmed Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use
title_short Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use
title_sort rapid evolution of fluoroquinolone-resistant escherichia coli in nigeria is temporally associated with fluoroquinolone use
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3226678/
https://www.ncbi.nlm.nih.gov/pubmed/22060770
http://dx.doi.org/10.1186/1471-2334-11-312
work_keys_str_mv AT lamikanraadebayo rapidevolutionoffluoroquinoloneresistantescherichiacoliinnigeriaistemporallyassociatedwithfluoroquinoloneuse
AT crowejenniferl rapidevolutionoffluoroquinoloneresistantescherichiacoliinnigeriaistemporallyassociatedwithfluoroquinoloneuse
AT lijekrebeccahs rapidevolutionoffluoroquinoloneresistantescherichiacoliinnigeriaistemporallyassociatedwithfluoroquinoloneuse
AT odetoyinbabatundew rapidevolutionoffluoroquinoloneresistantescherichiacoliinnigeriaistemporallyassociatedwithfluoroquinoloneuse
AT wainjohn rapidevolutionoffluoroquinoloneresistantescherichiacoliinnigeriaistemporallyassociatedwithfluoroquinoloneuse
AT aboderinaoladipo rapidevolutionoffluoroquinoloneresistantescherichiacoliinnigeriaistemporallyassociatedwithfluoroquinoloneuse
AT okekeirukan rapidevolutionoffluoroquinoloneresistantescherichiacoliinnigeriaistemporallyassociatedwithfluoroquinoloneuse