Antimalarial therapy selection for quinolone resistance among Escherichia coli in the absence of quinolone exposure, in tropical South America.

<h4>Background</h4>Bacterial resistance to antibiotics is thought to develop only in the presence of antibiotic pressure. Here we show evidence to suggest that fluoroquinolone resistance in Escherichia coli has developed in the absence of fluoroquinolone use.<h4>Methods</h4>O...

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Autores principales: Ross J Davidson, Ian Davis, Barbara M Willey, Keyro Rizg, Shelly Bolotin, Vanessa Porter, Jane Polsky, Nick Daneman, Allison McGeer, Paul Yang, Dennis Scolnik, Roy Rowsell, Olga Imas, Michael S Silverman
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Publicado: Public Library of Science (PLoS) 2008
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spelling oai:doaj.org-article:cb3e719463914f0fabc989a7b51f524f2021-11-25T06:11:33ZAntimalarial therapy selection for quinolone resistance among Escherichia coli in the absence of quinolone exposure, in tropical South America.1932-620310.1371/journal.pone.0002727https://doaj.org/article/cb3e719463914f0fabc989a7b51f524f2008-07-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/18648533/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Bacterial resistance to antibiotics is thought to develop only in the presence of antibiotic pressure. Here we show evidence to suggest that fluoroquinolone resistance in Escherichia coli has developed in the absence of fluoroquinolone use.<h4>Methods</h4>Over 4 years, outreach clinic attendees in one moderately remote and five very remote villages in rural Guyana were surveyed for the presence of rectal carriage of ciprofloxacin-resistant gram-negative bacilli (GNB). Drinking water was tested for the presence of resistant GNB by culture, and the presence of antibacterial agents and chloroquine by HPLC. The development of ciprofloxacin resistance in E. coli was examined after serial exposure to chloroquine. Patient and laboratory isolates of E. coli resistant to ciprofloxacin were assessed by PCR-sequencing for quinolone-resistance-determining-region (QRDR) mutations.<h4>Results</h4>In the very remote villages, 4.8% of patients carried ciprofloxacin-resistant E. coli with QRDR mutations despite no local availability of quinolones. However, there had been extensive local use of chloroquine, with higher prevalence of resistance seen in the villages shortly after a Plasmodium vivax epidemic (p<0.01). Antibacterial agents were not found in the drinking water, but chloroquine was demonstrated to be present. Chloroquine was found to inhibit the growth of E. coli in vitro. Replica plating demonstrated that 2-step QRDR mutations could be induced in E. coli in response to chloroquine.<h4>Conclusions</h4>In these remote communities, the heavy use of chloroquine to treat malaria likely selected for ciprofloxacin resistance in E. coli. This may be an important public health problem in malarious areas.Ross J DavidsonIan DavisBarbara M WilleyKeyro RizgShelly BolotinVanessa PorterJane PolskyNick DanemanAllison McGeerPaul YangDennis ScolnikRoy RowsellOlga ImasMichael S SilvermanPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 3, Iss 7, p e2727 (2008)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Ross J Davidson
Ian Davis
Barbara M Willey
Keyro Rizg
Shelly Bolotin
Vanessa Porter
Jane Polsky
Nick Daneman
Allison McGeer
Paul Yang
Dennis Scolnik
Roy Rowsell
Olga Imas
Michael S Silverman
Antimalarial therapy selection for quinolone resistance among Escherichia coli in the absence of quinolone exposure, in tropical South America.
description <h4>Background</h4>Bacterial resistance to antibiotics is thought to develop only in the presence of antibiotic pressure. Here we show evidence to suggest that fluoroquinolone resistance in Escherichia coli has developed in the absence of fluoroquinolone use.<h4>Methods</h4>Over 4 years, outreach clinic attendees in one moderately remote and five very remote villages in rural Guyana were surveyed for the presence of rectal carriage of ciprofloxacin-resistant gram-negative bacilli (GNB). Drinking water was tested for the presence of resistant GNB by culture, and the presence of antibacterial agents and chloroquine by HPLC. The development of ciprofloxacin resistance in E. coli was examined after serial exposure to chloroquine. Patient and laboratory isolates of E. coli resistant to ciprofloxacin were assessed by PCR-sequencing for quinolone-resistance-determining-region (QRDR) mutations.<h4>Results</h4>In the very remote villages, 4.8% of patients carried ciprofloxacin-resistant E. coli with QRDR mutations despite no local availability of quinolones. However, there had been extensive local use of chloroquine, with higher prevalence of resistance seen in the villages shortly after a Plasmodium vivax epidemic (p<0.01). Antibacterial agents were not found in the drinking water, but chloroquine was demonstrated to be present. Chloroquine was found to inhibit the growth of E. coli in vitro. Replica plating demonstrated that 2-step QRDR mutations could be induced in E. coli in response to chloroquine.<h4>Conclusions</h4>In these remote communities, the heavy use of chloroquine to treat malaria likely selected for ciprofloxacin resistance in E. coli. This may be an important public health problem in malarious areas.
format article
author Ross J Davidson
Ian Davis
Barbara M Willey
Keyro Rizg
Shelly Bolotin
Vanessa Porter
Jane Polsky
Nick Daneman
Allison McGeer
Paul Yang
Dennis Scolnik
Roy Rowsell
Olga Imas
Michael S Silverman
author_facet Ross J Davidson
Ian Davis
Barbara M Willey
Keyro Rizg
Shelly Bolotin
Vanessa Porter
Jane Polsky
Nick Daneman
Allison McGeer
Paul Yang
Dennis Scolnik
Roy Rowsell
Olga Imas
Michael S Silverman
author_sort Ross J Davidson
title Antimalarial therapy selection for quinolone resistance among Escherichia coli in the absence of quinolone exposure, in tropical South America.
title_short Antimalarial therapy selection for quinolone resistance among Escherichia coli in the absence of quinolone exposure, in tropical South America.
title_full Antimalarial therapy selection for quinolone resistance among Escherichia coli in the absence of quinolone exposure, in tropical South America.
title_fullStr Antimalarial therapy selection for quinolone resistance among Escherichia coli in the absence of quinolone exposure, in tropical South America.
title_full_unstemmed Antimalarial therapy selection for quinolone resistance among Escherichia coli in the absence of quinolone exposure, in tropical South America.
title_sort antimalarial therapy selection for quinolone resistance among escherichia coli in the absence of quinolone exposure, in tropical south america.
publisher Public Library of Science (PLoS)
publishDate 2008
url https://doaj.org/article/cb3e719463914f0fabc989a7b51f524f
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