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首页> 外文期刊>Journal of Clinical Microbiology >Development of a Pefloxacin Disk Diffusion Method for Detection of Fluoroquinolone-Resistant Salmonella enterica
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Development of a Pefloxacin Disk Diffusion Method for Detection of Fluoroquinolone-Resistant Salmonella enterica

机译：培氟沙星圆盘扩散法检测耐氟喹诺酮肠炎沙门氏菌的研究进展

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Fluoroquinolones (FQs) are among the drugs of choice for treatment of Salmonella infections. However, fluoroquinolone resistance is increasing in Salmonella due to chromosomal mutations in the quinolone resistance-determining regions (QRDRs) of the topoisomerase genes gyrA, gyrB, parC, and parE and/or plasmid-mediated quinolone resistance (PMQR) mechanisms including qnr variants, aac(6′)-Ib-cr, qepA, and oqxAB. Some of these mutations cause only subtle increases in the MIC, i.e., MICs ranging from 0.12 to 0.25 mg/liter for ciprofloxacin (just above the wild-type MIC of ≤0.06 mg/liter). These isolates are difficult to detect with standard ciprofloxacin disk diffusion, and plasmid-mediated resistance, such as qnr, is often not detected by the nalidixic acid screen test. We evaluated 16 quinolone/fluoroquinolone disks for their ability to detect low-level-resistant Salmonella enterica isolates that are not serotype Typhi. A total of 153 Salmonella isolates characterized for the presence (n = 104) or absence (n = 49) of gyrA and/or parC topoisomerase mutations, qnrA, qnrB, qnrD, qnrS, aac(6′)-Ib-cr, or qepA genes were investigated. All isolates were MIC tested by broth microdilution against ciprofloxacin, levofloxacin, and ofloxacin and by disk diffusion using EUCAST or CLSI methodology. MIC determination correctly categorized all isolates as either wild-type isolates (MIC of ≤0.06 mg/liter and absence of resistance genes) or non-wild-type isolates (MIC of >0.06 mg/liter and presence of a resistance gene). Disk diffusion using these antibiotics and nalidixic acid failed to detect some low-level-resistant isolates, whereas the 5-μg pefloxacin disk correctly identified all resistant isolates. However, pefloxacin will not detect isolates having aac(6′)-Ib-cr as the only resistance determinant. The pefloxacin disk assay was approved and implemented by EUCAST (in 2014) and CLSI (in 2015).
机译：氟喹诺酮类药物（FQs）是用于治疗沙门氏菌感染的首选药物。然而，由于拓扑异构酶基因 gyrA ， gyrB ， parC 和 parE 和/或质粒介导的喹诺酮耐药性（PMQR）机制，包括 qnr 变体， aac （ 6 '）- Ib-cr ， qepA 和 oqxAB 。这些突变中的一些仅引起MIC的细微增加，即环丙沙星的MIC从0.12至0.25 mg / L不等（略高于≤≤0.06mg / L的野生型MIC）。用标准环丙沙星盘片扩散很难检测到这些分离物，并且萘啶酸筛选试验通常无法检测到质粒介导的抗性，例如 qnr 。我们评估了16种喹诺酮/氟喹诺酮片的检测非血清型伤寒沙门氏菌的低水平耐药性的能力。共有153株沙门氏菌分离株，其特征是 gyrA 和/或存在（ n = 104）或不存在（ n = 49） > parC 拓扑异构酶突变， qnrA ， qnrB ， qnrD ， qnrS ， aac < / em>（ 6 '）- Ib-cr 或 qepA 基因。通过对环丙沙星，左氧氟沙星和氧氟沙星的肉汤微量稀释，并使用EUCAST或CLSI方法通过盘扩散对所有分离物进行MIC检测。 MIC测定正确地将所有分离物归类为野生型分离物（MIC≤0.06mg / L，并且没有抗性基因）或非野生型分离物（MIC> 0.06 mg / L，并且有抗性基因）。使用这些抗生素和萘啶酸的圆盘扩散法未能检测到一些低水平耐药菌，而5μg培氟沙星圆盘正确地鉴定了所有耐药菌。但是，培氟沙星不会检测到具有 aac （ 6 '）- Ib-cr 作为唯一抗性决定因素的分离株。培氟沙星圆盘测定法已获EUCAST（2014年）和CLSI（2015年）批准并实施。

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