Skip to main content
SpringerLink
Log in

Bacteremia due to fluoroquinolone-resistantEscherichia coli in two immunocompromised patients

  • Notes
  • Published:
European Journal of Clinical Microbiology and Infectious Diseases Aims and scope Submit manuscript

Abstract

Two patients with acute leukemia developedEscherichia coli bacteremia while receiving oral ofloxacin for antibacterial prophylaxis during profound neutropenia. The isolates were resistant to ofloxacin (MIC 25 and 12.5 µg/ml respectively), other fluoroquinolones and several unrelated agents. Whole cell drug accumulation studies with four different fluoroquinolones suggested major differences between drugs but only minor alterations in individual drug permeability in the two resistant isolates compared with a susceptible control strain. In a supercoiling assay using the purified DNA gyrase and plasmid pBR322, high concentrations (≥250 µg/ml) of both ofloxacin and ciprofloxacin were needed for visible inhibition of enzyme activity suggesting mutations in the DNA gyrase gene as the significant mechanism of resistance in both strains.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Rozenberg-Arska M, Dekker AW, Verhoef J Prevention of infections in granulocytopenic patients by fluorinated quinolones. Reviews of Infectious Diseases 1989, 11, Supplement 5: 1231–1236.

    Google Scholar 

  2. Kelly MT, Brenner DJ, Farmer JJ Enterobacteriaceae. In: Lennette EH, Balows A, Hausler WJ, Shadomy HJ (ed): Manual of clinical microbiology. American Society for Microbiology, Washington, DC, 1985, p. 263–277.

    Google Scholar 

  3. Hirai K, Aoyama H, Irikura T, Iyobe S, Mitsuhashi S Differences in susceptibilities to quinolones of outer membrane mutants ofSalmonella typhimurium andEscherichia coli. Antimicrobial Agents and Chemotherapy 1985, 29: 535–538.

    Google Scholar 

  4. Aoyama H, Sato K, Fujii T, Fujimaki K, Inoue M, Mitsuhashi S Purification ofCitrobacter freundii DNA gyrase and inhibition by quinolones. Antimicrobial Agents and Chemotherapy 1988, 32: 104–109.

    PubMed  Google Scholar 

  5. Bedard J, Wong S, Bryan LE Accumulation of enoxacin byEscherichia coli andBacillus subtilis. Antimicrobial Agents and Chemotherapy 1987, 31: 1348–1354.

    PubMed  Google Scholar 

  6. Diver JM, Piddock LJV, Wise R The accumulation of five quinolone antibacterial agents byEscherichia coli. Journal of Antimicrobial Chemotherapy 1990, 25: 319–333.

    PubMed  Google Scholar 

  7. Mitsuyama JI, Itoh Y, Takahata M, Okamoto S, Yasuda T In vitro antibacterial activities of tosufloxacin against and uptake of tosufloxacin by outer membrane mutants ofEscherichia coli, Proteus mirabilis andSalmonella typhimurium. Antimicrobial Agents and Chemotherapy 1992, 36: 2030–2036.

    PubMed  Google Scholar 

  8. Sato K, Inoue Y, Fujii T, Aoyama H, Inoue M, Mitsuhashi S Purification and properties of DNA gyrase from a fluoroquinolone-resistant strain ofEscherichia coli. Antimicrobial Agents and Chemotherapy 1986, 30: 777–780.

    PubMed  Google Scholar 

  9. Dornbusch K andthe European Study Group on Antibiotic Resistance Resistance to β-lactam antibiotics and ciprofloxacin in gram-negative bacilli and staphylococci isolated from blood: a European collaborative study. Journal of Antimicrobial Chemotherapy 1990, 26: 269–278.

    PubMed  Google Scholar 

  10. Hooper DC, Wolfson JS Mode of action of the new quinolones: new data. European Journal of Clinical Microbiology & Infectious Diseases 1991, 10: 223–231.

    Google Scholar 

  11. Cohen SP, McMurry LM, Hooper DC, Wolfson JS, Levy SB Cross-resistance to fluoroquinolones in multiple-antibiotic-resistant (Mar)Escherichia coli selected by tetracycline or chloramphenicol: decreased drug accumulation associated with membrane changes in addition to OmpF reduction. Antimicrobial Agents and Chemotherapy 1989, 33: 1318–1325.

    PubMed  Google Scholar 

  12. Aoyama H, Sato K, Kato T, Hirai K, Mitsuhashi S Norfloxacin resistance in a clinical isolate ofEscherichia coli. Antimicrobial Agents and Chemotherapy 1987, 31: 1640–1641.

    PubMed  Google Scholar 

  13. López-Brea M, Alarcón T Isolation of fluoro-quinolone-resistantEscherichia coli andKlebsiella pneumoniae from an infected Hickman catheter. European Journal of Clinical Microbiology & Infectious Diseases 1990, 9: 345–347.

    Google Scholar 

  14. Moniot-Ville N, Guibert J, Moreau N, Acar JF, Collatz E, Gutmann L Mechanisms of quinolone-resistance in a clinical isolate ofEscherichia coli highly resistant to fluoroquinolones but susceptible to nalidixic acid. Antimicrobial Agents and Chemotherapy 1991, 35: 519–523.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Infectious Diseases, Ulm University Hospital and Medical Center, 89070, Ulm, Germany

    W. V. Kern & E. Andriof

  2. Department of Hematology-Oncology, Ulm University Hospital and Medical Center, 89070, Ulm, Germany

    W. V. Kern

  3. Hoechst AG, 65929, Frankfurt am Main, Germany

    A. Markus

Authors
  1. W. V. Kern
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Markus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. E. Andriof
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kern, W.V., Markus, A. & Andriof, E. Bacteremia due to fluoroquinolone-resistantEscherichia coli in two immunocompromised patients. Eur. J. Clin. Microbiol. Infect. Dis. 13, 161–165 (1994). https://doi.org/10.1007/BF01982191

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01982191

Keywords

Search

Navigation