913 THE MECHANISMS AND RISK FACTORS FOR FLUOROQUINOLONE-RESISTANCE IN ENTEROCOCCUS FAECALIS STRAINS CLINICALLY ISOLATED FROM URINARY TRACT INFECTION PATIENTS

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Kidney & Bladder1 Apr 2012913 THE MECHANISMS AND RISK FACTORS FOR FLUOROQUINOLONE-RESISTANCE IN ENTEROCOCCUS FAECALIS STRAINS CLINICALLY ISOLATED FROM URINARY TRACT INFECTION PATIENTS Tomihiko Yasufuku, Katsumi Shigemura, Minori Matsumoto, Yuzo Nakano, Toshiro Shirakawa, Kazushi Yanaka, Masato Kawabata, Soichi Arakawa, and Masato Fujisawa Tomihiko YasufukuTomihiko Yasufuku Kobe, Japan More articles by this author , Katsumi ShigemuraKatsumi Shigemura Kobe, Japan More articles by this author , Minori MatsumotoMinori Matsumoto Kobe, Japan More articles by this author , Yuzo NakanoYuzo Nakano Kobe, Japan More articles by this author , Toshiro ShirakawaToshiro Shirakawa Kobe, Japan More articles by this author , Kazushi YanakaKazushi Yanaka Kobe, Japan More articles by this author , Masato KawabataMasato Kawabata Kobe, Japan More articles by this author , Soichi ArakawaSoichi Arakawa Kobe, Japan More articles by this author , and Masato FujisawaMasato Fujisawa Kobe, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1009AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Enterococcus faecalis (E. faecalis) isolated from urinary tract infection (UTI) patients often demonstrates antibiotic resistance. The emergence of fluoroquinolone resistant strains have become problem even though fluoroquinolones were frequently used to treat UTI patients. The objective of this study is to investigate the mechanism and risk factors for fluoroquinolone resistance in E. faecalis causing UTI. METHODS We examined the minimum inhibitory concentration (MIC) in levofloxacin (LVFX) and amino acid mutations by direct DNA sequence in 100 clinical isolates of E. faecalis isolated from UTI patients. We set risk factors for LVFX resistance such as age, sex, the number of significant amino acid mutations, and the previous use of fluoroquinolone. The correlation of risk factors with LVFX resistance and with the presence of amino acid mutations was investigated. RESULTS We demonstrated 4 mutations (Ser83-to-Ile and Glu87-to-Lys in gyrA and Ser80-to-Ile and Glu84-to-Val in parC) in the quinolone resistance determining regions (QRDR) in E. faecalis strains clinically isolated from UTI patients. Among all isolates tested, 18 (18.0%) isolates had amino acid mutations and 14 (14.0%) isolates were resistant to LVFX. All LVFX-resistant isolates had amino acid mutations in the QRDR and the isolates which had more than 2 mutations significantly related to LVFX resistance. We revealed that the previous use of fluoroquinolones was significantly related to LVFX resistance (p = 0.015) and the presence of amino acid mutations (p = 0.040) by multivariate analyses. We had 77 isolates from complicated UTI and 23 isolates from uncomplicated UTI from the classificationn of the presence of urinary tract underlying diseases. Sixteen isolates from complicated UTI (20.8%) had amino acid mutations and 2 isolates (16.9%) were resistant to LVFX. On the other hand, 2 isolates from uncomplicated UTI (8.70%) had amino acid mutations and only one isolate (4.3%) was resistant to LVFX. The previous use of fluoroquinolones and other types of antibiotics were significantly associated with LVFX resistance in complicated UTI cases. CONCLUSIONS We demonstrated that amino acid mutations in the QRDR related to fluoroquinolone resistance in E. faecalis and found that there was a significant correlation between the number of amino acid mutations and LVFX resistance. We also revealed that the previous use of fluoroquinolones related to not only LVFX resistance but the presence of amino acid mutations in the QRDR. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e372 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tomihiko Yasufuku Kobe, Japan More articles by this author Katsumi Shigemura Kobe, Japan More articles by this author Minori Matsumoto Kobe, Japan More articles by this author Yuzo Nakano Kobe, Japan More articles by this author Toshiro Shirakawa Kobe, Japan More articles by this author Kazushi Yanaka Kobe, Japan More articles by this author Masato Kawabata Kobe, Japan More articles by this author Soichi Arakawa Kobe, Japan More articles by this author Masato Fujisawa Kobe, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...