Resistance profiles to fluoroquinolones in clinical isolates of Gram positive cocci
Keywords:
fluoroquinolones, Streptococcus pneumoniae, Staphylococcus aureus, Enterococcus, drug resistance, microbial, Colombia
Abstract
Introduction. Fluoroquinolones are broad spectrum antibiotics commonly used in the treatment of infections.Objective. Resistance profiles of coccus bacteria to fluoroquinolones were evaluated in isolates of Streptococcus pneumoniae, Staphylococcus aureus, coagulase negative staphylococci and Enterococcus spp. The samples were recovered from Colombian hospitals between 1994 and 2004.
Materials and methods. The minimal inhibitory concentration of ciprofloxacin, moxifloxacin and gatifloxacin was determined in 270 clinical isolates of S. pneumoniae, 348 of S. aureus, 176 of coagulase negative staphylococci and 123 of coagulase-negative enterococci. The minimal inhibitory concentration of levofloxacin was also determined in all isolates of methicillin-resistant S. aureus. An agar diffusion susceptibility test with disks of levofloxacin and ofloxacin was also applied to all isolates of S. pneumoniae.
Results. A total of 269 (99.6%) isolates of S. pneumoniae were susceptible to moxifloxacin and gatifloxacin. For levofloxacin and ofloxacin, resistance in S. pneumoniae was found in 1.5% and 8.9% of isolates, respectively. The ciprofloxacin minimal inhibitory concentration was >4 µg/ml in 15.9% of pneumococcal isolates. The rates of resistance to ciprofloxacin, gatifloxacin and moxifloxacin in the 348 S. aureus isolates were 55.4%, 54.9% and 52.6%, respectively; increasing to 92.3%, 91.3% and 87.5%, respectively in methicillin resistant isolates. Resistance to levofloxacin was found in 91.8% of MRSA isolates. The rates of resistance to ciprofloxacin, gatifloxacin and moxifloxacin in coagulase negative staphylococci and vancomycin-susceptible enterococci were between 25.6% and 31.8%. All vancomycin-resistant enterococci were resistant to all fluroquinolones tested.
Conclusion. The newer fluoroquinolones have maintained effective activity against clinical isolates of S. pneumoniae. The rates of fluoroquinolone resistance in S. aureus were very high, particularly in methicillin resistant isolates (approaching 100%).
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References
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7. Tran JH, Jacoby GA. Mechanism of plasmid-mediated quinolone resistance. Proc Natl Acad Sci USA. 2002;99: 5638-42.
8. Ruiz J. Mechanisms of resistance to quinolones: target alterations, decreased accumulation and DNA gyrase protection. J Antimicrob Chemother. 2003;51:1109-17.
9. Arsene S, Leclercq R. Role of a qnr-like gene in the intrinsic resistance of Enterococcus faecalis to fluoroquinolones. Antimicrob Agents Chemother. 2007;51:3254-8.
10. Arias CA, Reyes J, Zuñiga M, Cortés L, Cruz C, Rico CL, et al. Multicentre surveillance of antimicrobial resistance in enterococci and staphylococci from Colombian hospitals, 2001-2002. J Antimicrob Chemother. 2003;51:59-68.
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12. Grupo de Microbiología. Streptococcus pneumoniae aislamientos invasores. Consultado: 19 de septiembre 2006.Disponible en: http://www.ins.gov.co/pdf_investiga/Microbiologia_spn_005.pdf.
13. Organización Panamericana de la Salud. Programa de Vigilancia de los serotipos y resistencia antimicrobiana de Streptococcus pneumonaie y Haemophilus influenzae. Manual de Procedimientos. Consultado: 3 de marzo de 2006. Disponible en:http://www.paho.org/Spanish/AD/THS/EV/LABS-manual-vigilancia-serotipos.pdf.
14. Agudelo CI, Moreno J, Sanabria OM, Ovalle MV, Di Fabio JL, Castañeda E, et al. Streptococcus pneumoniae: evolución de los serotipos y los patrones de susceptibilidad antimicrobiana en aislamientos invasores en 11 años de vigilancia en Colombia (1994- 2004). Biomédica. 2006;26:234-49.
15. Martineau F, Picard FJ, Lansac N, Ménard C, Roy PH, Ouellette M, et al. Correlation between the resistance genotype determined by multiplex PCR assays and the antibiotic susceptibility patterns of Staphylococcus aureus and Staphylococcus epidermidis. Antimicrob Agents Chemother. 2000;44: 231-8.
16. Dutka-Malen S, Evers S, Courvalin P. Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR. J Clin Microbiol. 1995;33:24-7.
17. Woodford N, Egelton CM, Morrison D. Comparison of PCR with phenotypic methods for the speciation of enterococci. Adv Exp Med Biol. 1997;418:405-8.
18. Reyes J, Hidalgo M, Díaz L, Rincón S, Moreno J, Vanegas N, et al. Characterization of macrolide resistance in Gram-positive cocci from Colombian hospitals: a countrywide surveillance. Int J Infect Dis. 2007;11:329-36.
19. Cruz C, Moreno J, Renzoni A, Hidalgo M, Reyes J, Schrenzel J, et al. Tracking methicillin-resistant Staphylococcus aureus clones in Colombian hospitals over 7 years (1996-2003): emergence of a new dominant clone. Int J Antimicrob Agents. 2005;26:457-62.
20. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Fifteenth Informational Supplement. M7-A6 Methods for dilution antimicrobial susceptibility test for bacteria that grow aerobically: Approved Standard. Sixth Edition. Wayne, Pennsylvania: CLSI; 2005.
21. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Fifteenth Informational Supplement. M2-A8 Performance standards for antimicrobial disk susceptibility test; Approved standard. Eighth edition. Wayne, Pennsylvania: CLSI; 2005.
22. López H, Sader H, Amábile C, Pedreira W, Muñoz-Bellido JL, García-Rodríguez JA, et al. in vitro activity of moxifloxacin against respiratory pathogens in Latin America. Rev Esp Quimioter. 2002;15:325-34
23. Adam HJ, Schurek KN, Nichol KA, Hoban CJ, Baudry TJ, Laing DJ, et al. Molecular characterization of increasing fluoroquinolone resistance in Streptococcus pneumoniae in Canada 1997 to 2005. Antimicrob Agents Chemother. 2007;51:198-207.
24. Song JH, Jung SI, Ko KS, Kim NY, Son JS, Chang HH, et al. High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study). Antimicrob Agents Chemother. 2004;48:2101-7.
25. Ip M, Chau SSL, Chi F, Cheuk ES, Ma H, Lai RW, et al. Longitudinally tracking fluoroquinolone resistance and its determinants in penicillin-susceptible and non-susceptible Streptococcus pneumoniae isolates in Hong Kong, 2000-2005. Antimicrob Agents Chemother. 2007; 51:2192-4.
26. Pérez-Trallero E, Fernández-Mazarrasa C, García-Rey C, Bouza E, Aguilar L, García-de-Lomas J, et al. Spanish Surveillance Group for Respiratory Pathogens. Antimicrobial susceptibilities of 1,684 Streptococcus pneumoniae and 2,039 Streptococcus pyogenes isolates and their ecological relationships: results of a 1-year (1998-1999) multicenter surveillance study in Spain. Antimicrob Agents Chemother. 2001;45: 3334-40.
27. Mandell LA, Bartlett JG, Dowell SF, File TM, Musher DM, Whitney C, et al. Update of practice guidelines for the management of community-acquired pneumonia in immunocompetent adults. Clin Infect Dis. 2003;37: 1405-33.
28. Ambrose PG, Bast D, Doern GV, Iannini PB, Jones RN, Klugman KP, et al. Fluoroquinolone-resistant Streptococcus pneumoniae, an emerging but unrecognized public health concern: is it time to resight the goalposts? Clin Infect Dis. 2004;39:1554-6.
29. Fuller JD, Low D. A review of Streptococcus pneumoniae infection treatment failures associated with fluoroquinolone resistance. Clin Infect Dis. 2005;41: 118-21.
30. Legg JM, Bint AJ. Will pneumococci put quinolones in their place? J Antimicrob Chemother. 1999;44:425-7.
31. Niederman MS. Challenges in the management of community-acquired pneumonia: the role of quinolones and moxifloxacin. Clin Infect Dis. 2005;41:S158-66.
32. Dobay O, Rozgonyi F, Ghidán A, Matuz M, Nagy K, Amyes SG. The first steps towards fluoroquinolone resistance in Hungarian pneumococci. J Chemother. 2006;18:624-7.
33. Dias R, Louro D, The Antimicrobial Resistance Surveillance Program in Portugal, Caniça M. Antimicrobial susceptibility of invasive Streptococcus pneumoniae isolates in Portugal over an 11-Year Period. Antimicrob Agents Chemother. 2006;50:2098-105.
34. Jones ME, Blosser-Middleton RS, Thornsberry C, Karlowsky JA, Sahm DF. The activity of levofloxacin and other antimicrobials against clinical isolates of Streptococcus pneumon iae collected worldwide during 1999-2002. Diagn Microbiol Infect Dis. 2003;47:579- 86.
35. Ho PL, Yung RW, Tsang DN, Que TL, Ho M, Seto WH. Increasing resistance of Streptococcus pneumoniae to fluoroquinolones: results of a Hong Kong multicentre study in 2000. J Antimicrob Chemother. 2001; 48:659-65.
36. Richter SS, Heilmann KP, Beekmann SE, Miller NJ, Rice CL, Doern GV. The molecular epidemiology of Streptococcus pneumoniae with quinolone resistant mutations. Clin Infect Dis. 2005;40:225-35.
37. Karlowsky JA, Jones ME, Draghi DC, Thornsberry C, Sahm DF, Volturo GA. Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States in 2002. Ann Clin Microbiol Antimicrob. 2004;10:3-7.
38. Canton R, Morosini M, Enright MC, Morrissey I. Worldwide incidence, molecular epidemiology and mutations implicated in fluoroquinolone-resistant Streptococcus pneumoniae: data from the global PROTEKT surveillance programme. J Antimicrob Chemother. 2003;52:944-52.
39. Andrews J, Ashby J, Jevons G, Marshall T, Lines N, Wise R. A comparison of antimicrobial resistance rates in Gram-positive pathogens isolated in the UK from October 1996 to January 1997 and October 1997 to January 1998. J Antimicrob Chemother. 2000;45: 285-93.
40. El Kholy A, Baseem H, Hall GS, Procop GW, Longworth DL. Antimicrobial resistance in Cairo, Egypt 1999-2000: a survey of five hospitals. J Antimicrob Chemother. 2003;51:625-30.
41. Decousser JW, Pina P, Picot F, Delalande C, Pangon B, Courvalin P, et al. Frequency of isolation and antimicrobial susceptibility of bacterial pathogens isolated from patients with bloodstream infections: a French prospective national survey. J Antimicrob Chemother. 2003;51:1213-22.
42. Blumberg HM, Rimland D, Carroll DJ, Terry P, Wachsmuth IK. Rapid development of ciprofloxacin resistance in methicillin-susceptible and methicillin-resistant Staphylococcus aureus. J Infect Dis. 1991; 163:1279-85.
43. Zangrillo A, Landoni G, Fumagalli L, Bove T, Bellotti F, Sottocorna O, et al. Methicillin-resistant Staphylococcus species in a cardiac surgical intensive care unit: a 5-year experience. J Cardiothorac Vasc Anesth. 2006;20:31-7.
44. Klevens M. Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992-2003 . Clin Infect Dis. 2006;42: 389-91.
45. Reynolds R, Potz N, Colman M, Williams A, Livermore D, MacGowan A, et al. Antimicrobial susceptibility of the pathogens of bacteraemia in the UK and Ireland 2001-2002: the BSAC Bacteraemia Resistance Surveillance Programme. J Antimicrob Chemother. 2004;53:1018-32.
46. Andrade SS, Sader HS, Jones RN, Pereira AS, Pignatari AC, Gales AC. Increased resistance to first-line agents among bacterial pathogens isolated from urinary tract infections in Latin America: time for local guidelines? Mem Inst Oswaldo Cruz. 2006;101:741-8.
47. Deshpande LM, Fritsche TR, Moet GJ, Biedenbach DJ, Jones RN. Antimicrobial resistance and molecular epidemiology of vancomycin-resistant enterococci from North America and Europe: a report from the SENTRY antimicrobial surveillance program. Diagn Microbiol Infect Dis. 2007;58:163-70.
48. Aires De Sousa M, Miragaia M, Sanches IS, Avila S, Adamson I, Casagrande ST, et al. Three-year assessment of methicillin-resistant Staphylococcus aureus clones in Latin America from 1996 to 1998. J Clin Microbiol. 2001;39:2197-205.
49. Weber SG, Gold HS, Hooper DC, Karchmer AW, Carmeli Y. Fluoroquinolones and the risk for methicillin-resistant Staphylococcus aureus in hospitalized patients. Emerg Infect Dis. 2003;9:1415-22.
50. Loo VG, Poirier L, Miller MA, Oughton M, Libman MD, Michaud S, et al. A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med. 2005;8;353:2442-9.
51. Sanders CC. Mechanisms responsible for cross-resistance and dichotomous resistance among the quinolones. Clin Infect Dis. 2001;32(Suppl.1):S1-8.
52. Rodríguez-Martínez JM. Mechanisms of plasmid-mediated resistance to quinolones. Enferm Infecc Microbiol Clin. 2005;23:25-31.
53. Álvarez CA, Barrientes OJ, Leal AL, Contreras GA, Barrero L, Rincón S, et al. Community-associated methicillin-resistant Staphylococcus aureus, Colombia. Emerg Infect Dis. 2006;12:2000-1.
2. Hopper DC. New uses for new and old quinolones and challenge of resistance. Clin Infect Dis. 2000;30:243-54.
3. Hooper DC. Fluoroquinolone resistance among Gram-positive cocci. Lancet Infect Dis. 2002;2:530-8.
4. Saravolatz LD, Leggett J. Gatifloxacin, gemifloxacin, and moxifloxacin: the role of 3 newer fluoroquinolones. Clin Infect Dis. 2003;37:1210-5.
5. Jacoby GA. Mechanisms of resistance to quinolones. Clin Infect Dis. 2005;41:S120-6.
6. Schmitz FJ, Higgins PG, Mayer S, Fluit AC, Dalhof A. Activity of quinolones against Gram positive cocci: Mechanisms of drug action and bacterial resistance. Eur J Clin Microbiol Infect Dis. 2002;21:647-59.
7. Tran JH, Jacoby GA. Mechanism of plasmid-mediated quinolone resistance. Proc Natl Acad Sci USA. 2002;99: 5638-42.
8. Ruiz J. Mechanisms of resistance to quinolones: target alterations, decreased accumulation and DNA gyrase protection. J Antimicrob Chemother. 2003;51:1109-17.
9. Arsene S, Leclercq R. Role of a qnr-like gene in the intrinsic resistance of Enterococcus faecalis to fluoroquinolones. Antimicrob Agents Chemother. 2007;51:3254-8.
10. Arias CA, Reyes J, Zuñiga M, Cortés L, Cruz C, Rico CL, et al. Multicentre surveillance of antimicrobial resistance in enterococci and staphylococci from Colombian hospitals, 2001-2002. J Antimicrob Chemother. 2003;51:59-68.
11. Álvarez C, Cortés J, Arango A, Correa C, Leal A, Grupo para el Control de la Resistencia Bacteriana en Bogotá. Antimicrobial resistance in intensive care units in Bogotá, Colombia, 2001-2003. Rev Salud Pública (Bogotá). 2006;8(Suppl.1):86-101.
12. Grupo de Microbiología. Streptococcus pneumoniae aislamientos invasores. Consultado: 19 de septiembre 2006.Disponible en: http://www.ins.gov.co/pdf_investiga/Microbiologia_spn_005.pdf.
13. Organización Panamericana de la Salud. Programa de Vigilancia de los serotipos y resistencia antimicrobiana de Streptococcus pneumonaie y Haemophilus influenzae. Manual de Procedimientos. Consultado: 3 de marzo de 2006. Disponible en:http://www.paho.org/Spanish/AD/THS/EV/LABS-manual-vigilancia-serotipos.pdf.
14. Agudelo CI, Moreno J, Sanabria OM, Ovalle MV, Di Fabio JL, Castañeda E, et al. Streptococcus pneumoniae: evolución de los serotipos y los patrones de susceptibilidad antimicrobiana en aislamientos invasores en 11 años de vigilancia en Colombia (1994- 2004). Biomédica. 2006;26:234-49.
15. Martineau F, Picard FJ, Lansac N, Ménard C, Roy PH, Ouellette M, et al. Correlation between the resistance genotype determined by multiplex PCR assays and the antibiotic susceptibility patterns of Staphylococcus aureus and Staphylococcus epidermidis. Antimicrob Agents Chemother. 2000;44: 231-8.
16. Dutka-Malen S, Evers S, Courvalin P. Detection of glycopeptide resistance genotypes and identification to the species level of clinically relevant enterococci by PCR. J Clin Microbiol. 1995;33:24-7.
17. Woodford N, Egelton CM, Morrison D. Comparison of PCR with phenotypic methods for the speciation of enterococci. Adv Exp Med Biol. 1997;418:405-8.
18. Reyes J, Hidalgo M, Díaz L, Rincón S, Moreno J, Vanegas N, et al. Characterization of macrolide resistance in Gram-positive cocci from Colombian hospitals: a countrywide surveillance. Int J Infect Dis. 2007;11:329-36.
19. Cruz C, Moreno J, Renzoni A, Hidalgo M, Reyes J, Schrenzel J, et al. Tracking methicillin-resistant Staphylococcus aureus clones in Colombian hospitals over 7 years (1996-2003): emergence of a new dominant clone. Int J Antimicrob Agents. 2005;26:457-62.
20. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Fifteenth Informational Supplement. M7-A6 Methods for dilution antimicrobial susceptibility test for bacteria that grow aerobically: Approved Standard. Sixth Edition. Wayne, Pennsylvania: CLSI; 2005.
21. Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: Fifteenth Informational Supplement. M2-A8 Performance standards for antimicrobial disk susceptibility test; Approved standard. Eighth edition. Wayne, Pennsylvania: CLSI; 2005.
22. López H, Sader H, Amábile C, Pedreira W, Muñoz-Bellido JL, García-Rodríguez JA, et al. in vitro activity of moxifloxacin against respiratory pathogens in Latin America. Rev Esp Quimioter. 2002;15:325-34
23. Adam HJ, Schurek KN, Nichol KA, Hoban CJ, Baudry TJ, Laing DJ, et al. Molecular characterization of increasing fluoroquinolone resistance in Streptococcus pneumoniae in Canada 1997 to 2005. Antimicrob Agents Chemother. 2007;51:198-207.
24. Song JH, Jung SI, Ko KS, Kim NY, Son JS, Chang HH, et al. High prevalence of antimicrobial resistance among clinical Streptococcus pneumoniae isolates in Asia (an ANSORP study). Antimicrob Agents Chemother. 2004;48:2101-7.
25. Ip M, Chau SSL, Chi F, Cheuk ES, Ma H, Lai RW, et al. Longitudinally tracking fluoroquinolone resistance and its determinants in penicillin-susceptible and non-susceptible Streptococcus pneumoniae isolates in Hong Kong, 2000-2005. Antimicrob Agents Chemother. 2007; 51:2192-4.
26. Pérez-Trallero E, Fernández-Mazarrasa C, García-Rey C, Bouza E, Aguilar L, García-de-Lomas J, et al. Spanish Surveillance Group for Respiratory Pathogens. Antimicrobial susceptibilities of 1,684 Streptococcus pneumoniae and 2,039 Streptococcus pyogenes isolates and their ecological relationships: results of a 1-year (1998-1999) multicenter surveillance study in Spain. Antimicrob Agents Chemother. 2001;45: 3334-40.
27. Mandell LA, Bartlett JG, Dowell SF, File TM, Musher DM, Whitney C, et al. Update of practice guidelines for the management of community-acquired pneumonia in immunocompetent adults. Clin Infect Dis. 2003;37: 1405-33.
28. Ambrose PG, Bast D, Doern GV, Iannini PB, Jones RN, Klugman KP, et al. Fluoroquinolone-resistant Streptococcus pneumoniae, an emerging but unrecognized public health concern: is it time to resight the goalposts? Clin Infect Dis. 2004;39:1554-6.
29. Fuller JD, Low D. A review of Streptococcus pneumoniae infection treatment failures associated with fluoroquinolone resistance. Clin Infect Dis. 2005;41: 118-21.
30. Legg JM, Bint AJ. Will pneumococci put quinolones in their place? J Antimicrob Chemother. 1999;44:425-7.
31. Niederman MS. Challenges in the management of community-acquired pneumonia: the role of quinolones and moxifloxacin. Clin Infect Dis. 2005;41:S158-66.
32. Dobay O, Rozgonyi F, Ghidán A, Matuz M, Nagy K, Amyes SG. The first steps towards fluoroquinolone resistance in Hungarian pneumococci. J Chemother. 2006;18:624-7.
33. Dias R, Louro D, The Antimicrobial Resistance Surveillance Program in Portugal, Caniça M. Antimicrobial susceptibility of invasive Streptococcus pneumoniae isolates in Portugal over an 11-Year Period. Antimicrob Agents Chemother. 2006;50:2098-105.
34. Jones ME, Blosser-Middleton RS, Thornsberry C, Karlowsky JA, Sahm DF. The activity of levofloxacin and other antimicrobials against clinical isolates of Streptococcus pneumon iae collected worldwide during 1999-2002. Diagn Microbiol Infect Dis. 2003;47:579- 86.
35. Ho PL, Yung RW, Tsang DN, Que TL, Ho M, Seto WH. Increasing resistance of Streptococcus pneumoniae to fluoroquinolones: results of a Hong Kong multicentre study in 2000. J Antimicrob Chemother. 2001; 48:659-65.
36. Richter SS, Heilmann KP, Beekmann SE, Miller NJ, Rice CL, Doern GV. The molecular epidemiology of Streptococcus pneumoniae with quinolone resistant mutations. Clin Infect Dis. 2005;40:225-35.
37. Karlowsky JA, Jones ME, Draghi DC, Thornsberry C, Sahm DF, Volturo GA. Prevalence and antimicrobial susceptibilities of bacteria isolated from blood cultures of hospitalized patients in the United States in 2002. Ann Clin Microbiol Antimicrob. 2004;10:3-7.
38. Canton R, Morosini M, Enright MC, Morrissey I. Worldwide incidence, molecular epidemiology and mutations implicated in fluoroquinolone-resistant Streptococcus pneumoniae: data from the global PROTEKT surveillance programme. J Antimicrob Chemother. 2003;52:944-52.
39. Andrews J, Ashby J, Jevons G, Marshall T, Lines N, Wise R. A comparison of antimicrobial resistance rates in Gram-positive pathogens isolated in the UK from October 1996 to January 1997 and October 1997 to January 1998. J Antimicrob Chemother. 2000;45: 285-93.
40. El Kholy A, Baseem H, Hall GS, Procop GW, Longworth DL. Antimicrobial resistance in Cairo, Egypt 1999-2000: a survey of five hospitals. J Antimicrob Chemother. 2003;51:625-30.
41. Decousser JW, Pina P, Picot F, Delalande C, Pangon B, Courvalin P, et al. Frequency of isolation and antimicrobial susceptibility of bacterial pathogens isolated from patients with bloodstream infections: a French prospective national survey. J Antimicrob Chemother. 2003;51:1213-22.
42. Blumberg HM, Rimland D, Carroll DJ, Terry P, Wachsmuth IK. Rapid development of ciprofloxacin resistance in methicillin-susceptible and methicillin-resistant Staphylococcus aureus. J Infect Dis. 1991; 163:1279-85.
43. Zangrillo A, Landoni G, Fumagalli L, Bove T, Bellotti F, Sottocorna O, et al. Methicillin-resistant Staphylococcus species in a cardiac surgical intensive care unit: a 5-year experience. J Cardiothorac Vasc Anesth. 2006;20:31-7.
44. Klevens M. Changes in the epidemiology of methicillin-resistant Staphylococcus aureus in intensive care units in US hospitals, 1992-2003 . Clin Infect Dis. 2006;42: 389-91.
45. Reynolds R, Potz N, Colman M, Williams A, Livermore D, MacGowan A, et al. Antimicrobial susceptibility of the pathogens of bacteraemia in the UK and Ireland 2001-2002: the BSAC Bacteraemia Resistance Surveillance Programme. J Antimicrob Chemother. 2004;53:1018-32.
46. Andrade SS, Sader HS, Jones RN, Pereira AS, Pignatari AC, Gales AC. Increased resistance to first-line agents among bacterial pathogens isolated from urinary tract infections in Latin America: time for local guidelines? Mem Inst Oswaldo Cruz. 2006;101:741-8.
47. Deshpande LM, Fritsche TR, Moet GJ, Biedenbach DJ, Jones RN. Antimicrobial resistance and molecular epidemiology of vancomycin-resistant enterococci from North America and Europe: a report from the SENTRY antimicrobial surveillance program. Diagn Microbiol Infect Dis. 2007;58:163-70.
48. Aires De Sousa M, Miragaia M, Sanches IS, Avila S, Adamson I, Casagrande ST, et al. Three-year assessment of methicillin-resistant Staphylococcus aureus clones in Latin America from 1996 to 1998. J Clin Microbiol. 2001;39:2197-205.
49. Weber SG, Gold HS, Hooper DC, Karchmer AW, Carmeli Y. Fluoroquinolones and the risk for methicillin-resistant Staphylococcus aureus in hospitalized patients. Emerg Infect Dis. 2003;9:1415-22.
50. Loo VG, Poirier L, Miller MA, Oughton M, Libman MD, Michaud S, et al. A predominantly clonal multi-institutional outbreak of Clostridium difficile-associated diarrhea with high morbidity and mortality. N Engl J Med. 2005;8;353:2442-9.
51. Sanders CC. Mechanisms responsible for cross-resistance and dichotomous resistance among the quinolones. Clin Infect Dis. 2001;32(Suppl.1):S1-8.
52. Rodríguez-Martínez JM. Mechanisms of plasmid-mediated resistance to quinolones. Enferm Infecc Microbiol Clin. 2005;23:25-31.
53. Álvarez CA, Barrientes OJ, Leal AL, Contreras GA, Barrero L, Rincón S, et al. Community-associated methicillin-resistant Staphylococcus aureus, Colombia. Emerg Infect Dis. 2006;12:2000-1.
How to Cite
1.
Arias CA, Hidalgo M, Reyes J, Cárdenas AM, Díaz L, Ríncon S, et al. Resistance profiles to fluoroquinolones in clinical isolates of Gram positive cocci. biomedica [Internet]. 2008 Jun. 1 [cited 2024 May 11];28(2):284-9. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/99
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