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Journal of Clinical Microbiology, Sep 1997, 2315-2319, Vol 35, No. 9
S Ozeki, T Deguchi, M Yasuda, M Nakano, T Kawamura, Y Nishino and Y Kawada
The MICs of ofloxacin for 743 strains of Escherichia coli isolated from
1988 to 1994 were determined by testing. The strains were from patients
with urinary tract infections complicated by functional or anatomical
disorders of the urinary tract. Those determined to be ofloxacin resistant
(MIC, > or =12.5 microg/ml) comprised 3 of 395 strains (1.3%) from the
1988 to 1990 group, 2 of 166 strains (1.2%) from the 1991 to 1992 group,
and 7 of 182 strains (3.8%) from the 1993 to 1994 group. The incidence of
resistant strains increased significantly during this period. The
percentage of isolates with moderately decreased susceptibilities to
ofloxacin (MIC, 0.39 to 3.13 microg/ml) also rose during the same period.
To determine the incidence of gyrA mutations in urinary-tract-derived
strains of E. coli, we developed a simple and rapid assay based on PCR
amplification of the region of the gyrA gene containing the mutation sites
followed by digestion of the PCR product with a restriction enzyme. Using
this assay, we examined all 182 strains isolated in 1993 and 1994 for the
presence of mutations at Ser- 83 and Asp-87 in the gyrA gene. Of these
strains, 33 (18.1%) had mutations in the gyrA gene. The incidences of
mutations at Ser-83, at Asp-87, and at both codons were 10.4 (19 strains),
4.4 (8 strains), and 3.3% (6 strains), respectively. To determine the
correlation of the mutations in the gyrA gene with susceptibilities to
quinolones (nalidixic acid, ofloxacin, norfloxacin, and ciprofloxacin), we
further examined 116 strains for which the MICs of ofloxacin were > or
=0.2 microg/ml that were chosen from the isolates in the 1988 to 1992
group. The MICs of nalidixic acid for the strains without mutations at
either Ser-83 or Asp-87 were < or =25 microg/ml, whereas those for the
strains with single mutations or double mutations were from 50 to >800
microg/ml. For the fluoroquinolones, significant differences in the
distributions of the MICs were observed among the strains without
mutations, with single mutations, and with double mutations. The
accumulation of mutations in the gyrA gene was associated with an increase
in fluoroquinolone resistance. Ofloxacin MICs for the majority of the
strains with single and double mutations were 0.39 to 3.13 and 6.25 to 100
microg/ml, respectively. This study demonstrates a chronological increase
in the percentage of not only highly fluoroquinolone-resistant strains,
corresponding to those with double mutations in the gyrA gene, but also
strains with moderately decreased susceptibilities to fluoroquinolones,
corresponding to those with single mutations. This increase in the
incidence of strains with a single mutation in the gyrA gene portends a
further increase in the incidence of strains with clinically significant
resistance to fluoroquinolones.
Copyright © 1997 by the American Society for Microbiology. All rights reserved.
Development of a rapid assay for detecting gyrA mutations in Escherichia coli and determination of incidence of gyrA mutations in clinical strains isolated from patients with complicated urinary tract infections
Department of Urology, Gifu University School of Medicine, Gifu City, Japan.
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