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Levofloxacin Efflux and smeD in Clinical Isolates of Stenotrophomonas maltophilia

Title
Levofloxacin Efflux and smeD in Clinical Isolates of Stenotrophomonas maltophilia
Authors
Chong, So YoungLee, KyungwonChung, Hae-SunHong, Seong GeunSuh, YoungheeChong, Yunsop
Ewha Authors
정혜선
SCOPUS Author ID
정혜선scopus
Issue Date
2017
Journal Title
MICROBIAL DRUG RESISTANCE
ISSN
1076-6294JCR Link1931-8448JCR Link
Citation
vol. 23, no. 2, pp. 163 - 168
Keywords
Stenotrophomonas maltophilialevofloxacin resistanceSmeDEF pumpbiocide
Publisher
MARY ANN LIEBERT, INC
Indexed
SCI; SCIE; SCOPUS WOS
Abstract
Trimethoprim-sulfamethoxazole is the first-line antimicrobial combination for Stenotrophomonas maltophilia infections. However, allergy or intolerance and increasing resistance limit the use of trimethoprim-sulfamethoxazole. Quinolones can be used as an alternative therapeutic option, but resistance can emerge rapidly during therapy. We analyzed the contribution of SmeABC and SmeDEF efflux pumps to levofloxacin resistance in clinical isolates of S. maltophilia. Nonduplicate clinical isolates of S. maltophilia were collected in 2010 from 11 university hospitals (n=102). Fifty-five levofloxacin nonsusceptible (minimum inhibitory concentration [MIC] 4g/ml) and 47 susceptible (MIC 2g/ml) isolates were tested for efflux pump overexpression. Real-time reverse transcription-PCR was performed for amplification and quantification of smeB, smeC, smeD, and smeF mRNA. To determine which antimicrobials were affected by smeD overexpression, the growth rates of a levofloxacin-susceptible S. maltophilia isolate were compared by measuring absorbance of antimicrobial-supplemented Luria-Bertani broth (LB) cultures with or without triclosan. Significant relationships between sme gene overexpression and resistance were observed for smeD against levofloxacin, smeC and smeF against ceftazidime, and smeC against ticarcillin-clavulanate. The mean MICs of moxifloxacin and tigecycline did not significantly differ for isolates with or without overexpression of smeB, smeC, and smeF, but were significantly higher for isolates with smeD overexpression. The mean MICs of amikacin were significantly higher for smeC or smeF overexpressing isolates. Increased growth of a levofloxacin-susceptible isolate was observed in LB with 1/2 MIC levofloxacin in the presence of triclosan. These data suggest that the expression of smeD plays a role in levofloxacin resistance in S. maltophilia.
DOI
10.1089/mdr.2015.0228
Appears in Collections:
의과대학 > 의학과 > Journal papers
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