μ gyra parc Escherichia coli Klebsiella pneumoniae Pseudomonas aeruginosa E. coli gyra E. coli parc gyra parc gyra Escherichia coli E. coli E.
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1 gyra parc Escherichia coli Klebsiella pneumoniae Pseudomonas aeruginosa E. coli μ E. coli gyra parc gyra parc gyra parc μ μ gyra parc Key words Escherichia coli gyra parc Escherichia coli E. coli gyra parc I E. coli E. coli gyra parc E. coli μ gyra parc gyra parc gyra
2 Table 1. Background of patients Number of patients (%) In patients Out patients Pre-medication Sex Age Pre-medication No pre-medication Male Female Total Table 2. Bacteria isolated from urinary tract infection Gram-negative bacilli Gram-positive cocci Organism Uncomplicated urinary tract infection Complicated urinary tract infection Total Isolates (%) Isolates (%) Isolates (%) Escherichia coli Klebsiella pneumoniae Enterobacter, Citrobacter Proteus mirabilis Pseudomonas aeruginosa Other Gram-negative bacillus Subtotal Enterococcus faecalis Other Enterococcus Staphylococcus aureus (MSSA) Staphylococcus aureus (MRSA) Other Staphylococcus Streptococcus spp Subtotal Total parc E. coli gyra parc II E. coliklebsiella pneumoniae Enterococcus faecalis Enterococcus Staphylococcus E. colie. faecalis K. pneumoniae E. colie. faecalis Pseudomonas aeruginosa K. pneumoniae
3 Table 3. Susceptibility testing in gram-negative bacteria Escherichia coli (n 82) Klebsiella pneumoniae (n 12) Pseudomonas aeruginosa (n 10) MIC ( g/ml) Susceptibility (%) range 50% 90% Susceptible Resistant SBT/ABPC PIPC (82.5) 15.9 (15.5) CEZ (85.7) 14.6 (7.4) CMZ (98.2) 0.0 (0.5) CFPM CTRX CPFX (84.3) 32.9 (15.7) LVFX (84.8) 26.8 (12.9) MEPM (100.0) 2.4 (0.0) IPM (100.0) 2.4 (0.0) DRPM MINO (89.9) 12.2 (5.1) ABK GM SBT/ABPC PIPC (83.0) 33.3 (6.7) CEZ (78.7) 25.0 (19.1) CMZ (93.6) 0.0 (4.3) CFPM CTRX CPFX (89.4) 8.3 (10.6) LVFX (91.5) 8.3 (8.5) MEPM (97.9) 0.0 (0.0) IPM (95.7) 0.0 (2.1) DRPM MINO (83.0) 33.3 (10.6) ABK (97.9) 0.0 (2.1) GM (97.9) 8.3 (2.1) PIPC (61.8) 10.0 (18.2) CFPM CPFX (63.6) 20.0 (34.5) LVFX (58.2) 10.0 (22.7) MEPM (74.5) 10.0 (21.8) IPM (76.4) 10.0 (18.2) ABK (92.7) 0.0 (8.3) GM (80.0) 10.0 (22.7) P. aeruginosa E. coli K. pneumoniae P. aeruginosa E. coli K. pneumoniae E. coli E. coli K. pneumoniae E. coli E. coli E. coli
4 Table 4. A comparison of patient background, fluoroquinolone susceptive-strains and resistant-strains Sex Urinary tract infection Age Susceptible (%) Resistant (%) Male % % Female % % Uncomplicated % % Complicated % % % % % % % % % % Total % % Cumulative percentage 100% 80% 60% 40% CPFX LVFX 20% 0% MIC ( g/ml) Fig. 1. Sensitivity distribution of clinical isolates of Escherichia coli to CPFX and LVFX. Table 5.Substitutions identified in the gyra and parc containing QRDRs in clinical isolates of E. coli Mutation points Amino acid substitution gyra parc Isolates 0 None 8 1 S83L 13 1 S80I 1 Subtotal 14 3 S83L D87N S80I 6 3 S83L D87G S80I 1 3 S83L S80I E84V 1 3 S83L S80I E84G 1 Subtotal 9 4 S83L D87N S80I E84V 12 4 S83L D87N S80I E84G 2 4 S83L D87N S80I E84K 1 Subtotal 15 Total 46 E. coli E. coli μ μ μ μ μ μ gyra parc gyra parc
5 Table 6. MICs and numbers of substitutions identified in the gyra and parc genes MIC ( g/ml) CPFX LVFX gyra substitution parc substitution point substitution point substitution point substitution point substitution Numbers of isolates gyra substitution parc substitution point substitution point substitution point substitution point substitution Numbers of isolates gyra parc gyra parc gyra parc gyra parc gyra parc gyra parc gyra parc μ μ μ III E. coli E. coli E. faecalis P. aeruginosa E. coli K. pneumoniae E. coli E. coli E. coli E. coli
6 E. coli E. coli E. coli gyra parc gyra parc E. coli gyra μ gyra μ parc μ μ parc μ μ parc μ μ μ μ gyra parc μ gyra parc E. coli gyra nfxa nora nala parc qnr Qnr E. coli gyra parc P. aeruginosa gyra parc E. coli μ gyra parc E. coli Escherichia coli Bacteroides fragilis Escherichia coli
7 Staphylococcus aureus Pseudomonas aeruginosa opr mex mexopr gyra parc Escherichia coli Klebsiella pneumoniaepseudomonas aeruginosa E. coli gyra parc E. coli μ gyra parc gyra parc gyra parc gyra parc μ
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IV (meningitis) IV (non-meningitis) (meningitis) (non-meningitis) Blood Isolates % Susceptible 644 18 36 70 78 74 59 69 75 262 100 19 64 75 100 92 54 72 78 76 68 89 86 99 Escherichia coli 153 58 30 67
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