Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA.
Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
Antimicrob Agents Chemother. 2017 Sep 22;61(10). doi: 10.1128/AAC.01104-17. Print 2017 Oct.
Urinary tract infections (UTIs) affect nearly 20% of women age 15 to 29 and account for an estimated $3.5 billion in costs. Antibiotic resistance prolongs UTI treatment, and resistance profiles vary regionally. This regional variation is an important consideration in guiding empirical treatment selection. Regional studies in the United States have identified tetracycline resistance in over one-third of species isolates, but no studies have evaluated antibiotic resistance levels in college-aged women with a first-time UTI. We tested a panel of antibiotics and determined the MICs of species (60 and 13 ) and 10 isolates obtained from urine from college-aged women with a first-time UTI. Low antibiotic resistance was found in this population of women with a first-time UTI. All and isolates were sensitive. However, two isolates were resistant, with one to levofloxacin (MIC, 4 μg/ml) and one to tetracycline (MIC, 8 μg/ml). For the spp., the MICs were highest against gentamicin (21 μg/ml) and lowest against doxycycline (0.25 μg/ml). In a comparison of MIC levels between spp., had significantly higher MICs against each antibiotic except doxycycline. For the resistant isolates, the genetic mechanisms of resistance were determined. PCR amplification identified to be present in the tetracycline-resistant isolate and an S83W mutation within the gene of the quinolone-resistant isolate. To our knowledge, this study is the first to provide molecular and phenotypic evidence of the S83W mutation conferring levofloxacin resistance in isolated from a patient in the United States.
尿路感染（UTI）影响了近 29 岁以下的 15%的女性，估计花费 35 亿美元。抗生素耐药性延长了 UTI 的治疗时间，且耐药性谱在不同地区存在差异。这种区域差异是指导经验性治疗选择的一个重要考虑因素。美国的区域性研究已经确定了超过三分之一的 种分离株存在四环素耐药性，但尚无研究评估首次发生 UTI 的大学生女性的抗生素耐药水平。我们测试了一组抗生素，并确定了 种（60 和 13 ）和 10 种从首次发生 UTI 的大学生女性尿液中分离的 种的 MIC 值。在首次发生 UTI 的女性中，发现这种人群对抗生素的耐药性较低。所有 种和 种分离株均敏感。然而，有两个 种分离株耐药，一个对左氧氟沙星（MIC，4 μg/ml）耐药，一个对四环素（MIC，8 μg/ml）耐药。对于 种，MIC 值对庆大霉素最高（21 μg/ml），对强力霉素最低（0.25 μg/ml）。在比较 种的 MIC 值时，除了强力霉素外， 种的 MIC 值对每种抗生素均显著较高。对于耐药分离株，确定了其耐药机制。PCR 扩增鉴定出在四环素耐药分离株中存在 ，而在喹诺酮耐药分离株的 基因中存在 S83W 突变。据我们所知，这项研究首次提供了来自美国患者的 分离株中 S83W 突变赋予左氧氟沙星耐药性的分子和表型证据。
