Molecular epidemiology of extended-spectrum beta-lactamase-producing, fluoroquinolone-resistant isolates of Klebsiella pneumoniae in Taiwan

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Title:	Molecular epidemiology of extended-spectrum beta-lactamase-producing, fluoroquinolone-resistant isolates of Klebsiella pneumoniae in Taiwan
Authors:	Yu, WL;Jones, RN;Hollis, RJ;Messer, SA;Biedenbach, DJ;Deshpande, LM;Pfaller, AA
Contributors:	附設醫院內科部感染科;Univ Iowa, Coll Med, Dept Pathol, Mol Epidemiol Lab,Div Med Microbiol, Iowa City, IA 52242 USA;Jones Grp, JMI Labs, N Liberty, IA 52317 USA;Tufts Univ, Sch Med, Boston, MA 02111 USA;China Med Coll Hosp, Dept Med, Div Infect Dis, Taichung, Taiwan
Date:	2002
Issue Date:	2010-09-24 14:21:26 (UTC+8)
Publisher:	AMER SOC MICROBIOLOGY American Society for Microbiology
Abstract:	Two new phloroglucinol derivatives, mallotophilippen A (1) and B (2) were isolated from the fruits of Mallotus philippensis. These compounds were identified, using chemical and spectral data, as 1-[5,7-dihydroxy-2,2-dimethyl-6-(2,4,6-trihydroxy-3-isobutyryl-5-methyl-benzyl)-2H-chromen-8-yl] -2-methyl-butan-1-one and 1-[6-(3-Acetyl-2,4,6-trihydroxy-5-methyl-benzyl)-5,7-dihydroxy-2,2-dimethyl-2H-chromen-8-yl] -2-methyl-butan-1-one, respectively. They inhibited nitric oxide (NO) production and inducible NO synthase (iNOS) gene expression by a murine macrophage-like cell line (RAW 264.7), which was activated by lipopolysaccharide (LPS) and recombinant mouse interferon-gamma (IFN-gamma). Furthermore, they inhibited histamine release from rat peritoneal mast cells induced by Compound 48/80. These results suggest that the novel phloroglucinol derivatives have anti-inflammatory effects. Strains of extended-spectrum ß-lactamase-producing Klebsiella pneumoniae (ESBL-KP) have emerged worldwide. Concomitant ciprofloxacin resistance with ESBL production in K. pneumoniae isolates would severely restrict treatment options. Among 39 (18.5%) of 211 ESBL-KP isolates resistant to ciprofloxacin (MIC, 4 µg/ml), 37 (95%) were high level resistant (MIC, 16 µg/ml). These isolates were also cross resistant to the newer fluoroquinolones, including levofloxacin, gatifloxacin, gemifloxacin, and garenoxacin (BMS 284756). Sitafloxacin was most active against these ciprofloxacin-resistant ESBL-KP isolates with MICs for 67% of the isolates being 2 µg/ml. The molecular epidemiology of these multiresistant isolates was investigated by automated ribotyping and pulsed-field gel electrophoresis (PFGE). Ribotyping identified 18 different strains among the 39 ciprofloxacin-resistant ESBL-KP isolates. The majority (67%) of these isolates were contained in six ribogroups which were further confirmed by PFGE. The distribution of the six major strains of ciprofloxacin-resistant ESBL-KP within Taiwan included one (ribogroup 255.3-PFGE type E) with a nationwide distribution and several institution-specific strains. Interhospital cooperation appears necessary, with strict infection control practices coupled with restriction of fluoroquinolone and extended-spectrum ß-lactam use to control both the major epidemic strain and the more diverse strains observed within individual institutions.
Relation:	JOURNAL OF CLINICAL MICROBIOLOGY 40(12):4666-4669
Appears in Collections:	[China Medical University Hospital] Jurnal articles

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