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In Vitro Activity of Sitafloxacin and Additional Newer Generation Fluoroquinolones Against Ciprofloxacin-Resistant Neisseria gonorrhoeae Isolates
Department of Urology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan.
Department of Urology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Rare Disease & LCM Laboratories, Group I, R&D Division, Daiichi Sankyo Co., Ltd., Tokyo, Japan.
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2017 (English)In: Microbial Drug Resistance, ISSN 1076-6294, E-ISSN 1931-8448Article in journal (Refereed) Epub ahead of print
Abstract [en]

Emergence of antimicrobial resistance in Neisseria gonorrhoeae is a major public health concern globally, and new antimicrobials for treatment of gonorrhea are imperative. In this study, the in vitro activity of sitafloxacin, a fluoroquinolone mainly used for respiratory tract or urogenital infections in Japan, and additional newer generation fluoroquinolones were determined against ciprofloxacin-resistant N. gonorrhoeae isolates. Minimum inhibitory concentrations (MICs) of ciprofloxacin, levofloxacin, moxifloxacin, sitafloxacin, pazufloxacin, and tosufloxacin against 47 N. gonorrhoeae isolates cultured in 2009 in Japan were determined by agar dilution method. The quinolone resistance-determining region (QRDR) of gyrA and parC was sequenced. The in vitro potency of sitafloxacin was substantially higher compared with all other tested fluoroquinolones. The MICs of sitafloxacin ranged from 0.03 to 0.5 mg/L for 35 ciprofloxacin-resistant N. gonorrhoeae isolates (ciprofloxacin MICs from 2 to 32 mg/L). No identified mutations in GyrA and ParC QRDR resulted in higher sitafloxacin MIC than 0.5 mg/L. Sitafloxacin had a high activity against N. gonorrhoeae isolates, including strains with mutations in DNA gyrase and topoisomerase IV, resulting in high-level resistance to ciprofloxacin and all other newer generation fluoroquinolones examined. However, it was still to a lower extent affected by GyrA and ParC QRDR mutations resulting in sitafloxacin MICs of up to 0.5 mg/L. This indicates that sitafloxacin should not be considered for empirical first-line monotherapy of gonorrhea. However, sitafloxacin could be valuable in a dual antimicrobial therapy and for cases with ceftriaxone resistance or allergy.

Place, publisher, year, edition, pages
2017.
Keyword [en]
In vitro potency, Japan, gyrA, parC, quinolone resistance-determining region
National Category
Microbiology in the medical area
Identifiers
URN: urn:nbn:se:oru:diva-60845DOI: 10.1089/mdr.2017.0054PubMedID: 28581359OAI: oai:DiVA.org:oru-60845DiVA: diva2:1147380
Available from: 2017-10-05 Created: 2017-10-05 Last updated: 2017-10-05Bibliographically approved

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