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Quinolone low-level resistance in Salmonellae and other Enterobacteriaceae Niels Frimodt-Møller National Center of Antimicrobials and Infection Control.

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Presentation on theme: "Quinolone low-level resistance in Salmonellae and other Enterobacteriaceae Niels Frimodt-Møller National Center of Antimicrobials and Infection Control."— Presentation transcript:

1 Quinolone low-level resistance in Salmonellae and other Enterobacteriaceae Niels Frimodt-Møller National Center of Antimicrobials and Infection Control Statens Serum Institut Copenhagen, Denmark

2 No. of Isolates MIC mg/l Breakpoints / interpretive zone diameters NCCLS: R  4; S  1 SRGA: R > 1; S < 0.063 Nalidixic acid - Susceptible No mutations 150.063 (0.016 - 0.063) Nalidixic acid - Susceptible Not genotyped 240.032 (0.016 - 0.063) Nalidixic acid – Intermediate No mutations 10.032 Nalidixic acid – Resistant No mutations 10.063 Nalidixic acid - Resistant + mutations 160,125 - 4 Salmonella spp., nalidixic acid S-R and ciprofloxacin MIC Hartmann, Skov & Frimodt-Møller

3 Salmonella spp: MIC for nalidixan og ciprofloxacin bestemt med mikrotiter og Etest Hartmann, Skov & Frimodt-Møller

4 Salmonella spp. and quinolone resistance Hartmann, Skov & Frimodt-Møller

5 Salmonella spp. and quinolone resistance Hartmann, Skov & Frimodt-Møller

6 Salmonella spp. and quinolone resistance Hartmann, Skov & Frimodt-Møller

7 Salmonella spp. and quinolone resistance Hartmann, Skov & Frimodt-Møller

8 Salmonella spp. and quinolone resistance Hartmann, Skov & Frimodt-Møller

9 Ciprofloxacin-resistance in Salmonella: Clinical failures

10 Quinolone resistance in E. coli Ruiz et al. Diagn Microbiol Infect Dis 2002, 42: 257-61 No. of Isolates Ciprofloxacin MIC Nalidixic acid MIC % Nal - R 20.0600 170.12847 390.253282 260.51869 3313194 4 strains were Cip-R (0.25) but Nal-S -> None grew over their Cip-MIC

11 Quinolone resistance and Enterobacteriaceae High correlation between Nal-R and Cipro- I/R (and other quinolones) Cipro MIC > 0.125 mg/l correlates with poor clinical outcome of Cipro treatment, i.e. Cipro-S should remain < 0.125 mg/l Cipro-R and Nal-S occurs, but so far no clinical relevance A Nalidixic acid disk/tablet is a good screening method for Cipro-I/R


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