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Mechanisms and spread of fluoroquinolone resistance in Streptococcus pneumoniae
Abstract:
The development of fluoroquinolones (FQs) with enhanced activity against Streptococcus pneumoniae is a potential advance in the treatment of pneumococcal infections, particularly those due to beta-lactam-resistant pneumococci. However, FQ-resistant clinical isolates selected by the older FQs have already been reported, with mutation(s) in both FQ targets conferring cross-resistance to newer FQs. It is likely that recombinational events between topoisomerase genes from related species of streptococci contribute to the spread of FQ resistance in S. pneumoniae. A scenario resembling that of the worldwide spread of resistance to beta lactams should be anticipated.
Insights
New fluoroquinolones (FQs) target Streptococcus pneumoniae, but resistance is emerging. Mutations in FQ targets cause cross-resistance, potentially spreading like beta-lactam resistance.
Area of Science:
- Microbiology
- Pharmacology
- Infectious Diseases
Background:
- Pneumococcal infections pose treatment challenges, especially with beta-lactam-resistant strains.
- Fluoroquinolones (FQs) offer potential for treating resistant Streptococcus pneumoniae infections.
- Emergence of FQ resistance threatens the efficacy of these drugs.
Purpose of the Study:
- To assess the potential of new fluoroquinolones against Streptococcus pneumoniae.
- To investigate mechanisms of fluoroquinolone resistance in S. pneumoniae.
- To anticipate the future spread of FQ resistance.
Main Methods:
- Analysis of clinical isolates of Streptococcus pneumoniae.
- Investigation of mutations in fluoroquinolone targets (topoisomerase genes).
- Comparative studies of resistance patterns to older and newer FQs.
Main Results:
- Fluoroquinolone-resistant clinical isolates of S. pneumoniae have been identified.
- Mutations in both FQ targets confer cross-resistance to newer agents.
- Recombination between topoisomerase genes may facilitate resistance spread.
Conclusions:
- Fluoroquinolone resistance in S. pneumoniae is an evolving concern.
- Cross-resistance to newer FQs is mediated by target mutations.
- The spread of FQ resistance may mirror that of beta-lactam resistance.