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The possible role of quinolones in yersiniosis
1Laboratory for Public Health, Leeuwarden.
Abstract:
The in vitro susceptibility of 135 strains of Yersinia enterocolitica was tested by agar dilution. About 85% of the strains were susceptible to trimethoprim (1 mg/L), tetracycline (4 mg/L), chloramphenicol (4 mg/L) and cefuroxime (8 mg/L); 90 to 100% to piperacillin (16 mg/L), cefotaxime (8 mg/L) and gentamicin (1 mg/L); 100% to ciprofloxacin (less than or equal to 0.016 mg/L), ofloxacin (0.06 mg/L) and pefloxacin (0.12 mg/L). The outcome of 88 patients, treated for various forms of yersiniosis, showed 15% failure for trimethoprim or co-trimoxazole and tetracycline and 70% failure for cephalosporins and aminoglycoside-beta-lactam combinations. Four patients were successfully treated with ciprofloxacin 500 mg orally or 300 mg intravenously administered twice daily for up to 6 weeks.
Insights
Yersinia enterocolitica susceptibility testing revealed high resistance to older antibiotics. Fluoroquinolones like ciprofloxacin demonstrated excellent in vitro activity and clinical success in treating yersiniosis.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Yersinia enterocolitica is a significant human pathogen causing yersiniosis.
- Antimicrobial resistance in Y. enterocolitica necessitates updated treatment guidelines.
- Evaluating antibiotic efficacy is crucial for effective yersiniosis management.
Purpose of the Study:
- To determine the in vitro antimicrobial susceptibility of Yersinia enterocolitica strains.
- To assess the clinical outcomes of patients treated for yersiniosis with various antibiotics.
Main Methods:
- Agar dilution method was used to test the susceptibility of 135 Y. enterocolitica strains.
- Clinical data from 88 patients with yersiniosis were analyzed retrospectively.
- Treatment outcomes were correlated with antibiotic susceptibility patterns.
Main Results:
- High susceptibility rates (85-100%) were observed for fluoroquinolones (ciprofloxacin, ofloxacin, pefloxacin), cefotaxime, and gentamicin.
- Lower susceptibility was noted for trimethoprim, tetracycline, chloramphenicol, and cefuroxime.
- Clinical treatment failures were higher with cephalosporins and aminoglycoside-beta-lactam combinations (70%) compared to trimethoprim/co-trimoxazole and tetracycline (15%).
Conclusions:
- Fluoroquinolones exhibit potent in vitro activity against Yersinia enterocolitica.
- Ciprofloxacin demonstrated successful clinical outcomes in treating yersiniosis.
- Antibiotic choice for yersiniosis should consider in vitro susceptibility data and clinical efficacy.