Active substance: Ciprofloxacin
Antiretroviral therapy is not included. Most recently, a third type of plasmid-mediated quinolone resistance has been identified: the quinolone efflux pumps OqxAB and Qep,. The OqxAB- and QepA-proteins confer resistance to hydrophilic fluoroquinolones like norfloxacin, ciprofloxacin, and enrofloxacin, causing a 32- to 64-fold increase in MICs.
QepA extrudes in addition to quinolones a narrow range of agents such as erythromycin, ethidium bromide, and acrifliavine; OqxAB exports a wider range of agents like ethidium bromide, tetracyclines, chloramphenicol, trimethoprim, olaquindox, and the desinfectants like triclosan.
Extrusion of chemically unrelated agents by efflux-pumps represents a third mechanism of cross-resistance.
In conclusion, fluoroquinolone resistance can emerge even in the absence of exposure to this drug class as several coselection mechanisms favour the emergence of quinolone resistance. Additional Resistance Mechanisms Any antibacterial agent interacting with an intracellular target must traverse the bacterial cell-wall and cytoplasmic membrane to reach the target.
Once taken up, most antibacterials are actively effluxed. Therefore, fluoroquinolones, too, are affected by permeation barriers and efflux pumps, either in association with target modifications or on their own.
As mentioned above, many Gram-positive and Gram-negative fluoroquinolone-resistant mutant strains do not show any mutation in the quinolones resistance determining region QRDR.
Furthermore, chemically unrelated substances like cyclohexane, salicylate, and tetracycline affected fluoroquinolone susceptibilities of E.
Multiple antibiotic resistance mar genes cause an efflux of a variety of chemically unrelated compounds including different drug classes of antibacterials and are affected by a variety of chemically unrelated substances.
The mar genes regulate accumulation and thus intracellular concentrations of quinolones by altering the expression of porins and efflux pumps.
Another efflux pump, AcrAB, extrudes quinolones out of the bacteria. The pump is partly controlled by the mar gene and appears to be the major mechanism of resistance for mar mutants. Health advice and immunizations for travelers.
Prevalence of enteric pathogens among international travelers with diarrhea acquired in Kenya Monbassa, India Goa or Jamaica Montego Bay. J Infect Dis. Schistosomiasis in travelers and expatriates.One to two-thirds of Enterobacteriaceae producing resistance rates increased in the past too except S. Senok Received 25 Mar Published 14 Oct Abstract This paper on the fluoroquinolone resistance epidemiology stratifies the data according to the different prescription patterns by either primary or tertiary caregivers and by indication.
Outbreak of schistosomiasis among travelers returning from Mali, West Africa. Outwater A, Mpangala E.
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