Mechanisms of Resistance to Quinolones

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ID: 300958
2005
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Ranked #297 of 531 articles by views in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

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Abstract
The increased use of fluoroquinolones has led to increasing resistance to these antimicrobials, with rates of resistance that vary by both organism and geographic region. Resistance to fluoroquinolones typically arises as a result of alterations in the target enzymes (DNA gyrase and topoisomerase IV) and of changes in drug entry and efflux. Mutations are selected first in the more susceptible target: DNA gyrase, in gram-negative bacteria, or topoisomerase IV, in gram-positive bacteria. Additional mutations in the next most susceptible target, as well as in genes controlling drug accumulation, augment resistance further, so that the most-resistant isolates have mutations in several genes. Resistance to quinolones can also be mediated by plasmids that produce the Qnr protein, which protects the quinolone targets from inhibition. Qnr plasmids have been found in the United States, Europe, and East Asia. Although Qnr by itself produces only low-level resistance, its presence facilitates the selection of higher-level resistance mutations, thus contributing to the alarming increase in resistance to quinolones.
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Authors George A. Jacoby
Journal Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Year 2005
DOI
10.1086/428052
URL
https://academic.oup.com/cid/article-pdf/41/Supplement_2/S120/20906682/41-Supplement_2-S120.pdf
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