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Quinolone Resistance in Absence of Selective Pressure: The Experience of a Very Remote Community in the Amazon Forest

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dc.contributor.author Pallecchi, L.
dc.contributor.author Bartoloni, A.
dc.contributor.author Riccobono, E.
dc.contributor.author Fernandez, C.
dc.contributor.author Mantella, A.
dc.contributor.author Magnelli, D.
dc.contributor.author Mannini, D.
dc.contributor.author Strohmeyer, M.
dc.contributor.author Bartalesi, F.
dc.contributor.author Rodriguez, H.
dc.contributor.author Gotuzzo Herencia, José Eduardo
dc.contributor.author Rossolini, G.M.
dc.date.accessioned 2022-01-18T19:34:38Z
dc.date.available 2022-01-18T19:34:38Z
dc.date.issued 2012
dc.identifier.uri https://hdl.handle.net/20.500.12866/11079
dc.description.abstract Background: Quinolones are potent broad-spectrum bactericidal agents increasingly employed also in resource-limited countries. Resistance to quinolones is an increasing problem, known to be strongly associated with quinolone exposure. We report on the emergence of quinolone resistance in a very remote community in the Amazon forest, where quinolones have never been used and quinolone resistance was absent in 2002. Methods: The community exhibited a considerable level of geographical isolation, limited contact with the exterior and minimal antibiotic use (not including quinolones). In December 2009, fecal carriage of antibiotic resistant Escherichia coli was investigated in 120 of the 140 inhabitants, and in 48 animals reared in the community. All fluoroquinolone-resistant isolates were genotyped and characterized for the mechanisms of plasmid- and chromosomal-mediated quinolone resistance. Principal Findings: Despite the characteristics of the community remained substantially unchanged during the period 2002-2009, carriage of quinolone-resistant E. coli was found to be common in 2009 both in humans (45% nalidixic acid, 14% ciprofloxacin) and animals (54% nalidixic acid, 23% ciprofloxacin). Ciprofloxacin-resistant isolates of human and animal origin showed multidrug resistance phenotypes, a high level of genetic heterogeneity, and a combination of GyrA (Ser83Leu and Asp87Asn) and ParC (Ser80Ile) substitutions commonly observed in fluoroquinolone-resistant clinical isolates of E. coli. Conclusions: Remoteness and absence of antibiotic selective pressure did not protect the community from the remarkable emergence of quinolone resistance in E. coli. Introduction of the resistant strains from antibiotic-exposed settings is the most likely source, while persistence and dissemination in the absence of quinolone exposure is likely mostly related with poor sanitation. Interventions aimed at reducing the spreading of resistant isolates (by improving sanitation and water/food safety) are urgently needed to preserve the efficacy of quinolones in resource-limited countries, as control strategies based only on antibiotic restriction policies are unlikely to succeed in those settings. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartofseries PLoS Neglected Tropical Diseases
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Humans en_US
dc.subject Animals en_US
dc.subject non phenotype en_US
dc.subject Carrier State en_US
dc.subject South America en_US
dc.subject Genetic Variation en_US
dc.subject Rural Population en_US
dc.subject Feces en_US
dc.subject molecular diagnosis en_US
dc.subject Anti-Bacterial Agents en_US
dc.subject amikacin en_US
dc.subject ampicillin en_US
dc.subject ceftriaxone en_US
dc.subject streptomycin en_US
dc.subject Escherichia coli en_US
dc.subject bacterium isolate en_US
dc.subject ciprofloxacin en_US
dc.subject gentamicin en_US
dc.subject Drug Resistance, Multiple, Bacterial en_US
dc.subject multidrug resistance en_US
dc.subject chloramphenicol en_US
dc.subject cotrimoxazole en_US
dc.subject Escherichia coli Infections en_US
dc.subject nalidixic acid en_US
dc.subject tetracycline en_US
dc.subject antibiotic resistance en_US
dc.subject Plasmids en_US
dc.subject Quinolones en_US
dc.subject feces microflora en_US
dc.subject growth inhibition en_US
dc.subject DNA sequence en_US
dc.subject genotyping technique en_US
dc.subject genetic heterogeneity en_US
dc.subject kanamycin en_US
dc.subject gene amplification en_US
dc.subject amino acid substitution en_US
dc.subject multilocus sequence typing en_US
dc.subject community living en_US
dc.subject Trees en_US
dc.subject DNA topoisomerase (ATP hydrolysing) A en_US
dc.subject fecal coliform en_US
dc.subject forest en_US
dc.subject protein ParC en_US
dc.title Quinolone Resistance in Absence of Selective Pressure: The Experience of a Very Remote Community in the Amazon Forest en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pntd.0001790
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn 1935-2735

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