Clonal and resistance profiles of fluoroquinolone-resistant uropathogenic in countries with different practices of antibiotic prescription.

Background: Antibiotic prescription practices differ between countries, influencing regional antimicrobial resistance prevalence. However, comparisons of clonal diversity among resistant bacteria in countries with different prescribing practices are rare. The rise of fluoroquinolone-resistant (FQREC), often multidrug-resistant, exacerbates global antibiotic resistance.

Commensal Fitness Advantage May Contribute to the Global Dissemination of Multidrug-Resistant Lineages of Bacteria-The Case of Uropathogenic .

It is widely accepted that favorable fitness in commensal colonization is one of the prime facilitators of clonal dissemination in bacteria. The question arises as to what kind of fitness advantage may be wielded by uropathogenic strains of the two predominant fluoroquinolone- and multidrug-resistant clonal groups of -ST131-H30 and ST1193, which has permitted their unprecedented pandemic-like global expansion in the last few decades. The colonization-associated genes' content, carriage of low-cost plasmids, and integrons with weak promoters could certainly contribute to the fitness of the pandemic groups, although those genetic factors are common among other clonal groups as well.

Global Evolution of Pathogenic Bacteria With Extensive Use of Fluoroquinolone Agents.

It is well-established that the spread of many multidrug-resistant (MDR) bacteria is predominantly clonal. Interestingly the international clones/sequence types (STs) of most pathogens emerged and disseminated during the last three decades. Strong experimental evidence from multiple laboratories indicate that diverse fitness cost associated with high-level resistance to fluoroquinolones contributed to the selection and promotion of the international clones/STs of hospital-associated methicillin-resistant (HA-MRSA), extended-spectrum β-lactamase-(ESBL)-producing , ESBL-producing and .

Transmissible silver resistance readily evolves in high-risk clone isolates of Klebsiella pneumoniae.

Silver is used extensively in both hospitals and outpatient clinics as a disinfectant coating agent on various devices. Resistance to silver was recently reported as an emerging problem in Enterobacteriaceae. Multidrug-resistant high-risk clones of Klebsiella pneumoniae are common causes of serious healthcare-associated infections worldwide posing a serious threat to patients.