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Antimicrobial Agents and Chemotherapy, December 2000, p. 3344-3350, Vol. 44, No. 12
Infectious Disease Division and Medical
Services, Massachusetts General Hospital, Harvard Medical School,
Boston, Massachusetts 02114-2696
Received 21 April 2000/Returned for modification 27 June
2000/Accepted 11 September 2000
Premafloxacin is a novel 8-methoxy fluoroquinolone with enhanced
activity against Staphylococcus aureus. We found
premafloxacin to be 32-fold more active than ciprofloxacin against
wild-type S. aureus. Single mutations in either subunit of
topoisomerase IV caused a four- to eightfold increase in the MICs of
both quinolones. A double mutation (gyrA and either
grlA or grlB) caused a 32-fold increase in the
MIC of premafloxacin, while the MIC of ciprofloxacin increased
128-fold. Premafloxacin appeared to be a poor substrate for NorA, with
NorA overexpression causing an increase of twofold or less in the MIC
of premafloxacin in comparison to a fourfold increase in the MIC of
ciprofloxacin. The frequency of selection of resistant mutants was
6.4 × 10
0066-4804/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.
Mechanisms and Frequency of Resistance to
Premafloxacin in Staphylococcus aureus: Novel Mutations
Suggest Novel Drug-Target Interactions
10 to 4.0 × 10
7 at
twofold the MIC of premafloxacin, 2 to 4 log10 less than
that with ciprofloxacin. Single-step mutants could not be selected at
higher concentrations of premafloxacin. In five single-step mutants,
only one previously described uncommon mutation (Ala116Glu), and four
novel mutations (Arg43Cys, Asp69Tyr, Ala176Thr, and Pro157Leu), three
of which were outside the quinolone resistance-determining region
(QRDR) were found. Genetic linkage studies, in which incross of
grlA+ and outcross of mutations were performed,
showed a high correlation between the mutations and the resistance
phenotypes, and allelic exchange experiments confirmed the role of the
novel mutations in grlA in resistance. Our results suggest
that although topoisomerase IV is the primary target of premafloxacin,
premafloxacin appears to interact with topoisomerase IV in a
manner different from that of other quinolones and that the range of
the QRDR of grlA should be expanded.
*
Corresponding author. Mailing address: Infectious
Disease Division, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114-2696. Phone: (617) 726-3812. Fax: (617) 726-7416. E-mail: dhooper{at}partners.org.
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