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Antimicrobial Agents and Chemotherapy, February 2006, p. 572-579, Vol. 50, No. 2
0066-4804/06/$08.00+0     doi:10.1128/AAC.50.2.572-579.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Nonmolecular Test for Detection of Low-Level Resistance to Fluoroquinolones in Streptococcus pneumoniae

Emmanuelle Varon,1,2* Serge Houssaye,2 Sophie Grondin,2 Laurent Gutmann,1,2 the Groupe des Observatoires de la Résistance du Pneumocoque

L.R.M.A., INSERM, U655, Université Paris 6, and Université Paris 5, 75270 Paris cedex 06, France,1 C.N.R. des Pneumocoques, Hôpital Européen Georges Pompidou, 20-40 rue Leblanc, 75908 Paris cedex 15, France2

Received 22 June 2005/ Returned for modification 28 August 2005/ Accepted 3 November 2005

With respect to pneumococci, there is a need to detect first-step mutants with reduced fluoroquinolone (FQ) susceptibility from which second-step, resistant mutants are likely to be selected in the presence of antipneumococcal FQs. Here, we describe an interpretative disk diffusion test, of which three options are presented, that allows the distinction between first- and second-step mutants. Using five FQ disks (pefloxacin, norfloxacin, levofloxacin, ciprofloxacin, and sparfloxacin, option 1), all known mechanisms of altered FQ susceptibility found in first-step mutants (ParC, ParE, GyrA, or efflux) and in second-step mutants (ParC and GyrA or ParE and GyrA) can be accurately detected, making this option a useful epidemiological tool. Using three FQ disks (pefloxacin, norfloxacin, and levofloxacin, option 2), the most prevalent FQ-resistant mutants, but not the first-step GyrA mutants, can be detected. With only two FQ disks (norfloxacin and levofloxacin) in the third and simplest option, first-step mutants can be distinguished from second-step mutants, however, without differentiation of ParC, ParE, or efflux alterations.

* Corresponding author. Mailing address: Centre National de Référence des Pneumocoques, Hôpital Européen Georges Pompidou, 20-40 rue Leblanc, 75908 Paris cedex 15, France. Phone: 33-1-56 09 39 51. Fax: 33-1-56 09 24 46. E-mail: emmanuelle.varon{at}hop.egp.ap-hop-paris.fr.

Antimicrobial Agents and Chemotherapy, February 2006, p. 572-579, Vol. 50, No. 2
0066-4804/06/$08.00+0     doi:10.1128/AAC.50.2.572-579.2006
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



This article has been cited by other articles:

  • Page, S., Vernel-Pauillac, F., O'Connor, O., Bremont, S., Charavay, F., Courvalin, P., Goarant, C., Le Hello, S. (2008). Real-Time PCR Detection of gyrA and parC Mutations in Streptococcus pneumoniae. Antimicrob. Agents Chemother. 52: 4155-4158 [Abstract] [Full Text]  
  • de Cueto, M., Rodriguez, J. M., Soriano, M. J., Lopez-Cerero, L., Venero, J., Pascual, A. (2008). Fatal Levofloxacin Failure in Treatment of a Bacteremic Patient Infected with Streptococcus pneumoniae with a Preexisting parC Mutation. J. Clin. Microbiol. 46: 1558-1560 [Abstract] [Full Text]  


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