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Chapter 28 : Antibiotic Resistance in

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Abstract:

The basic mechanisms that generate and propagate antibiotic resistance can all be found within ; understanding the evolving pattern of antibiotic resistance in our favourite model organism will continue to be of importance as we try to understand and prevent the expansion and spread of bacterial antibiotic resistance in the years to come. Antibiotic therapy is often necessary to resolve infections caused by . Life threatening conditions such as meningitis, sepsis and bacteremia all require rapid antibiotic intervention to prevent high levels of mortality. Infections caused by range from those that are mild and self-limiting to those that display very high mortality. It is worth noting though that can exhibit examples of all these antibiotic resistance mechanisms concomitantly; for example, resistance to quinolones requires mutation in the target site topoisomerase genes, β-lactam resistance is primarily mediated by β-lactamase enzymes, the Tet efflux pumps determine tetracycline resistance, and novel hydrofolate reductase alleles allow tolerance to trimpethoprim. The presence of all these resistance mechanisms in shows the versatility of this pathogen and validates the study of the emergence and dissemination of antibiotic resistance in. Research into the evolutionary selection of antibiotic resistance genes and their stability within a population will again provide important information regarding the appropriate use of antibiotics, is an ideal candidate for such research as we know more about this organism than any other.

Citation: Webber M, Piddock L. 2005. Antibiotic Resistance in , p 374-386. In White D, Alekshun M, McDermott P (ed), Frontiers in Antimicrobial Resistance. ASM Press, Washington, DC. doi: 10.1128/9781555817572.ch28

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Urinary Tract Infections
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Escherichia coli
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DNA Topoisomerase IV
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References

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Tables

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Table 1

Common conditions where antibiotics are indicated for the treatment of infections

UK, United Kingdom.

Citation: Webber M, Piddock L. 2005. Antibiotic Resistance in , p 374-386. In White D, Alekshun M, McDermott P (ed), Frontiers in Antimicrobial Resistance. ASM Press, Washington, DC. doi: 10.1128/9781555817572.ch28
Generic image for table
Table 2

Fluoroquinolone resistance rates recorded by surveillance programs around the world

Care should be taken when comparing data from one study with that from another if different interpretive criteria have been applied; hence, we have indicated which guidelines have been used by each study.

Many studies include data for more than one fluoroquinolone as well as nalidixic acid. Ciprofloxacin is the most commonly used indicator fluoroquinolone.

Data from the ECO.SENS project are interpreted by using recommendations of the Swedish Reference Group for Antimicrobials (SRGA).

The data are for groups of countries put together according to region. The overall rate of 6% includes data from Spain and Portugal, which have much higher levels of resistance than other countries.

Data from the SENTRY program are interpreted using recommendations of the National Committee for Clinical Laboratory Standards (NCCLS).

Data from the TRUST and TSN programs are interpreted using recommendations of the NCCLS.

The highest resistance was in Spain, and the lowest was in Germany.

Citation: Webber M, Piddock L. 2005. Antibiotic Resistance in , p 374-386. In White D, Alekshun M, McDermott P (ed), Frontiers in Antimicrobial Resistance. ASM Press, Washington, DC. doi: 10.1128/9781555817572.ch28
Generic image for table
Table 3

β-Lactam resistance rates reported by surveillance programs around the world

Data from the SENTRY program (NCCLS methodology).

Data from the TSN program (NCCLS methodology).

Data from the ECO.SENS program (Swedish Reference Group for Antimicrobials methodology).

Citation: Webber M, Piddock L. 2005. Antibiotic Resistance in , p 374-386. In White D, Alekshun M, McDermott P (ed), Frontiers in Antimicrobial Resistance. ASM Press, Washington, DC. doi: 10.1128/9781555817572.ch28

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