Quinolone Resistance in Absence of Selective Pressure The Experience of a Very Remote Community in the Amazon Forest 英文参考文献.docVIP

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Quinolone Resistance in Absence of Selective Pressure The Experience of a Very Remote Community in the Amazon Forest 英文参考文献.doc

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Quinolone Resistance in Absence of Selective Pressure The Experience of a Very Remote Community in the Amazon Forest 英文参考文献

QuinoloneResistanceinAbsenceofSelectivePressure: TheExperienceofaVeryRemoteCommunityinthe AmazonForest LuciaPallecchi1.,AlessandroBartoloni2,3.,EleonoraRiccobono1,ConnieFernandez4,AntoniaMantella2, DonataMagnelli2,DarioMannini2,MarianneStrohmeyer2,FilippoBartalesi3,HugoRodriguez4, EduardoGotuzzo5,GianMariaRossolini1,6* 1Dipartimento di Biotecnologie, Sezione di Microbiologia, Universita` di Siena, Siena, Italy, 2Dipartimento Area Critica Medico Chirurgica, Clinica Malattie Infettive, Universita` diFirenze,Florence,Italy,3MalattieInfettiveeTropicali,AziendaOspedaliero-UniversitariaCareggi,Florence,Italy,4HospitalApoyoYurimaguas,Yurimaguas, Peru,5InstitutodeMedicinaTropicalAlexandervonHumboldt,UniversidadPeruanaCayetanoHeredia,Lima,Peru,6DipartimentodiEmergenza,UrgenzaedeiServizi Diagnostici,U.O.MicrobiologiaeVirologia,AziendaOspedaliera-UniversitariaSenese,Siena,Italy Abstract Background: Quinolones are potent broad-spectrum bactericidal agents increasingly employed also in resource-limited countries.Resistancetoquinolonesisanincreasingproblem,knowntobestronglyassociatedwithquinoloneexposure.We reportontheemergenceofquinoloneresistanceinaveryremotecommunityintheAmazonforest,wherequinoloneshave neverbeenusedandquinoloneresistancewasabsentin2002. Methods: The community exhibited a considerable level of geographical isolation, limited contact with the exterior and minimalantibioticuse(notincludingquinolones).InDecember2009,fecalcarriageofantibioticresistant Escherichiacoli wasinvestigatedin120ofthe140inhabitants,andin48animalsrearedinthecommunity.Allfluoroquinolone-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,carriageofquinolone-resistantE.coliwasfoundtobecommonin2009bothinhumans(45%nalidixicacid,14% ciprofloxacin) and animals (54% nalidixic acid, 23% ci