{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:38:07Z","timestamp":1791380287776,"version":"4.3.3"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:00:00Z","timestamp":1682035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      Legionnaires\u2019 Disease is a pneumonia caused by\n                      <jats:italic>Legionella<\/jats:italic>\n                      spp., currently treated empirically with fluoroquinolones and macrolides. In this study, we aim to describe the antibiotic susceptibility pattern of environmental\n                      <jats:italic>Legionella<\/jats:italic>\n                      recovered in the south of Portugal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Minimal inhibitory concentration (MIC) determination of 57\n                      <jats:italic>Legionella<\/jats:italic>\n                      isolates (10 Lp sg 1, 32, Lp sg 2-14 15 L. spp) was achieved by broth microdilution, as described by EUCAST, for azithromycin, clarithromycin, ciprofloxacin, levofloxacin, and doxycycline.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fluoroquinolones were the most active antibiotic, displaying the lowest MIC values in contrast to doxycycline which had the highest. MIC90 and epidemiological cut-off (ECOFF) values were, respectively, 0.5\/1 mg\/L for azithromycin, 0.125\/0.25 mg\/L for clarithromycin, 0.064\/0.125 mg\/L for ciprofloxacin, 0.125\/0.125 mg\/L for levofloxacin and 16\/32 mg\/L for doxycycline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>\n                      MIC distributions were higher than reported by EUCAST for all antibiotics. Interestingly, two phenotypically resistant isolates with high-level quinolone resistance were identified. This is the first time that MIC distributions,\n                      <jats:italic>lpeAB<\/jats:italic>\n                      and tet56 genes have been investigated in Portuguese environmental isolates of\n                      <jats:italic>Legionella<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2023.1141115","type":"journal-article","created":{"date-parts":[[2023,4,21]],"date-time":"2023-04-21T00:22:40Z","timestamp":1682036560000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Antibiotic susceptibility pattern of Portuguese environmental Legionella isolates"],"prefix":"10.3389","volume":"13","author":[{"given":"Carolina","family":"Cruz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L\u00facia","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipa","family":"Fernandes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo","family":"Paix\u00e3o","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Jesus","family":"Chasqueira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,4,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1093\/jac\/dkp173","article-title":"Mutational paths towards increased fluoroquinolone resistance in legionella pneumophila","volume":"64","author":"Almahmoud","year":"2009","journal-title":"J. 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