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Technology","doi-asserted-by":"publisher","award":["NCKUH-11304002"],"award-info":[{"award-number":["NCKUH-11304002"]}],"id":[{"id":"10.13039\/501100006245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006245","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["MOST 111-2314-B-214-006"],"award-info":[{"award-number":["MOST 111-2314-B-214-006"]}],"id":[{"id":"10.13039\/501100006245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006245","name":"Ministry of Science and Technology","doi-asserted-by":"publisher","award":["NSTC 112-2314-B-006-089-MY3"],"award-info":[{"award-number":["NSTC 112-2314-B-006-089-MY3"]}],"id":[{"id":"10.13039\/501100006245","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Fluoroquinolones are potentially active against Elizabethkingia anophelis. Rapidly increased minimum inhibitory concentrations (MICs) and emerging point mutations in the quinolone resistance-determining regions (QRDRs) following exposure to fluoroquinolones have been reported in E. anophelis. We aimed to investigate point mutations in QRDRs through exposure to levofloxacin (1 \u00d7 MIC) combinations with different concentrations (0.5\u00d7 and 1 \u00d7 MIC) of minocycline, rifampin, cefoperazone\/sulbactam, or sulfamethoxazole\/trimethoprim in comparison with exposure to levofloxacin alone. Of the four E.\u00a0anophelis isolates that were clinically collected, lower MICs of levofloxacin were disclosed in cycle 2 and 3 of induction and selection in all levofloxacin combination groups other than levofloxacin alone (all p = 0.04). Overall, no mutations were discovered in parC and parE throughout the multicycles inducted by levofloxacin and all its combinations. Regarding the vastly increased MICs, the second point mutations in gyrA and\/or gyrB in one isolate (strain no. 1) occurred in cycle 2 following exposure to levofloxacin plus 0.5 \u00d7 MIC minocycline, but they were delayed appearing in cycle 5 following exposure to levofloxacin plus 1 \u00d7 MIC minocycline. Similarly, the second point mutation in gyrA and\/or gyrB occurred in another isolate (strain no. 3) in cycle 4 following exposure to levofloxacin plus 0.5 \u00d7 MIC sulfamethoxazole\/trimethoprim, but no mutation following exposure to levofloxacin plus 1 \u00d7 MIC sulfamethoxazole\/trimethoprim was disclosed. In conclusion, the rapid selection of E. anophelis mutants with high MICs after levofloxacin exposure could be effectively delayed or postponed by antimicrobial combination with other in vitro active antibiotics.<\/jats:p>","DOI":"10.3390\/ijms25042215","type":"journal-article","created":{"date-parts":[[2024,2,12]],"date-time":"2024-02-12T11:30:12Z","timestamp":1707737412000},"page":"2215","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Antibiotic Combination to Effectively Postpone or Inhibit the In Vitro Induction and Selection of Levofloxacin-Resistant Mutants in Elizabethkingia anophelis"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4949-2742","authenticated-orcid":false,"given":"Ching-Chi","family":"Lee","sequence":"first","affiliation":[{"name":"Clinical Medical Research Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan"},{"name":"Departments of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Hsu","family":"Lai","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan"},{"name":"Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Hui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Biological Science and Technology, Meiho University, Pingtung 912, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Han","family":"Huang","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan"},{"name":"Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4417-5350","authenticated-orcid":false,"given":"Jiun-Nong","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan"},{"name":"Division of Infectious Diseases, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan"},{"name":"Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/j.diagmicrobio.2017.03.007","article-title":"Mini review: New pathogen profiles: Elizabethkingia anophelis","volume":"88","author":"Janda","year":"2017","journal-title":"Diag. 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