{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T02:29:17Z","timestamp":1781317757821,"version":"3.54.1"},"reference-count":35,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T00:00:00Z","timestamp":1536710400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Tri-Service General Hospital, Taipei, Taiwan, ROC, Grant Numbers","award":["TSGH-C104-203 and TSGH-C106-170"],"award-info":[{"award-number":["TSGH-C104-203 and TSGH-C106-170"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Objectives<\/jats:title>\n \n Several\n Elizabethkingia<\/jats:italic>\n species often exhibit extensive antibiotic resistance, causing infections associated with severe morbidity and high mortality rates worldwide. In this study, we determined fluoroquinolone susceptibility profiles of clinical\n Elizabethkingia<\/jats:italic>\n spp. isolates and investigated the resistance mechanisms.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In 2017\u20132018, 131\n Elizabethkingia<\/jats:italic>\n spp. isolates were recovered from specimens collected at tertiary care centers in northern Taiwan. Initial species identification using the Vitek MS system and subsequent verification by 16S rRNA sequencing confirmed the presence of\n Elizabethkingia anophelis<\/jats:italic>\n (\n n<\/jats:italic>\n = 111),\n E. miricola<\/jats:italic>\n (\n n<\/jats:italic>\n = 11), and\n E. meningoseptica<\/jats:italic>\n (\n n<\/jats:italic>\n = 9). Fluoroquinolone susceptibility was determined using the microbroth dilution method, and fluoroquinolone resistance genes were analyzed by sequencing.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among\n Elizabethkingia<\/jats:italic>\n spp. isolates, 91% and 77% were resistant to ciprofloxacin and levofloxacin, respectively. The most prevalent alterations were two single mutations in GyrA, Ser83Ile, and Ser83Arg, detected in 76% of the isolates exhibiting fluoroquinolone MIC between 8 and 128 \u03bcg\/ml. Another GyrA single mutation, Asp87Asn, was identified in two quinolone-resistant\n E. miricola<\/jats:italic>\n strains. None of the isolates had alterations in GyrB, ParC, or ParE. We developed a high-resolution melting assay for rapid identification of the prevalent\n gyrA<\/jats:italic>\n gene mutations. The genetic relationship between the isolates was evaluated by random amplified polymorphic DNA PCR that yielded diverse pulsotypes, indicating the absence of any temporal or spatial overlap among the patients during hospitalization.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Our analysis of fluoroquinolone-resistant\n Elizabethkingia<\/jats:italic>\n spp. isolates provides information for further research on the variations of the resistance mechanism and potential clinical guidance for infection management.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.7717\/peerj.5608","type":"journal-article","created":{"date-parts":[[2018,9,12]],"date-time":"2018-09-12T04:47:32Z","timestamp":1536727652000},"page":"e5608","source":"Crossref","is-referenced-by-count":14,"title":["Molecular typing and profiling of topoisomerase mutations causing resistance to ciprofloxacin and levofloxacin in\n Elizabethkingia<\/i>\n species"],"prefix":"10.7717","volume":"6","author":[{"given":"Ming-Jr","family":"Jian","sequence":"first","affiliation":[{"name":"Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan"},{"name":"Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Hsiang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan"},{"name":"Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherng-Lih","family":"Perng","sequence":"additional","affiliation":[{"name":"Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan"},{"name":"Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Sheng","family":"Shang","sequence":"additional","affiliation":[{"name":"Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan"},{"name":"Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"4443","published-online":{"date-parts":[[2018,9,12]]},"reference":[{"issue":"1","key":"10.7717\/peerj.5608\/ref-1","doi-asserted-by":"publisher","first-page":"30379","DOI":"10.1038\/srep30379","article-title":"Genomic epidemiology and global diversity of the emerging bacterial pathogen Elizabethkingia anophelis","volume":"6","author":"Breurec","year":"2016","journal-title":"Scientific 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