The Center for Disease Dynamics, Economics & Policy

Fluoroquinolone resistance is rising along East Coast but remains lower than among ralted species

BACKGROUND

Klebsiella pneumoniae is a member of the Enterobacteriacae family, which along with E. coli  accounts for the vast majority of hospital and community-acquired urinary tract infections (UTIs). It is also a frequent cause of nosocomial (health care–associated) bloodstream infections and community-acquired pneumonia among alcoholics.

Fluoroquinolones are the most frequently prescribed drug class in the United States and include drugs like ciprofloxacin and levofloxacin, which are recommended as first-line drugs for uncomplicated UTIs where local trimethophrim-sulfa resistance is known to be high. Rising fluoroquinolone resistance is worriesome because it has been linked to the emergence of plasmid-mediated quinolone resistance (PMQR), a mechanism by which genes that encode for resistance are transmitted horizontally (from one organism to another) rather than vertically (from parent organism to offspring), thus accelerating the rate at which similar species, such as K. pneumoniae, develop resistance.

U.S. RESISTANCE IN THE GLOBAL CONTEXT

RESISTANCE BY U.S. CENSUS DIVISION, 1999-2010