Variable <i>In Vitro</i> Efficacy of Delafloxacin on Multidrug-Resistant <i>Pseudomonas aeruginosa</i> and the Detection of Delafloxacin Resistance Determinants

<b>Background:</b> In this study, molecular mechanisms contributing to delafloxacin resistance in <i>Pseudomonas aeruginosa</i> strains were investigated. Delafloxacin is a recently approved fluoroquinolone currently introduced to clinical applications. <b>Methods:</...

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Main Authors: András Kubicskó, Katalin Kamotsay, Péter Banczerowski, László Sipos, Dóra Szabó, Béla Kocsis
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Antibiotics
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Online Access:https://www.mdpi.com/2079-6382/14/6/542
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author András Kubicskó
Katalin Kamotsay
Péter Banczerowski
László Sipos
Dóra Szabó
Béla Kocsis
author_facet András Kubicskó
Katalin Kamotsay
Péter Banczerowski
László Sipos
Dóra Szabó
Béla Kocsis
author_sort András Kubicskó
collection DOAJ
description <b>Background:</b> In this study, molecular mechanisms contributing to delafloxacin resistance in <i>Pseudomonas aeruginosa</i> strains were investigated. Delafloxacin is a recently approved fluoroquinolone currently introduced to clinical applications. <b>Methods:</b> A total of 52 <i>P. aeruginosa</i> strains were collected from clinical isolates. Antimicrobial susceptibility testing was performed via broth microdilution, and the minimum inhibitory concentration (MIC) values for ciprofloxacin, levofloxacin, delafloxacin, ceftazidime and imipenem were determined. Five delafloxacin-resistant <i>P. aeruginosa</i> strains were selected for whole-genome sequencing (WGS). <b>Results:</b> MIC50 values were determined, and the following results were obtained: ciprofloxacin 0.25 mg/L, levofloxacin 0.25 mg/L and delafloxacin 1 mg/L. All five selected strains showed both extended-spectrum beta-lactamase and carbapenemase production. WGS analysis of these strains determined the sequence types (STs), namely, ST235 (two strains), ST316 (two strains) and ST395. Several mutations in quinolone-resistance-determining regions (QRDRs) were detected in all five delafloxacin-resistant <i>P. aeruginosa</i> strains as follows: <i>gyrA</i> Thr83Ile and <i>parC</i> Ser87Leu mutations were present in all five strains, while <i>parE</i> Thr223Ala in ST235, Glu459Val in ST316 and Val200Met in ST395 were detected. MexAB-OprM and MexCD-OprJ efflux pumps were uniformly present in all delafloxacin-resistant <i>P. aeruginosa</i> strains. All strains of ST235 and ST316 carried <i>bla</i><sub>NDM-1</sub> in combination with other beta-lactamases. In our study, the <i>in vitro</i> efficacy of delafloxacin is inferior compared to previous fluoroquinolones based on MIC50 values; however, MIC values of delafloxacin ranged between 0.125 and 128 mg/L in our <i>P. aeruginosa</i> collection, and 21 out of 52 strains showed susceptibility to delafloxacin. <b>Conclusions</b>: Multiple QRDR mutations combined with several efflux pumps confer delafloxacin resistance in <i>P. aeruginosa</i>. Among the different detected multidrug-resistant <i>P. aeruginosa</i> strains in this study, we also report on an NDM-1 producing <i>P. aeruginosa</i> ST316 in Hungary.
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spelling doaj-art-0274bdb46de34da4ba5678bd0cab7dec2025-08-20T03:26:09ZengMDPI AGAntibiotics2079-63822025-05-0114654210.3390/antibiotics14060542Variable <i>In Vitro</i> Efficacy of Delafloxacin on Multidrug-Resistant <i>Pseudomonas aeruginosa</i> and the Detection of Delafloxacin Resistance DeterminantsAndrás Kubicskó0Katalin Kamotsay1Péter Banczerowski2László Sipos3Dóra Szabó4Béla Kocsis5Institute of Medical Microbiology, Semmelweis University, 1089 Budapest, HungaryCentral Microbiology Laboratory, National Institute of Hematology and Infectious Disease, Central Hospital of Southern-Pest, 1097 Budapest, HungaryDepartment of Neurosurgery and Neurointervention, Semmelweis University, 1085 Budapest, HungaryDepartment of Neurosurgery and Neurointervention, Semmelweis University, 1085 Budapest, HungaryInstitute of Medical Microbiology, Semmelweis University, 1089 Budapest, HungaryInstitute of Medical Microbiology, Semmelweis University, 1089 Budapest, Hungary<b>Background:</b> In this study, molecular mechanisms contributing to delafloxacin resistance in <i>Pseudomonas aeruginosa</i> strains were investigated. Delafloxacin is a recently approved fluoroquinolone currently introduced to clinical applications. <b>Methods:</b> A total of 52 <i>P. aeruginosa</i> strains were collected from clinical isolates. Antimicrobial susceptibility testing was performed via broth microdilution, and the minimum inhibitory concentration (MIC) values for ciprofloxacin, levofloxacin, delafloxacin, ceftazidime and imipenem were determined. Five delafloxacin-resistant <i>P. aeruginosa</i> strains were selected for whole-genome sequencing (WGS). <b>Results:</b> MIC50 values were determined, and the following results were obtained: ciprofloxacin 0.25 mg/L, levofloxacin 0.25 mg/L and delafloxacin 1 mg/L. All five selected strains showed both extended-spectrum beta-lactamase and carbapenemase production. WGS analysis of these strains determined the sequence types (STs), namely, ST235 (two strains), ST316 (two strains) and ST395. Several mutations in quinolone-resistance-determining regions (QRDRs) were detected in all five delafloxacin-resistant <i>P. aeruginosa</i> strains as follows: <i>gyrA</i> Thr83Ile and <i>parC</i> Ser87Leu mutations were present in all five strains, while <i>parE</i> Thr223Ala in ST235, Glu459Val in ST316 and Val200Met in ST395 were detected. MexAB-OprM and MexCD-OprJ efflux pumps were uniformly present in all delafloxacin-resistant <i>P. aeruginosa</i> strains. All strains of ST235 and ST316 carried <i>bla</i><sub>NDM-1</sub> in combination with other beta-lactamases. In our study, the <i>in vitro</i> efficacy of delafloxacin is inferior compared to previous fluoroquinolones based on MIC50 values; however, MIC values of delafloxacin ranged between 0.125 and 128 mg/L in our <i>P. aeruginosa</i> collection, and 21 out of 52 strains showed susceptibility to delafloxacin. <b>Conclusions</b>: Multiple QRDR mutations combined with several efflux pumps confer delafloxacin resistance in <i>P. aeruginosa</i>. Among the different detected multidrug-resistant <i>P. aeruginosa</i> strains in this study, we also report on an NDM-1 producing <i>P. aeruginosa</i> ST316 in Hungary.https://www.mdpi.com/2079-6382/14/6/542delafloxacinfluoroquinolone resistance<i>Pseudomonas aeruginosa</i>high-risk cloneQRDRefflux pump
spellingShingle András Kubicskó
Katalin Kamotsay
Péter Banczerowski
László Sipos
Dóra Szabó
Béla Kocsis
Variable <i>In Vitro</i> Efficacy of Delafloxacin on Multidrug-Resistant <i>Pseudomonas aeruginosa</i> and the Detection of Delafloxacin Resistance Determinants
Antibiotics
delafloxacin
fluoroquinolone resistance
<i>Pseudomonas aeruginosa</i>
high-risk clone
QRDR
efflux pump
title Variable <i>In Vitro</i> Efficacy of Delafloxacin on Multidrug-Resistant <i>Pseudomonas aeruginosa</i> and the Detection of Delafloxacin Resistance Determinants
title_full Variable <i>In Vitro</i> Efficacy of Delafloxacin on Multidrug-Resistant <i>Pseudomonas aeruginosa</i> and the Detection of Delafloxacin Resistance Determinants
title_fullStr Variable <i>In Vitro</i> Efficacy of Delafloxacin on Multidrug-Resistant <i>Pseudomonas aeruginosa</i> and the Detection of Delafloxacin Resistance Determinants
title_full_unstemmed Variable <i>In Vitro</i> Efficacy of Delafloxacin on Multidrug-Resistant <i>Pseudomonas aeruginosa</i> and the Detection of Delafloxacin Resistance Determinants
title_short Variable <i>In Vitro</i> Efficacy of Delafloxacin on Multidrug-Resistant <i>Pseudomonas aeruginosa</i> and the Detection of Delafloxacin Resistance Determinants
title_sort variable i in vitro i efficacy of delafloxacin on multidrug resistant i pseudomonas aeruginosa i and the detection of delafloxacin resistance determinants
topic delafloxacin
fluoroquinolone resistance
<i>Pseudomonas aeruginosa</i>
high-risk clone
QRDR
efflux pump
url https://www.mdpi.com/2079-6382/14/6/542
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