학술논문

Low-Level Antimicrobials in the Medicinal Leech Select for Resistant Pathogens That Spread to Patients
Document Type
article
Source
mBio, Vol 9, Iss 4 (2018)
Subject
Aeromonas
antibiotic resistance
ciprofloxacin
leech therapy
genomics
microbiome
Microbiology
QR1-502
Language
English
ISSN
2150-7511
Abstract
ABSTRACT Fluoroquinolones (FQs) and ciprofloxacin (Cp) are important antimicrobials that pollute the environment in trace amounts. Although Cp has been recommended as prophylaxis for patients undergoing leech therapy to prevent infections by the leech gut symbiont Aeromonas, a puzzling rise in Cp-resistant (Cpr) Aeromonas infections has been reported. We report on the effects of subtherapeutic FQ concentrations on bacteria in an environmental reservoir, the medicinal leech, and describe the presence of multiple antibiotic resistance mutations and a gain-of-function resistance gene. We link the rise of Cpr Aeromonas isolates to exposure of the leech microbiota to very low levels of Cp (0.01 to 0.04 µg/ml),