Inappropriateness of Quinolone in Scrub Typhus Treatment Due to gyrA Mutation in Orientia tsutsugamushi Boryong Strain
Journal of Korean Medical Science
;
: 667-671, 2013.
Article
in English
| WPRIM
| ID: wpr-65461
ABSTRACT
The use of quinolone for treatment of rickettsial diseases remains controversial. Recent clinical studies suggest that quinolone is not as effective as others in patients with rickettsial diseases including scrub typhus, although the mechanism is not well understood. In this study, we evaluated the mutation in gyrA associated with quinolone resistance. We prospectively enrolled scrub typhus patients, collected blood samples and clinical data from October, 2010 to November, 2011. Among the 21 patients enrolled, one initially received ciprofloxacin for 3 days but was switched to doxycycline due to clinical deterioration. We obtained the gyrA gene of Orientia tsutsugamushi from 21 samples (20 Boryong strain, 1 Kato strain) and sequenced the quinolone resistance-determining region. All of 21 samples had the Ser83Leu mutation in the gyrA gene, which is known to be associated with quinolone resistance. This suggests that quinolones may be avoided for the treatment of serious scrub typhus.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Phylogeny
/
Orientia tsutsugamushi
/
Bacterial Proteins
/
Scrub Typhus
/
Molecular Sequence Data
/
Ciprofloxacin
/
Prospective Studies
/
Sequence Alignment
/
Amino Acid Sequence
/
Sequence Analysis, DNA
Type of study:
Observational study
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2013
Type:
Article
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