ArticleBMC infectious diseases2011
Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use.
Article in BMC infectious diseases, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Molecular epidemiology of fluoroquinolone resistant Salmonella in Africa: A systematic review and meta-analysis.PloS one · 2018Pooled it
- Mobile Genetic Elements Associated with Antimicrobial Resistance Across One Health Interfaces in Africa: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2026Review
- Squama Manitis Extract Exhibits Broad-Spectrum Antibacterial Activity Through Energy and DNA Disruption Mechanisms.Biology · 2025Article
- Molecular Characterization of Plasmid-Mediated Quinolone Resistance Genes in Multidrug-ResistantEnvironmental health insights · 2025Article
- Antimicrobial stewardship: knowledge, perceptions, and factors associated with antibiotics misuse among consumer's visiting the community pharmacies in a Nigeria Southwestern State.Journal of pharmaceutical policy and practice · 2023Article
- Awareness and Knowledge of Antimicrobial Resistance, Antimicrobial Stewardship and Barriers to Implementing Antimicrobial Susceptibility Testing among Medical Laboratory Scientists in Nigeria: A Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2023Article
- An ST131 clade and a phylogroup A clade bearing an O101-like O-antigen cluster predominate among bloodstreamMicrobial genomics · 2022Article
- Anti-Inflammatory, Antioxidative, and Nitric Oxide-Scavenging Activities of a Quercetin Nanosuspension with Polyethylene Glycol in LPS-Induced RAW 264.7 Macrophages.Molecules (Basel, Switzerland) · 2022Article
- A bottom-up view of antimicrobial resistance transmission in developing countries.Nature microbiology · 2022Review
- A national survey of public awareness of antimicrobial resistance in Nigeria.Antimicrobial resistance and infection control · 2020Article
- A large self-transmissible resistance plasmid from Nigeria contains genes that ameliorate a carrying cost.Scientific reports · 2019Article
- Antimicrobial resistance ofAfrican journal of laboratory medicine · 2018Review
- Preferential Use of Nitrofurantoin Over Fluoroquinolones for Acute Uncomplicated Cystitis and Outpatient Escherichia coli Resistance in an Integrated Healthcare System.Infection control and hospital epidemiology · 2017Article
- Prevalence of Quinolone Resistance in Enterobacteriaceae from Sierra Leone and the Detection of qnrB Pseudogenes and Modified LexA Binding Sites.Antimicrobial agents and chemotherapy · 2016Article
- Diarrhoeagenic Escherichia coli in mother-child Pairs in Ile-Ife, South Western Nigeria.BMC infectious diseases · 2016Article
- Laboratory systems as an antibacterial resistance containment tool in Africa.African journal of laboratory medicine · 2016Review
- Fluoroquinolone-Resistant Enteric Bacteria in Sub-Saharan Africa: Clones, Implications and Research Needs.Frontiers in microbiology · 2016Review
- The ins and outs of RND efflux pumps in Escherichia coli.Frontiers in microbiology · 2015Review
- Antimicrobial-resistant genes associated with Salmonella spp. isolated from human, poultry, and seafood sources.Food science & nutrition · 2014Article
- Dissemination of the transmissible quinolone-resistance gene qnrS1 by IncX plasmids in Nigeria.PloS one · 2014Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundAntibiotic resistance has necessitated fluoroquinolone use but little is known about the selective forces and resistance trajectory in malaria-endemic settings, where selection from the antimalarial chloroquine for fluoroquinolone-resistant bacteria has been proposed.
methodsAntimicrobial resistance was studied in fecal Escherichia coli isolates in a Nigerian community. Quinolone-resistance determining regions of gyrA and parC were sequenced in nalidixic acid resistant strains and horizontally-transmitted quinolone-resistance genes were sought by PCR. Antimicrobial prescription practices were compared with antimicrobial resistance rates over a period spanning three decades.
resultsBefore 2005, quinolone resistance was limited to low-level nalixidic acid resistance in fewer than 4% of E. coli isolates. In 2005, the proportion of isolates demonstrating low-level quinolone resistance due to elevated efflux increased and high-level quinolone resistance and resistance to the fluoroquinolones appeared. Fluoroquinolone resistance was attributable to single nucleotide polymorphisms in quinolone target genes gyrA and/or parC. By 2009, 35 (34.5%) of isolates were quinolone non-susceptible with nine carrying gyrA and parC SNPs and six bearing identical qnrS1 alleles. The antimalarial chloroquine was heavily used throughout the entire period but E. coli with quinolone-specific resistance mechanisms were only detected in the final half decade, immediately following the introduction of the fluoroquinolone antibacterial ciprofloxacin.
conclusionsFluoroquinolones, and not chloroquine, appear to be the selective force for fluoroquinolone-resistant fecal E. coli in this setting. Rapid evolution to resistance following fluoroquinolone introduction points the need to implement resistant containment strategies when new antibacterials are introduced into resource-poor settings with high infectious disease burdens.
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Registered trials
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