Mutant prevention concentration of ciprofloxacin and enrofloxacin against Escherichia coli, Salmonella Typhimurium and Pseudomonas aeruginosa

The mutant prevention concentration (MPC) is a new concept meant to face the increased prevalence of antibiotic resistance by using antibiotic concentrations able to prevent the selection of single-step resistant mutants. In the present study, the MPCs of ciprofloxacin and enrofloxacin were evaluated against fully susceptible strains of Escherichia coli, Salmonella Typhimurium and Pseudomonas aeruginosa. Additionally, representative single-step mutants arising after exposure to sub-MPC antibiotic concentrations were investigated for molecular basis of their fluoroquinolone resistance phenotypes. MPC value was recorded when more than 10(10) CFU/mL were spread on Muëller Hinton Agar supplemented with different antibiotic concentrations (from 1X to 16X MIC value). MICs of original strains as well as single-step mutants were determined in presence or absence of the Efflux Pump Inhibitor Phe-Arg-beta-naphthylamide (PAbetaN). Moreover point mutations in the QRDR of the gyrA and parC genes were investigated by sequencing. The enrofloxacin MPC values were 4-16-fold higher than ciprofloxacin values. E. coli and S. Typhimurium representative single-step mutants showed reduced susceptibilities associated with point mutations in the QRDR of the gyrA gene or efflux pump system. P. aeruginosa mutants showed resistance phenotypes associated predominantly with efflux pump system activity. According to in vitro MPC data, ciprofloxacin showed a better efficacy than enrofloxacin, in preventing the selection of E. coli, S. Typhimurium and P. aeruginosa single-step mutants. However, in relation to AUC/MPC ratio, the MPC concept can be applied in vivo to ciprofloxacin and enrofloxacin for E. coli and S. Typhimurium but not for P. aeruginosa.