Could traces of fluoroquinolones in food induce ciprofloxacin resistance in Escherichia coli and Klebsiella pneumoniae ? An in vivo study in Galleria mellonella with important implications for maximum residue limits in food

Author:

Gestels Zina1,Baranchyk Yuliia12,Van den Bossche Dorien3,Laumen Jolein1,Abdellati Said3,Britto Xavier Basil14,Manoharan-Basil Sheeba Santhini1ORCID,Kenyon Chris15ORCID

Affiliation:

1. STI Unit, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium

2. UnivLyon, Université Claude Bernard Lyon 1, Villeurbanne, France

3. Clinical and Reference Laboratory, Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium

4. Hospital Outbreak Support Team—HOST, Ziekenhuis Netwerk Antwerpen Middelheim, Antwerp, Belgium

5. Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa

Abstract

ABSTRACT We hypothesized that the residual concentrations of fluoroquinolones allowed in food (acceptable daily intake—ADIs) could select for ciprofloxacin resistance in our resident microbiota. We developed models of chronic Escherichia coli and Klebsiella pneumoniae infection in Galleria mellonella larvae and exposed them to ADI doses of ciprofloxacin via single dosing and daily dosing regimens. The emergence of ciprofloxacin resistance was assessed via isolation of the target bacteria in selective agar plates. Exposure to as low as one-tenth of the ADI dose of the single and daily dosing regimens of ciprofloxacin resulted in the selection of ciprofloxacin resistance in K. pneumoniae but not E. coli . This resistance was associated with cross-resistance to doxycycline and ceftriaxone. Whole genome sequencing revealed inactivating mutations in the transcription repressors, ramR and rrf2 , as well as mutations in gyrA and gyrB . We found that ciprofloxacin doses 10-fold lower than those classified as acceptable for daily intake could induce resistance to ciprofloxacin in K. pneumoniae . These results suggest that it would be prudent to include the induction of antimicrobial resistance as a significant criterion for determining ADIs and the associated maximum residue limits in food. IMPORTANCE This study found that the concentrations of ciprofloxacin/enrofloxacin allowed in food can induce de novo ciprofloxacin resistance in Klebsiella pneumoniae . This suggests that it would be prudent to reconsider the criteria used to determine “safe” upper concentration limits in food.

Publisher

American Society for Microbiology

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