In vitro and in vivo activities of fluoroquinolones against Aeromonas hydrophila

Aeromonas hydrophila, an uncommon human pathogen, can cause invasive infections in immunocompromised individuals. As the fluoroquinolones have been shown to be active in vitro against mesophilic aeromonads and clinical experience with the use of fluoroquinolones to treat aeromonads infections is limited, the antimicrobial activities of five selected drugs (ciprofloxacin, gatifloxacin, levofloxacin, lomefloxacin, and moxifloxacin) against A. hydrophila were studied in vitro and in mice. The MICs of the fluoroquinolones (except lomefloxacin), cefotaxime, and minocycline for 90% of 64 clinical isolates of A. hydrophila tested by the agar dilution method were ≤1 μg/ml. With a clinical cefotaxime-resistant strain, Ah 2743, in an in vitro time-kill study, at an inoculum of 7 × 10⁵ CFU/ml incubated with fluoroquinolones, cefotaxime, or minocycline at concentrations equal to twice the MICs, the inhibitory effect lasted for less than 6 h and regrowth occurred thereafter. In an animal model with female BALB/c mice intraperitoneally infected with an inoculum of 1.1 × 10⁷ CFU of Ah 2743, more mice in the ciprofloxacin-treated group survived (72.2%) than in the cefotaxime-, minocycline-, or cefotaxime-minocycline-treated group (P < 0.00001, log rank test). However, there were similar fatality rates, ranging from 71.4 to 87.5%, among mice treated with any of five fluoroquinolones. With a larger inoculum, 4.9 × 10⁷ CFU, mice in the ciprofloxacin-treated group survived longer than those in the minocycline-, cefotaxime-, or cefotaxime-minocycline-treated group (30 h versus 18, 12, and 12 h, respectively [P < 0.002, log rank test]). However, in mice infected with cefotaxime-susceptible Ah 2556, ciprofloxacin was as effective as cefotaxime-minocycline. Thus, our results suggest that ciprofloxacin is at least as effective as cefotaxime-minocycline against murine A. hydrophila infections, which warrants clinical studies to delineate its role in human infections.