Background and aims: With the growing number of virtual sites and easy access to them, as well as increasing popularity of the game, online poker could foster addiction. The aim of the current inquiry was to gauge susceptibility to behavioural addiction in online and traditional poker players. Methods: Ninety-six online poker players and 35 traditional players were tested on the basis of the “Components model” for addiction (Griffiths, 2005). Using a Likert scale, ratings on six components were examined: salience, conflict, mood modification, withdrawal symptoms, tolerance, and relapse. Results: The traditional players scored higher than online players on measures of conflict, mood modification, and relapse. While none of the traditional players were at risk, the majority of them (94.7%) were symptomatic. Two online players were at risk, 67.7% symptomatic and 30.2% asymptomatic. No significant correlations have emerged between the amount and history of poker playing and the addiction scores. Conclusions: The current findings suggest that most traditional players are prone to behavioural addiction while the majority of the online players are also symptomatic.
Fluoroquinolone resistance in Enterobacteriales is developed by chromosomal and plasmid-mediated mechanisms. Plasmids play an important role in dissemination of resistant genes and they carry genes that protect bacteria in different stress-induced situations. In this study, we studied Escherichia coli strains, each carried one plasmid-mediated quinolone resistance determinant namely, qnrA1, qnrB1, qnrC1, and qnrD1. We exposed 0.5 McFarland density of each strain to 0.5 mg/L ciprofloxacin from the period of 30, 60, 90, and 120 min over 24 h. All treated strains were further exposed to a constantly increasing 1, 2, 4, and 8 mg/L ciprofloxacin solution through 24, 48, and 120 h. In given timepoints, RNA was extracted from all treated strains. Expression of qnrA1, qnrB1, qnrC1, and qnrD1 was investigated by quantitative PCR. Mutations in gyrA and parC genes were analyzed by PCR and nucleic acid sequencing. In this study, during 0.5 mg/L ciprofloxacin exposition, the following expression levels were detected: 1.2 for qnrA1, 1.47 for qnrD1, 12.44 for qnrC1, and 80.63 for qnrB1. In case of long-term study, we selected a resistant strain in qnrB1-positive E. coli, and its expression increased from 105.91 to 212.31. On the contrary, plasmid copy number increased in time from 1 to 4.13. No mutations in gyrA or in parC chromosomal genes of treated strains were detected. Our results show that qnrB1-positive E. coli strain was able to develop fluoroquinolone resistance by upregulated qnrB1 expression that was linked to a minor increase in plasmid copy number but no mutations occurred in gyrA or parC.
Authors:Orsolya Szabó, Dániel Gulyás, Nikolett Szabó, Katalin Kristóf, Béla Kocsis and Dóra Szabó
Plasmid-mediated quinolone resistance (PMQR) determinants including, qnrA, qnrB, qnrC, qnrD, qnrS, aac(6′)-Ib-cr, oqxAB, and qepA, were investigated in 214 Enterobacteriaceae strains from urine clinical samples. Antimicrobial susceptibility testing for ciprofloxacin, ceftriaxone, and imipenem was performed by broth microdilution method. All strains were screened for PMQR genes by PCR. Virulence determinants, namely afa, pap, pil, sfa/foc, and kpsMT of eight Escherichia coli strains proven positive for at least one qnr gene, were investigated by PCR. All of the eight investigated strains carried the pil gene, showing that P fimbria is a common virulence determinant among qnr positive E. coli. Out of 214 tested strains, 38 yielded any PMQR determinant, altogether 45 genes were detected namely, 6 qnrA, 1 qnrB, 2 qnrD and 8 qnrS, 9 aac(6′)-Ib-cr, and 19 oqxAB; however, neither qepA nor qnrC were detected. Notably, 18 Klebsiella spp., harbored oqxAB, nine E. coli were positive for qnrS and two Morganella morganii yielded qnrD resistance determinant. In this study, we demonstrated 17.7% prevalence of PMQR-positive Enterobacteriaceae and first reported qnrD-resistance determinant in Hungary. Altogether, 25 PMQR-positive strains were susceptible or low-level resistant to ciprofloxacin with minimum inhibitory concentration (MIC) between 0.06 and 1 mg/L, suggesting that prevalence of PMQR determinants is underestimated and screening among clinical isolates exhibiting reduced susceptibility is necessary. Fluoroquinolone resistance breakpoints of Enterobacteriaceae were revised in 2017 by European Committee of Antimicrobial Susceptibility Testing indicating ciprofloxacin susceptibility only until 0.25 mg/L MIC value.