High prevalence of plasmid-mediated quinolone resistance determinants in Enterobacter cloacae isolated from hospitals of the Qazvin, Alborz, and Tehran provinces, Iran

Peymani, Amir; Farivar, Taghi Naserpour; Najafipour, Reza; Mansouri, Samaneh

doi:10.1590/0037-8682-0454-2015

Cited by 9 publications

(11 citation statements)

References 35 publications

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“…In concordance with other reports, qnrA1 and qnrS1 genes were rarely found in our study 6,22,28. Similar to qnrB , all isolates with qnrA1 determinants belonged to the main clone A.…”

Section: Discussionsupporting

confidence: 93%

“…isolates. They prevailed in isolates from Iran,28 Tunisia,22 Italy,29 and Algeria30 In our study, qnrB4 was found in one isolate only. This is in contrast with reports from some European countries, where qnrB4 is the main detected allele 31,32…”

Section: Discussionsupporting

confidence: 51%

“…In a recent survey from Iran, qnr genes were the predominant PMQR determinants in E. cloacae (60.3%). The authors found qnrB1, qnrS1, and qnrB4 alone or in combinations, to be the most common genes 28…”

Section: Discussionmentioning

confidence: 99%

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Quinolone resistance mechanisms among third-generation cephalosporin resistant isolates of Enterobacter spp. in a Bulgarian university hospital

Markovska

Stoeva

Dimitrova

et al. 2019

IDR

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Background: There have been no reports in Bulgaria about quinolone resistance determinants among Enterobacter spp. Aims: To investigate plasmid and chromosomal quinolone resistance rates among 175 third-generation cephalosporin resistant Enterobacter spp. isolates (167 Enterobacter cloacae complex and eight Enterobacter aerogenes isolates) collected at a university hospital in Varna, Bulgaria, as well as to reveal their association with ESBL/AmpC production and a carriage of specific plasmid replicon types. Methods: PCR, isoelectric focusing, replicon typing, sequencing, and epidemiology typing were carried out. Results: A high level of combined third-generation cephalosporin and quinolone resistant Enterobacter spp. was found − 79.4%. The ESBL production rate was 87%, consisting mainly of CTX-M-15 among E. cloacae complex (in 76%) and CTX-M-3 among E. aerogenes (in 88%). Plasmid mediated quinolone resistance (PMQR) determinants were identified in 57% of the isolates. The most commonly detected PMQR determinants were qnrB (90%), consisting mainly of qnrB1 (in 61%), and qnrB9 (in 27%) of the isolates. Both alleles were transferred with CTX-M-15 genes; transconjugants showed HI2 replicons (for qnrB1 positive transconjugants) and were non-typeable (for qnrB9 ). One Enterobacter spp. isolate produced qnrB4. QnrA1, qnrS1, and aac(6ʹ)-Ib-cr were detected in single isolates only. QnrC, qnrD, qep A, and oqx AB genes were not found. QnrB was associated with CTX-M-15 production, and qnrS1 was linked to CTX-M-3. Alterations in 83 and 87 positions of gyrB in quinolone-resistance determining regions, and 80 position of parC were detected in high level quinolone resistant isolates. Among all the Enterobacter spp. isolates tested, one predominant clone A was identified (53%). Conclusion: Our data showed the necessity of more prudent use of quinolones and third-generation cephalosporins, because of the risk of promoting dissemination, and selection of multiple resistance determinants (ESBL, PMQR) among Enterobacter spp. isolates in Bulgaria.

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“…In concordance with other reports, qnrA1 and qnrS1 genes were rarely found in our study 6,22,28. Similar to qnrB , all isolates with qnrA1 determinants belonged to the main clone A.…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 51%

See 1 more Smart Citation

Quinolone resistance mechanisms among third-generation cephalosporin resistant isolates of Enterobacter spp. in a Bulgarian university hospital

Markovska

Stoeva

Dimitrova

et al. 2019

IDR

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“…Attaining complete cure from UTIs caused by E. coli is highly challenging, and the presence of qnr genes and ESBLs production are said to be most responsible. However, some other factors such as the overexpression of efflux pump or declined intracellular concentration and mutations (in topoisomerase IV and DNA gyrase enzymes) could also be equally effective in this regard [12, 30, 31]. On the other hand, quinolones are the most prescribed antibiotics for UTI therapy in Iran.…”

Section: Discussionmentioning

confidence: 99%

Frequency of quinolone resistance genes among extended-spectrum β-lactamase (ESBL)-producing Escherichia coli strains isolated from urinary tract infections

et al. 2019

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Background As an opportunistic pathogen, Escherichia coli ( E. coli ) is widely recognized as the main cause of nosocomial infections as well as some disorders especially those associated with urinary tract infections (UTIs). This study, therefore, sets out to determine the extent of antibiotic resistance to quinolones and to measure the frequency of qnr genes (A, B, and S) within extended-spectrum beta-lactamase (ESBL) and non-ESBL-producing strains of E. coli isolated from UTI-diagnosed patients as well as to investigate their antimicrobial susceptibility patterns for some selected antibiotics in southwest Iran. Methods Two hundred E. coli strains were isolated from UTI-diagnosed patients, hospitalized in nine different wards of Ahvaz Golestan Hospital between November 2015 and March 2016. The isolates were confirmed through well-practiced phenotypical methods. Moreover, the antimicrobial susceptibility test was successfully performed using a disk diffusion method. ESBL production among the isolates was screened by double disk synergism test (DDST), and the qnr genes were identified using a multiplex PCR. Results Out of the 200 samples collected, 167 isolates were confirmed to be E. coli strains. Maximum and minimum resistance were reported against nalidixic acid and chloramphenicol with 65.3% and 17.4%, respectively. Most of the isolates were resistant to all three types of quinolones studied in this research. Using multiplex PCR, the qnr genes were found in 100 (59.88%) strains ( qnr A = 10, qnr B = 21, qnr S = 41, qnr B-S = 21, qnr B-A = 1, qnr A-S = 3, qnr A-B-S = 3), 58% of which was found among ESBL-producing isolates. Conclusions Resistance to quinolones antibiotics was highest among ESBL-producing isolates harboring, especially qnr S among other determinants of the qnr gene. There is a need for sensitive antibiotic stewardship especially in hospitals of Ahvaz, Khuzestan province. Further research is needed to ascertain the gravity of quinolones resistance in Iran and to quickly act against its spread among other nosocomial pathogens.

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“…(25.71%) and Mahmoud et al 32 (20%). However, lower results (12.6%) were obtained by Biendo et alin India 35 .…”

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confidence: 90%

FimH Adhesin among Enterobacter spp. Isolates and its Relation to Biofilm Formation and Antimicrobial Resistance Pattern

Ghonaim

Elkhyat

El-Hefnawy

et al. 2018

Egyptian Journal of Medical Microbiology

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Background: Enterobacter spp., which are able to carry a number of antibioticresistance genes, can cause a variety of infections especially in immune-compromised individuals and patients from intensive care units (ICUs). Objectives: To assess the prevalence of Enterobacter spp. in Menoufia University Hospitals, and to investigate the relation between antimicrobial susceptibility patterns and biofilm production. Methodology: A total 296 clinical samples from patients admitted to Menoufia University Hospitals. Enterobacter spp. were identified by standard microbiological methods and Vitek-2 system. All Enterobacter isolates antibiogram was tested by the modified Kirby Bauer disk diffusion method, and for extended-spectrum β-lactamases and metallo-β-lactamase production. Biofilm production was detected by congo red agar, modified congo red agar methods and PCR. Results: Enterobacter spp. represented 17.3% of all the collected nosocomial isolates. Vitek-2 system showed that the predominant spp. was Enterobacter aerogenes (44%). Enterobacter isolates were resistant to amoxicillin (100%), doxycycline (82%) and gentamycin (76%). The rates of resistance to ceftriaxone, cefoxitin, cefepime, and amikacin were 64%, 72%, 60% and 70% respectively. Half of Enterobacter isolates were sensitive to piperacillin/tazobactam, meropenem, ciprofloxacin, ofloxacin and norfloxacin while 84% were sensitive to chloramphenicol. Production of ESβLs and MβL was found among 28% and 22% of isolates respectively. Biofilm production was found among 50% by CRA method and 56% by MCRA method, while conventional PCR showed fimH gene among 58% of Enterobacter isolates. Conclusion: Enterobacter spp. are serious nosocomial pathogens as they can produce ESβLs and carbapenemase, and produce biofilm that is related to their antimicrobial resistance. Therefore, their adequate prevention and control is imperative.

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High prevalence of plasmid-mediated quinolone resistance determinants in Enterobacter cloacae isolated from hospitals of the Qazvin, Alborz, and Tehran provinces, Iran

Cited by 9 publications

References 35 publications

<p>Quinolone resistance mechanisms among third-generation cephalosporin resistant isolates of <em>Enterobacter</em> spp. in a Bulgarian university hospital</p>

<p>Quinolone resistance mechanisms among third-generation cephalosporin resistant isolates of <em>Enterobacter</em> spp. in a Bulgarian university hospital</p>

Frequency of quinolone resistance genes among extended-spectrum β-lactamase (ESBL)-producing Escherichia coli strains isolated from urinary tract infections

FimH Adhesin among Enterobacter spp. Isolates and its Relation to Biofilm Formation and Antimicrobial Resistance Pattern

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