Investigation of plasmid‐mediated quinolone resistance genes among clinical isolates of Klebsiella pneumoniae in southwest Iran

Abstract

Background Extensive and inappropriate use of quinolones has led to growing resistance rates to these broad‐spectrum antibiotics. The present study purposed to investigate the prevalence of plasmid‐mediated quinolone resistance (PMQR) genes in Klebsiella pneumoniae clinical isolates. Method Ninety‐two non‐repetitive K. pneumoniae clinical isolates were confirmed by standard microbiological methods. Antibacterial susceptibility of isolates toward seven agents from the quinolone family was evaluated by the disc diffusion method. Ciprofloxacin minimum inhibitory concentrations (MICs) were determined using the standard agar dilution method. PCR amplification was used to detect the existence of PMQR genes in the studied isolates. Results In the present study, significant quinolones' resistance (40%) was observed in K. pneumoniae isolates, and most of the strains were resistant to nalidixic acid (94.6%) and ofloxacin (45.6%). MIC analysis showed 15 strains were resistant to 6–128 μg/ml of ciprofloxacin, and five were intermediately‐resistant. PMQR genes were detected in 88% of all isolates. Acc(6’)‐Ib‐cr was constituted half of the total PMQR genes detected among ciprofloxacin non‐susceptible isolates. Of 20 ciprofloxacin non‐susceptible isolates, 65% (n = 13) harbored multiple PMQR determinants, and 15 strains were determined as integron carriage. Conclusion The findings of this study indicated considerable resistance against quinolones, which could be correlated with the extensive and inappropriate use of this class of antibiotics as empirical treatment.

Inverse Association between the Existence of CRISPR/Cas Systems with Antibiotic Resistance, Extended Spectrum β-Lactamase and Carbapenemase Production in Multidrug, Extensive Drug and Pandrug-Resistant Klebsiella pneumoniae

“…Our result for ciprofloxacin resistance in K. pneumoniae isolates was (40.0%), and for levofloxacin was (50.0%), which were not in agreement with Jomehzadeh et al [ 23 ] who showed different resistance ratios for ciprofloxcin (18.5%) and for levofloxacin (30.4%).…”

Association of qnr Genes and OqxAB Efflux Pump in Fluoroquinolone-Resistant Klebsiella pneumoniae Strains

“…The study results of Salimbahrami et al showed that 47 (52%), 22 (25%), and 21 (23%) K. pneumoniae isolated from hospitals in Sari (northern Iran) contains the qnr B, qnr A, and qnr S genes, respectively [ 16 ]. In another study from southwestern of Iran by jomehzadeh et al, ciprofloxacin resistance was lower than our results while qnr A, qnr B, and qnr S were detected in (12%), (24%), and 17% of K. pneumonia isolates [ 23 ]. In the following, studies that reported results similar to ours are reviewed.…”

“…In the following, studies that reported results similar to ours are reviewed. In a study conducted by Malek Jamshidi et al, at Yazd central laboratory, the qnr A gene was not detected in any of the K. pneumoniae strains, and the qnr B gene (25%) was identified as dominant [ 23 ]. In a study from India, 22% of isolates possessed both qnr B and qnr S genes, while the qnr A gene was not detected in any strains [ 19 ].…”

Octenidine’s Efficacy: A Matter of Interpretation or the Influence of Experimental Setups?

“…Caution should be taken when interpreting those data to be the result of the development of resistance, tolerance or adaptation to an investigated compound. In general, measures in global healthcare have to be taken, since recent reports indicate growing resistances also for the last-resort antibiotics like carbapenems [ 47 , 48 ].…”