Prevalence of Quinolone Resistance in Enterobacteriaceae from Sierra Leone and the Detection of
            <i>qnrB</i>
            Pseudogenes and Modified LexA Binding Sites

Łęski, Tomasz A.; Stockelman, Michael; Bangura, Umaru; Chae, Daniel H.; Ansumana, Rashid; Stenger, David A.; Vora, Gary J.; Taitt, Chris R.

doi:10.1128/aac.01576-16

Cited by 8 publications

(8 citation statements)

References 27 publications

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“…The qepA gene, one of the most recently identi ed PMQR determinants, has been associated with decreased susceptibility to uoroquinolones and increased MIC levels [24]. This determinant was detected in (16/188, 8.5%) E. coli isolates which was slightly lower compared to previous studies in Nigeria (18.5%) and Sierra Leon (23%) [27,29]. DNA sequencing con rmed the existence of the qepA gene among E. coli isolates in Kenya with F95L and V134I amino acid substitution consistent with amino acid substitution reported in the qepA4 allele [42].…”

Section: Discussionmentioning

confidence: 75%

Multiple PMQR genes including the rare qepA detected in Ciprofloxacin non-susceptible Escherichia coli and Klebsiella isolated from children under five years at hospital discharge, Kenya.

Kariuki

Diakhate

Musembi

et al. 2023

Preprint

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Background: The increasing spread of fluoroquinolone resistant enteric bacteria is a global public health concern. Children recently discharged from the hospital are at high risk of carriage of antimicrobial resistance (AMR) due to frequent exposure to antimicrobials during inpatient stays. This study aimed to determine the prevalence, correlates of ciprofloxacin non-susceptibility, and distribution of plasmid-mediated quinolone resistance (PMQR) genes in Escherichia coli (E. coli) and Klebsiella spp isolated from children under five years being discharged from two Kenyan Hospitals. Methods: E. coli and Klebsiella spp were isolated from fecal samples from children discharged from hospital and subjected to antimicrobial susceptibility testing by disc diffusion and E-test. Ciprofloxacin non-susceptible isolates were screened for seven PMQR genes using multiplex PCR. Poisson regression was used to determine the association between carriage of ciprofloxacin non-susceptible isolates and patient characteristics. Results: Of the 280 ciprofloxacin non-susceptible isolates: 188 E. coli and 92 Klebsiella spp isolates identified among 266 discharged children, 195 (68%) were ciprofloxacin-resistant (MIC ≥ 1µg/mL). Among these 195 isolates, 130 (67%) had high level ciprofloxacin minimum inhibitory concentrations (MICs) (≥32 µg/mL). Over 80% of the isolates had at least one PMQR gene identified: aac(6’)lb-cr (60%), qnrB (24%), oqxAB (22%), qnrS (16%), and qepA (6%), howeverqnrA was not identified in any isolates tested. Co-carriage of qnrB with acc(6’)-lb-cr was the most predominant accounting for 20% of all the isolates. Ceftriaxone use during hospital admission and the presence of ESBL production were significantly associated with the carriage of ciprofloxacin non-susceptible E. coli and Klebsiella spp. Conclusion: Ciprofloxacin non-susceptibility is common among E. coli and Klebsiella spp isolated from hospital discharged children in Kenya. Carriage and co-carriage of PMQR, including the newly identified qepA gene, were frequently observed. These findings suggest that children leaving the hospital may serve as an important reservoir for transmission of resistant E. coli and Klebsiella spp to the community. Enhanced surveillance for AMR determinants is critical to inform interventions to control antimicrobial-resistant bacteria.

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Section: Discussionmentioning

confidence: 75%

Multiple PMQR genes including the rare qepA detected in Ciprofloxacin non-susceptible Escherichia coli and Klebsiella isolated from children under five years at hospital discharge, Kenya.

Kariuki

Diakhate

Musembi

et al. 2023

Preprint

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“…); the microarray used here does not provide this capability. Next generation sequencing can further provide high resolution epidemiological tracking and “One Health” linkages [ 95 , 96 ], provide context for genes, and even detect promoter modifications that significantly affect gene expression [ 97 , 98 ]. However, a key limitation of any molecular technology approach is that genotype may not always be predictive of phenotype if differential expression and/or functionality of expressed proteins is not known or fully characterized.…”

Section: Resultsmentioning

confidence: 99%

“…The low prevalence of the FQ resistance gene, qnrS , observed from all collection sites mirrored results from other studies [ 106 , 107 , 108 ]. This and other plasmid-mediated quinolone resistance (PMQR) genes reduce susceptibility to quinolones, albeit not always to the level of clinical resistance [ 98 , 109 ]. High-level resistance to first-line FQ therapeutics is generally conferred by point mutations in gyrA and parC in Enterobacteriaceae, which are not detectable by the microarray technology used here; the ability to interrogate samples for such point mutations would be an advantage of any sequencing-based approach.…”

Section: Resultsmentioning

confidence: 99%

Tracking Antimicrobial Resistance Determinants in Diarrheal Pathogens: A Cross-Institutional Pilot Study

Taitt

Łęski

Prouty

et al. 2020

IJMS

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Infectious diarrhea affects over four billion individuals annually and causes over a million deaths each year. Though not typically prescribed for treatment of uncomplicated diarrheal disease, antimicrobials serve as a critical part of the armamentarium used to treat severe or persistent cases. Due to widespread over- and misuse of antimicrobials, there has been an alarming increase in global resistance, for which a standardized methodology for geographic surveillance would be highly beneficial. To demonstrate that a standardized methodology could be used to provide molecular surveillance of antimicrobial resistance (AMR) genes, we initiated a pilot study to test 130 diarrheal pathogens (Campylobacter spp., Escherichia coli, Salmonella, and Shigella spp.) from the USA, Peru, Egypt, Cambodia, and Kenya for the presence/absence of over 200 AMR determinants. We detected a total of 55 different determinants conferring resistance to ten different categories of antimicrobials: genes detected in ≥ 25 samples included blaTEM, tet(A), tet(B), mac(A), mac(B), aadA1/A2, strA, strB, sul1, sul2, qacEΔ1, cmr, and dfrA1. The number of determinants per strain ranged from none (several Campylobacter spp. strains) to sixteen, with isolates from Egypt harboring a wider variety and greater number of genes per isolate than other sites. Two samples harbored carbapenemase genes, blaOXA-48 or blaNDM. Genes conferring resistance to azithromycin (ere(A), mph(A)/mph(K), erm(B)), a first-line therapeutic for severe diarrhea, were detected in over 10% of all Enterobacteriaceae tested: these included >25% of the Enterobacteriaceae from Egypt and Kenya. Forty-six percent of the Egyptian Enterobacteriaceae harbored genes encoding CTX-M-1 or CTX-M-9 families of extended-spectrum β-lactamases. Overall, the data provide cross-comparable resistome information to establish regional trends in support of international surveillance activities and potentially guide geospatially informed medical care.

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“…Moreover, bla CMY -type, bla TEM -type, bla SHV -type, and bla DHA -type genes, in particular the latter three, were found to be encoded in one Citrobacter isolate and one Citrobacter plasmid for the first time, respectively. Quinolone resistance qnr genes and aminoglycoside resistance genes have been identified in Citrobacter species as well [68, 69], and the qnrB genes constitute the most predominant and variable group within the qnr family [70]. To the best of our knowledge, this work represents the first report of aadA16 in Citrobacter , as well as qnrB4 and aac6 in animal-associated C. freundii .…”

Section: Discussionmentioning

confidence: 97%

In Vitro Susceptibility and Florfenicol Resistance inCitrobacterIsolates and Whole-Genome Analysis of Multidrug-ResistantCitrobacter freundii

Zhou

Chen

Qian

et al. 2019

International Journal of Genomics

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The genus Citrobacter is an opportunistic pathogen causing infections in animals, and the published data for its resistance to florfenicol are scarce. In this study, we investigated the antimicrobial susceptibility and molecular characteristics of florfenicol resistance genes among Citrobacter isolates from animal and relevant environmental samples and conducted a comparative analysis of a multidrug-resistant Citrobacter freundii strain isolated from a rabbit. Among 20 Citrobacter strains isolated from animal samples, resistance was most commonly observed to ampicillin (100%), tetracycline (75%), streptomycin (65%), florfenicol (60%), chloramphenicol (60%), and aztreonam (50%), while all the strains found in environmental samples were resistant to few antibiotics. The florfenicol resistance gene floR was detected in 12 isolates (48%, 12/25) from animal samples, and all of the floR-positive isolates were resistant to florfenicol with minimum inhibitory concentration (MIC) values ≥256 μg/mL. Sequencing and comparative analysis of the plasmids from a multidrug-resistant C. freundii isolate named R47 showed that the floR-containing region in the plasmid pR47-54 was a truncated transposon-like structure and could be found on both plasmids and chromosomes of bacteria of either animal or human origin. Furthermore, a range of antimicrobial and metal resistance genes associated with mobile genetic elements could be identified in pR47-54 and the other plasmid pR47-309 of C. freundii R47. These results provide in-depth views into the phenotypic and molecular characteristics of Citrobacter isolates recovered from animal and relevant environmental samples, as well as highlight the role horizontal gene transfer plays in the dissemination of plasmid-encoded resistance genes.

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Prevalence of Quinolone Resistance in Enterobacteriaceae from Sierra Leone and the Detection of qnrB Pseudogenes and Modified LexA Binding Sites

Cited by 8 publications

References 27 publications

Multiple PMQR genes including the rare qepA detected in Ciprofloxacin non-susceptible Escherichia coli and Klebsiella isolated from children under five years at hospital discharge, Kenya.

Multiple PMQR genes including the rare qepA detected in Ciprofloxacin non-susceptible Escherichia coli and Klebsiella isolated from children under five years at hospital discharge, Kenya.

Tracking Antimicrobial Resistance Determinants in Diarrheal Pathogens: A Cross-Institutional Pilot Study

In Vitro Susceptibility and Florfenicol Resistance inCitrobacterIsolates and Whole-Genome Analysis of Multidrug-ResistantCitrobacter freundii

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