Quinolone resistance from a transferable plasmid

Martínez-Martínez, Luis; Pascual, Álvaro; Jacoby, George A.

doi:10.1016/s0140-6736(97)07322-4

Cited by 994 publications

(788 citation statements)

References 15 publications

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“…Three major groups of qnr determinants, qnrA, qnrB, and qnrS, are increasingly being identified in clinical isolates of various enterobacterial species worldwide (21) . The first PMQR gene was reported in a Klebsiella pneumoniae isolate from Birmingham in 1994 (22) . Later, these genes were also reported in other clinical isolates such as Enterobacter spp.…”

Section: Introductionmentioning

confidence: 99%

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

Peymani

Farivar

Najafipour

et al. 2016

Rev. Soc. Bras. Med. Trop.

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Introduction: Plasmid-mediated quinolone resistance (PMQR) is a growing clinical concern worldwide. The main aims of this study were to detect qnr-encoding genes and to evaluate the clonal relatedness of qnr-positive Enterobacter cloacae isolates. Methods: A total of 116 E. cloacae isolates that were not susceptible to quinolone were obtained from seven hospitals in Tehran, five hospitals in Qazvin, and two hospitals in Karaj (Iran). Bacterial identification was performed using standard laboratory methods and API 20E strips. Quinolone resistance was determined using the Kirby-Bauer disk diffusion method according to the Clinical Laboratory Standards Institute (CLSI) guidelines. PCR and sequencing were employed to detect qnrA, qnrB, and qnrS genes, and clonal relatedness was assessed using the enterobacterial repetitive intergenic consensus (ERIC)-PCR method. Results: In total, 45 (38.8%) and 71 (61.2%) of isolates showed high-and low-level quinolone resistance, respectively, and qnr-encoding genes were detected in 70 (60.3%) of them. qnrB1 [45 (38.8%) isolates] was the most commonly detected gene, followed by qnrS1 [28 (24.1%) isolates] and qnrB4 [18 (15.5%) isolates] either alone or in combination with other genes. The results of the ERIC-PCR revealed that 53 (75.7%) qnr-positive isolates were genetically unrelated. Conclusions: This study describes, for the first time, the high prevalence of the qnrB1, qnrS1, and qnrB4 genes among E. cloacae isolates in Iran. The detection of qnr genes emphasizes the need for establishing tactful policies associated with infection control measures in hospital settings in Iran.

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Section: Introductionmentioning

confidence: 99%

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

Peymani

Farivar

Najafipour

et al. 2016

Rev. Soc. Bras. Med. Trop.

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“…However, these genes are relevant because they facilitate the emergence of higher-level resistance and thus can speed the development and spread of resistance to these antimicrobial agents ( 27 ). Although foreign travel has been associated with the acquisition of plasmid-mediated quinolone resistant–positive isolates ( 28 – 30 ), these genes have thus far not been focused on in prospective cohort studies investigating the effects of travel on antimicrobial resistance.…”

Section: Discussionmentioning

confidence: 99%

High Rates of Antimicrobial Drug Resistance Gene Acquisition after International Travel, the Netherlands

Wintersdorff¹,

Penders²,

Stobberingh³

et al. 2014

Emerg. Infect. Dis.

119

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We investigated the effect of international travel on the gut resistome of 122 healthy travelers from the Netherlands by using a targeted metagenomic approach. Our results confirm high acquisition rates of the extended-spectrum β-lactamase encoding gene blaCTX-M, documenting a rise in prevalence from 9.0% before travel to 33.6% after travel (p<0.001). The prevalence of quinolone resistance encoding genes qnrB and qnrS increased from 6.6% and 8.2% before travel to 36.9% and 55.7% after travel, respectively (both p<0.001). Travel to Southeast Asia and the Indian subcontinent was associated with the highest acquisition rates of qnrS and both blaCTX-M and qnrS, respectively. Investigation of the associations between the acquisitions of the blaCTX-M and qnr genes showed that acquisition of a blaCTX-M gene was not associated with that of a qnrB (p = 0.305) or qnrS (p = 0.080) gene. These findings support the increasing evidence that travelers contribute to the spread of antimicrobial drug resistance.

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“…30 Interestingly, plasmid-mediated transferable resistance to quinolones has recently been shown in an E. coli strain. 54 This mechanism can contribute to the development and spread of resistance to quinolones.…”

Section: Discussionmentioning

confidence: 99%

Infections Caused By Escherichia Coli Resistant to Norfloxacin in Hospitalized Cirrhotic Patients

Ortiz¹,

Vila²,

Soriano³

et al. 1999

Hepatology

112

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Selective intestinal decontamination with norfloxacin is useful to prevent bacterial infections in several groups of cirrhotic patients at high risk of infection. However, the emergence of infections caused by Escherichia coli resistant to quinolones has recently been observed in cirrhotic patients undergoing prophylactic norfloxacin. Our aim is to determine the characteristics of the infections caused by E. coli resistant to norfloxacin in hospitalized cirrhotic patients. One hundred and six infections caused by E. coli in 99 hospitalized cirrhotic patients were analyzed and distributed into two groups: group I (n ‫؍‬ 67), infections caused by E. coli sensitive to norfloxacin, and group II (n ‫؍‬ 39), infections caused by E. coli resistant to norfloxacin. The clinical and analytical characteristics at diagnosis of the infection were similar in both groups. Previous prophylaxis with norfloxacin was more frequent in group II (15/67, 22.4% vs. 32/39, 82%, P F .0001), as a result of a higher number of patients submitted to continuous long-term prophylaxis in this group, whereas previous short-term prophylaxis was similar in both groups. Infections were more frequently nosocomial-acquired in group II than in group I (17/67, 25.3% vs. 20/39, 51.2%, P ‫؍‬ .01). The type of infections was similar in both groups: urinary tract infections 38 in group I and 24 in group II, spontaneous bacterial peritonitis 8 and 2, spontaneous bacteremia 4 and 4, and bacterascites 1 and 0, respectively (pNS). Mortality during hospitalization was similar in the two groups (4/67, 5.9% vs. 5/39, 12.8%, pNS). None of the E. coli resistant to norfloxacin were also resistant to cefotaxime and only one of them was resistant to amoxicillin-clavulanic acid. Prophylaxis with norfloxacin, usually continuous long-term prophylaxis, favors the development of infections caused by norfloxacin-resistant E. coli. Long-term antibiotic prophylaxis should therefore be restricted to highly selected groups of cirrhotic patients at high-risk of infection. Infections caused by E. coli resistant to norfloxacin show a severity similar to those caused by sensitive E. coli. No significant associated resistance between norfloxacin and the antibiotics most frequently used in the treatment of bacterial infections in cirrhotic patients has been observed.

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Quinolone resistance from a transferable plasmid

Cited by 994 publications

References 15 publications

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

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

High Rates of Antimicrobial Drug Resistance Gene Acquisition after International Travel, the Netherlands

Infections Caused By Escherichia Coli Resistant to Norfloxacin in Hospitalized Cirrhotic Patients

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