The Impact of Mutations in Topoisomerase Genes and the Plasmid-Mediated Quinolone Resistance (PMQR) Determinants on the Resistance to Fluoroquinolones in Klebsiella pneumoniae

Akya, Alisha; Lorestani, Roya Chegene; Elahi, Azam; Ghadiri, Keyghobad

doi:10.5812/archcid.57290

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…Additionally, the aac(6ʹ)-Ib-cr gene was observed more frequently than qnr genes among Enterobacteriaceae clinical isolates in different previous studies. 2,26,35,36 This comes to support our result.…”

Section: Discussionsupporting

confidence: 88%

Detection of Chromosomal and Plasmid-Mediated Quinolone Resistance Among Escherichia coli Isolated from Urinary Tract Infection Cases; Zagazig University Hospitals, Egypt

Esmaeel¹,

Gerges²,

Hosny³

et al. 2020

IDR

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Introduction: Resistance to fluoroquinolones (FQ) in uropathogenic Escherichia coli (UPEC) has emerged as a growing problem. Chromosomal mutations and plasmidmediated quinolone resistance (PMQR) determinants have been implicated. Data concerning the prevalence of these determinants in UPEC in our hospital are quite limited. Purpose: To investigate the occurrence and genetic determinants of FQ resistance in UPEC isolated from urinary tract infection (UTI) cases in Zagazig University Hospitals. Patients and Methods: Following their isolation, the identification and susceptibility of UPEC isolates were performed by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometer (MALDI-TOF MS). FQ resistance was detected by the disc diffusion method. Ciprofloxacin minimal inhibitory concentration (MIC) was determined using E-test. Chromosomal mutations in the gyrA gene were detected using polymerase chain reactionrestriction fragment length polymorphism (PCR-RFLP), and for detection of PMQR, a couple of multiplex PCR reactions were used. Results: Among a total of 192 UPEC isolates, 46.9% (n=90) were FQ resistant. More than half of the isolates (57.8%) exhibited high-level ciprofloxacin resistance (MIC > 32 µg/mL). Mutations in gyrA were detected in 76.7% of isolates, with 34.4% having mutations at more than one site. PMQR determinants were detected in 80.1% of UPEC isolates, with aac(6ʹ)-Ibcr gene being the most frequent found in 61.1% of isolates. Conclusion: There is a high prevalence of both gyrA mutations and PMQR determinants among UPEC isolates in our hospital which contribute to high-level ciprofloxacin resistance, a finding that may require the revision of the antibiotics used for empirical treatment of UTI.

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Section: Discussionsupporting

confidence: 88%

Detection of Chromosomal and Plasmid-Mediated Quinolone Resistance Among Escherichia coli Isolated from Urinary Tract Infection Cases; Zagazig University Hospitals, Egypt

Esmaeel¹,

Gerges²,

Hosny³

et al. 2020

IDR

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“…Similar high-prevalence rate for mutations in gyrA has been reported by Alisha et al from Iran and Muthu et al from India. 18,19 Although the gyrA and parC are most commonly reported, mutation-resistant genes in the QRDR regions, in the current study, gyrB and parE genes were also frequently encountered.…”

Section: Discussionmentioning

confidence: 52%

Fluoroquinolone Resistance in Clinical Isolates of Klebsiella Pneumoniae

et al. 2020

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Introduction Fluoroquinolones are widely used broad-spectrum antibiotics. Recently, increased rate of resistance to this antibiotic has been observed in Klebsiella pneumoniae. The aim of the present study was to determine the presence of quinolone resistance determining regions (QRDR) mutation genes and plasmid-mediated quinolone resistance (PMQR) determinants in clinical isolates of ciprofloxacin-resistant K. pneumoniae. Material and Methods The study included 110 nonduplicate ciprofloxacin-resistant K. pneumoniae clinical isolates. Antibiotic susceptibility testing by disk diffusion method and minimum inhibitory concentration (MIC) by agar dilution methods for ciprofloxacin was performed according to the recommendations of Clinical Laboratory Standards Institute. The presence of QRDR genes and PMQR genes was screened by polymerase chain reaction (PCR) amplification. Result All 110 isolates were resistance to ciprofloxacin, levofloxacin, and ofloxacin. As much as 88% of the isolates exhibited high-level of MIC to ciprofloxacin. Among the 110 isolates, 94(85%) harbored gyrA and 85 (77%) gyrB. The parC and parE genes were detected in 88 (80%) and 64 (58%) isolates. qnrB was detected in 13 (12%) isolates and qnrS in 5 (4.5%) isolates. Two (1.8%) isolates carried both qnrB and qnrS genes. The acc (6')-Ib-cr gene was found in 98 (89%) isolates and oqxAB was detected in 7 (6.3%) isolates. One (0.9%) isolate carried qnrB, acc(6')-Ib-cr and oqxAB genes. Conclusion The prevalence of acc (6')-Ib-cr gene is high among PMQR determinants, followed by qnrB, oqxAB and qnrS.

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“…Akya et al reported that K. pneumoniae strains carrying qnrB have MICs from 32 to 128 μg/ml for Ciprofloxacin (except one strain which has an MIC between 4 and 16 μg/ml). Those authors also noticed the strains that carried qnrB and qnrS together had even higher MICs (≥256 μg/ml) for ciprofloxacin [ 24 ]. Our findings for qnrB differed from those of the study by Akya et al However, it was clear that strains carrying qnrA has a higher MIC [24].…”

Section: Discussionmentioning

confidence: 99%

Detection of carbapenem-resistant Klebsiella pneumoniae harboring strains with carbapenemase, beta-lactamase and quinolone resistance genes in intensive care units

Ünlü

Demırci

2020

GMS Hygiene and Infection Control; 15:Doc31

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The Impact of Mutations in Topoisomerase Genes and the Plasmid-Mediated Quinolone Resistance (PMQR) Determinants on the Resistance to Fluoroquinolones in Klebsiella pneumoniae

Abstract: Background: Klebsiella pneumoniae causes a variety of infections including community acquired pneumonia and nosocomial infections.

Cited by 7 publications

References 31 publications

<p>Detection of Chromosomal and Plasmid-Mediated Quinolone Resistance Among <em>Escherichia coli</em> Isolated from Urinary Tract Infection Cases; Zagazig University Hospitals, Egypt</p>

<p>Detection of Chromosomal and Plasmid-Mediated Quinolone Resistance Among <em>Escherichia coli</em> Isolated from Urinary Tract Infection Cases; Zagazig University Hospitals, Egypt</p>

Fluoroquinolone Resistance in Clinical Isolates of Klebsiella Pneumoniae

Detection of carbapenem-resistant Klebsiella pneumoniae harboring strains with carbapenemase, beta-lactamase and quinolone resistance genes in intensive care units

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