The prevalence of plasmid-mediated quinolone resistance and ESBL-production in &lt;em&gt;Enterobacteriaceae &lt;/em&gt;isolated from urinary tract infections

Azargun, Robab; Sadeghi, Mohammad Reza; Barhaghi, Mohammad Hossein Soroush; Kafil, Hossein Samadi; Yeganeh, Fatemeh; Oskoee, Mahin Ahangar; Ghotaslou, Reza

doi:10.2147/idr.s160720

Cited by 75 publications

(72 citation statements)

References 27 publications

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“…In the current study, ESBL-producing Enterobacteriaceae was more than half of the isolates. In contrast to our results, Azargun et al (2018) reported the 34.2% of their isolates were ESBL-producing and K. pneumoniae was 53.5% then E. coli was 33.8% [32]. However Rao et al (2014) found 61.4% of ESBL production among E. coli and 46.2% among K. pneumoniae [33].…”

Section: Discussioncontrasting

confidence: 98%

Characterization of plasmid-mediated qnrA and qnrB genes among Enterobacteriaceae strains: quinolone resistance and ESBL production in Ismailia, Egypt

Taha

Omar

Hаssаn

2019

Egypt J Med Hum Genet

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Background: Plasmid-mediated quinolone resistance genes (PMQR) are mainly associated with clinical isolates of Enterobacteriaceae and complicate treatment of infections caused by these isolates worldwide. Extended-spectrumbeta-lactamase (ESBL)-producing bacteria are resistant to common antibiotics and also through many mechanisms, ESBL could be disabling other types of antibiotics. This study aimed to assess the prevalence of quinolone resistance and ESBL among Enterobacteriaceae strains and investigated the presence of qnrA and qnrB genes in these strains which were isolated from urinary tract infections in Ismailia, Egypt. Ninety-four Enterobacteriaceae isolates were collected from cases of UTIs admitted to the intensive care unit, Suez-Canal University Hospitals, between October 2017 and January 2018. Antibacterial susceptibility was determined by the disk diffusion method. A polymerase chain reaction assay was used to detect qnrA and qnrB resistance genes in quinolone-and fluoroquinolone-resistant and ESBL strains. Also, ciprofloxacin MIC was determined by the agar dilution method. Results: Resistance rates were 59.6%, 54.3%, 53.2%, 53.2%, and 53.2% to NA, LEV, NOR, CIP, and FX, respectively. Of 56 NA-resistant isolates, 7 (12.5%) and 6 (10.7%) were positive for qnrA and qnrB, respectively, with only one isolate coharboring both genes. ESBL-producing bacteria was 66.2% of isolates. The MICs for ciprofloxacin ranged from 32-256 μg/ml in ciprofloxacin-resistant isolates.Conclusion: Our study shows high resistance rates of Enterobacteriaceae to quinolones and ESBL in our hospital which necessitate appropriate use of these antibiotics to reserve their application for therapy. The prevalence of quinolone-resistant and ESBL-producing Enterobacteriaceae was approximately 60% and 70% respectively.

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Section: Discussioncontrasting

confidence: 98%

Characterization of plasmid-mediated qnrA and qnrB genes among Enterobacteriaceae strains: quinolone resistance and ESBL production in Ismailia, Egypt

Taha

Omar

Hаssаn

2019

Egypt J Med Hum Genet

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“…However, the isolates were most resistant to Nalixidic acid and were least resistant to Imipenem, Levofloxacin and Norfloxacin. This partially agrees with a similar study carried out in Azerbaijan and Iran on ESBL-PMQR co-carriage where resistance to Nalixidic acid was highest (68.5%) closely followed by resistance to Levofloxacin (55%) and Norfloxacin (65%) (Azargun et al, 2018). The injudicious and common use of Nalixidic acid in comparison to other fluroquinolones, Levofloxacin and Norfloxacin could be the reason for such high resistance to Nalixidic acid in this region.…”

Section: Discussionsupporting

confidence: 91%

Extended spectrum beta-lactamase production and plasmid mediated quinolone resistance among lactose non-fermenting nterobacteriaceae isolated from poultry sources in Calabar, Nigeria

Yhiler¹,

Bassey²,

Paul³

et al. 2019

Afr. J. Microbiol. Res.

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This study investigated the co-carriage of plasmid mediated quinolone resistance (PMQR) and extended spectrum beta-lactamase (ESBL) producing lactose non-fermenting (LNF) Enterobacteriaceae isolated from poultry birds. This was a descriptive cross-sectional study carried out between September, 2016 and March, 2017. The Kirby-Bauer disk diffusion method was used to determine the antimicrobial susceptibility patterns. ESBL screening disc kit was used to detect ESBL activities. Detection of ESBL and PMQR genes was carried out by means of polymerase chain reaction. In total, 207 LNF Enterobacteriaeae isolates were recovered from the cloacal swabs of poultry birds within the Calabar Metropolis. ESBL-producing isolates were 162 (78.3%) while fluroquinolone resistant isolates were 194 (93.7%). Among the ESBL-producing isolates, resistance to Ciprofloxacin, Norfloxacin, Levofloxacin, Ofloxacin and Nalidixic acid was 55 (34.2%), 26 (16.1%), 35 (21.7%), 50 (31.1%), and 162 (100%), respectively. About 65% of the quinolone resistant isolates were positive for at least one of the PMQR and ESBL genes in this study. Strict antimicrobial screening, surveillance of resistant isolates as well as the judicious practice of antimicrobial administration in the poultry setting with special emphasis on fluoroquinolones is advised given the high prevalence of co-existent ESBL and PMQR genes.

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“…The clinical relevance of our results is that ciprofloxacin is commonly subscribed to treat UTIs. It is estimated that around 150 million UTI cases are diagnosed each year and about 75% are caused by E. coli [22]. Ciprofloxacin concentrations used in this study demonstrate tissue concentrations during a per os therapy [30].…”

Section: Discussionmentioning

confidence: 96%

“…The reason of this abundance can have evolutionary advantage against other qnr determinants. This theory is supported by the fact that qnrB is often associated with other resistance genes, such as bla CTX-M-15 , bla CTX-M-14 , and aac(6′)-Ib-cr [22], which can cause multiresistance and facilitate dissemination of resistant strains [9].…”

Section: Discussionmentioning

confidence: 99%

“…The global prevalence of qnr determinants and aac(6′)-Ib-cr ranges from 0.2% to 94% depending on studied strains [19][20][21]. In Northwest Iran, prevalence of PMQRs in Enterobacteriaceae isolated from UTIs showed a very high prevalence about 89.1% and among them aac(6′)-Ib-cr was the most frequently detected [22]. In Hungary, prevalence of PMQR-positive Enterobacteriaceae isolated from urine clinical samples showed 17.7% [23].…”

Section: Introductionmentioning

confidence: 99%

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Plasmid copy number and qnr gene expression in selection of fluoroquinolone-resistant Escherichia coli

Gulyás

Kocsis

Szabó

2018

AMicr

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Fluoroquinolone resistance in Enterobacteriales is developed by chromosomal and plasmid-mediated mechanisms. Plasmids play an important role in dissemination of resistant genes and they carry genes that protect bacteria in different stress-induced situations. In this study, we studied Escherichia coli strains, each carried one plasmidmediated quinolone resistance determinant namely, qnrA1, qnrB1, qnrC1, and qnrD1. We exposed 0.5 McFarland density of each strain to 0.5 mg/L ciprofloxacin from the period of 30, 60, 90, and 120 min over 24 h. All treated strains were further exposed to a constantly increasing 1, 2, 4, and 8 mg/L ciprofloxacin solution through 24, 48, and 120 h. In given timepoints, RNA was extracted from all treated strains. Expression of qnrA1, qnrB1, qnrC1, and qnrD1 was investigated by quantitative PCR. Mutations in gyrA and parC genes were analyzed by PCR and nucleic acid sequencing. In this study, during 0.5 mg/L ciprofloxacin exposition, the following expression levels were detected: 1.2 for qnrA1, 1.47 for qnrD1, 12.44 for qnrC1, and 80.63 for qnrB1. In case of long-term study, we selected a resistant strain in qnrB1-positive E. coli, and its expression increased from 105.91 to 212.31. On the contrary, plasmid copy number increased in time from 1 to 4.13. No mutations in gyrA or in parC chromosomal genes of treated strains were detected. Our results show that qnrB1-positive E. coli strain was able to develop fluoroquinolone resistance by upregulated qnrB1 expression that was linked to a minor increase in plasmid copy number but no mutations occurred in gyrA or parC.

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The prevalence of plasmid-mediated quinolone resistance and ESBL-production in <em>Enterobacteriaceae </em>isolated from urinary tract infections

Cited by 75 publications

References 27 publications

Characterization of plasmid-mediated qnrA and qnrB genes among Enterobacteriaceae strains: quinolone resistance and ESBL production in Ismailia, Egypt

Characterization of plasmid-mediated qnrA and qnrB genes among Enterobacteriaceae strains: quinolone resistance and ESBL production in Ismailia, Egypt

Extended spectrum beta-lactamase production and plasmid mediated quinolone resistance among lactose non-fermenting nterobacteriaceae isolated from poultry sources in Calabar, Nigeria

Plasmid copy number and qnr gene expression in selection of fluoroquinolone-resistant Escherichia coli

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