Prevalence of Plasmid-mediated Quinolone Resistance and Its Association with Extended-spectrum Beta-lactamase and AmpC Beta-lactamase in Enterobacteriaceae.
10.3343/kjlm.2011.31.4.257
- Author:
Haeng Soon JEONG
1
;
Il Kwon BAE
;
Jeong Hwan SHIN
;
Hee Jung JUNG
;
Si Hyun KIM
;
Ja Young LEE
;
Seung Hwan OH
;
Hye Ran KIM
;
Chulhun Ludgerus CHANG
;
Weon Gyu KHO
;
Jeong Nyeo LEE
Author Information
1. Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea. jhsmile@inje.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Qnr;
Beta-lactamase;
Quinolone;
Enterobacteriaceae
- MeSH:
Anti-Bacterial Agents/*pharmacology;
Bacterial Proteins/biosynthesis/*genetics;
DNA, Bacterial/chemistry/genetics;
Drug Resistance, Bacterial/*genetics;
Enterobacteriaceae/enzymology/*genetics/isolation & purification;
Enterobacteriaceae Infections/microbiology;
*Genetic Variation;
Hospitals, University;
Humans;
Microbial Sensitivity Tests;
Plasmids/genetics/*metabolism;
Quinolones/*pharmacology;
beta-Lactamases/biosynthesis/genetics
- From:The Korean Journal of Laboratory Medicine
2011;31(4):257-264
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We investigated the prevalence of plasmid-mediated quinolone resistance and its association with extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase in Enterobacteriaceae. METHODS: A total of 347 non-duplicated isolates of Enterobacteriaceae were collected between August and October 2006 from 2 hospitals. Qnr determinant screening was conducted using PCR amplification, and all positive results were confirmed by direct sequencing. Qnr-positive strains were determined on the basis of the presence of ESBL and AmpC beta-lactamase genes. RESULTS: The qnr gene was detected in 47 of 347 clinical Enterobacteriaceae isolates. Among the 47 qnr-positive strains, Klebsiella pneumoniae (N=29) was the most common, followed by Escherichia coli (N=6), Enterobacter cloacae (N=6), Citrobacter freundii (N=5), and Enterobacter aerogenes (N=1). These isolates were identified as qnrA1 (N=6), 8 qnrB subtypes (N=40), and qnrS1 (N=1). At least 1 ESBL was detected in 38 of the 47 qnr-positive strains. Qnr-positive strains also showed high positive rates of ESBL or AmpC beta-lactamase, such as TEM, SHV, CTX-M, and DHA. DHA-1 was detected in 23 of 47 qnr-positive strains, and this was co-produced with 1 qnrA1 and 22 qnrB4. Strains harboring MIR-1T and CMY were also detected among the qnr-positive strains. Antimicrobial-resistance rates of qnr-positive strains to ciprofloxacin, levofloxacin, norfloxacin, nalidixic acid, and moxifloxacin were 51.1%, 46.8%, 46.8%, 74.5%, and 53.2%, respectively. CONCLUSIONS: The qnr genes were highly prevalent in Enterobacteriaceae, primarily the qnrB subtypes. They were closely associated with EBSL and AmpC beta-lactamase.
