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Piekarska K, Zacharczuk K, Wołkowicz T, Mokrzyś M, Wolaniuk N, Nowakowska M, Szempliński S, Dobruch J, Gierczyński R. The molecular mechanisms of fluoroquinolone resistance found in rectal swab isolates of Enterobacterales from men undergoing a transrectal prostate biopsy: the rationale for targeted prophylaxis. Ann Clin Microbiol Antimicrob 2021; 20:81. [PMID: 34876123 PMCID: PMC8650336 DOI: 10.1186/s12941-021-00487-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 11/22/2021] [Indexed: 01/29/2023] Open
Abstract
Background Transrectal ultrasound-guided prostate biopsy (TRUS-Bx) is considered an essential urological procedure for the histological diagnosis of prostate cancer. It is, however, considered a “contaminated” procedure which may lead to infectious complications. Recent studies suggest a significant share of fluoroquinolone-resistant rectal flora in post-biopsy infections. Methods The molecular mechanisms of fluoroquinolone resistance, including PMQR (plasmid-mediated quinolone resistance) as well as mutation in the QRDRs (quinolone-resistance determining regions) of gyrA, gyrB, parC and parE, among Enterobacterales isolated from 32 of 48 men undergoing a prostate biopsy between November 2015 and April 2016 were investigated. Before the TRUS-Bx procedure, all the patients received an oral antibiotic containing fluoroquinolones. Results In total, 41 Enterobacterales isolates were obtained from rectal swabs. The MIC of ciprofloxacin and the presence of common PMQR determinants were investigated in all the isolates. Nine (21.9%) isolates carried PMQR with qnrS as the only PMQR agent detected. DNA sequencing of the QRDRs in 18 Enterobacterales (E. coli n = 17 and E. cloacae n = 1) isolates with ciprofloxacin MIC ≥ 0.25 mg/l were performed. Substitutions in the following codons were found: GyrA—83 [Ser → Leu, Phe] and 87 [Asp → Asn]; GyrB codon—605 [Met → Leu], ParC codons—80 [Ser → Ile, Arg] and 84 [Glu → Gly, Met, Val, Lys], ParE codons—458 [Ser → Ala], 461 [Glu → Ala] and 512 [Ala → Thr]. Six isolates with ciprofloxacin MIC ≥ 2 mg/l had at least one mutation in GyrA together with qnrS. Conclusions This study provides information on the common presence of PMQRs among Enterobacterales isolates with ciprofloxacin MIC ≥ 0.25 mg/l, obtained from men undergoing TRUS-Bx. This fact may partially explain why some men develop post-TRUS-Bx infections despite ciprofloxacin prophylaxis.
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Affiliation(s)
- Katarzyna Piekarska
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland.
| | - Katarzyna Zacharczuk
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
| | - Tomasz Wołkowicz
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
| | - Mateusz Mokrzyś
- Department of Urology, St. Anna Hospital, A. Mickiewicza 39, 05-500, Piaseczno, Poland.,Department of Urology, Centre of Postgraduate Medical Education, 01-813, Warsaw, Poland
| | - Natalia Wolaniuk
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
| | - Magdalena Nowakowska
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
| | - Stanisław Szempliński
- Department of Urology, Centre of Postgraduate Medical Education, 01-813, Warsaw, Poland
| | - Jakub Dobruch
- Department of Urology, St. Anna Hospital, A. Mickiewicza 39, 05-500, Piaseczno, Poland.,Department of Urology, Centre of Postgraduate Medical Education, 01-813, Warsaw, Poland
| | - Rafał Gierczyński
- Department of Bacteriology, National Institute of Public Health NIH - National Research Institute, Chocimska 24, 00-791, Warsaw, Poland
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Ortiz-Padilla M, Diaz-Diaz S, Machuca J, Tejada-Gonzalez A, Recacha E, Docobo-Pérez F, Pascual A, Rodríguez-Martínez JM. Role of low-level quinolone resistance in generating tolerance in Escherichia coli under therapeutic concentrations of ciprofloxacin. J Antimicrob Chemother 2021; 75:2124-2132. [PMID: 32427318 DOI: 10.1093/jac/dkaa151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/13/2020] [Accepted: 03/26/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Tolerance (including persistence) and resistance result in increased survival under antibiotic pressure. OBJECTIVES We evaluated the interplay between resistance and tolerance to ciprofloxacin under therapeutic and killing conditions to determine the contribution of low-level quinolone resistance (LLQR) mechanisms to tolerance. We also determined how the interaction between resistance (LLQR phenotypes) and tolerance was modified under SOS response suppression. METHODS Twelve isogenic Escherichia coli strains harbouring quinolone resistance mechanisms combined with SOS response deficiency and six clinical E. coli isolates (LLQR or non-LLQR) were evaluated. Survival (tolerance or persistence) assays were used to measure surviving bacteria after a short period (up to 4 h) of bactericidal antibiotic treatment under therapeutic and killing concentrations of ciprofloxacin [1 mg/L, EUCAST/CLSI breakpoint for resistance; and 2.5 mg/L, peak serum concentration (Cmax) of this drug]. RESULTS QRDR substitutions (S83L in GyrA alone or combined with S80R in ParC) significantly increased the fraction of tolerant bacteria (2-4 log10 cfu/mL) after exposure to ciprofloxacin at clinically relevant concentrations. The impact on tolerant bacteria due to SOS response suppression (including persistence mediated by the tisB gene) was reversed by LLQR mechanisms at therapeutic concentrations. Furthermore, no reduction in the fraction of tolerant bacteria due to SOS response suppression was observed when S83L in GyrA plus S80R in ParC were combined. CONCLUSIONS Tolerance and quinolone resistance mutations interact synergistically, giving LLQR mechanisms an additional role in allowing bacterial survival and evasion of therapeutic antimicrobial conditions by a combination of the two strategies. At clinically relevant concentrations, LLQR mechanisms reverse further impact of SOS response suppression in reducing bacterial tolerance.
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Affiliation(s)
- M Ortiz-Padilla
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, Seville, Spain.,Departamento de Microbiología, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Biomedicina de Sevilla IBIS, Hospital Universitario Virgen Macarena/CSIC/Departamento de Microbiología, Universidad de Sevilla, Seville, Spain
| | - S Diaz-Diaz
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, Seville, Spain.,Departamento de Microbiología, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Biomedicina de Sevilla IBIS, Hospital Universitario Virgen Macarena/CSIC/Departamento de Microbiología, Universidad de Sevilla, Seville, Spain
| | - J Machuca
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, Seville, Spain.,Departamento de Microbiología, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Biomedicina de Sevilla IBIS, Hospital Universitario Virgen Macarena/CSIC/Departamento de Microbiología, Universidad de Sevilla, Seville, Spain
| | - A Tejada-Gonzalez
- Departamento de Microbiología, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain
| | - E Recacha
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, Seville, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Biomedicina de Sevilla IBIS, Hospital Universitario Virgen Macarena/CSIC/Departamento de Microbiología, Universidad de Sevilla, Seville, Spain
| | - F Docobo-Pérez
- Departamento de Microbiología, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Biomedicina de Sevilla IBIS, Hospital Universitario Virgen Macarena/CSIC/Departamento de Microbiología, Universidad de Sevilla, Seville, Spain
| | - A Pascual
- Unidad Clínica de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena, Seville, Spain.,Departamento de Microbiología, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Biomedicina de Sevilla IBIS, Hospital Universitario Virgen Macarena/CSIC/Departamento de Microbiología, Universidad de Sevilla, Seville, Spain
| | - J M Rodríguez-Martínez
- Departamento de Microbiología, Facultad de Medicina, Universidad de Sevilla, Sevilla, Spain.,Red Española de Investigación en Patología Infecciosa (REIPI), Instituto de Salud Carlos III, Madrid, Spain.,Instituto de Biomedicina de Sevilla IBIS, Hospital Universitario Virgen Macarena/CSIC/Departamento de Microbiología, Universidad de Sevilla, Seville, Spain
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Distribution of fluoroquinolone resistance determinants in Carbapenem-resistant Klebsiella pneumoniae clinical isolates associated with bloodstream infections in China. BMC Microbiol 2021; 21:164. [PMID: 34078263 PMCID: PMC8173869 DOI: 10.1186/s12866-021-02238-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/21/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The rate of fluoroquinolone (FQ) resistance among carbapenem-resistant Klebsiella pneumoniae (CRKP) is high. The present study aimed to investigate the distribution of fluoroquinolone resistance determinants in clinical CRKP isolates associated with bloodstream infections (BSIs). RESULTS A total of 149 BSI-associated clinical CRKP isolates collected from 11 Chinese teaching hospitals from 2015 to 2018 were investigated for the prevalence of fluoroquinolone resistance determinants, including plasmid-mediated quinolone resistance (PMQR) genes and spontaneous mutations in the quinolone resistance-determining regions (QRDRs) of the gyrA and parC genes. Among these 149 clinical CRKP isolates, 117 (78.5%) exhibited resistance to ciprofloxacin. The GyrA substitutions (Ser83 → IIe/Phe) and (Asp87 → Gly/Ala) were found among 112 (75.2%) of 149 isolates, while the substitution (Ser80 → IIe) of ParC was found in 111 (74.5%) of the 149 isolates. In total, 70.5% (105/149) of the CRKP isolates had at least two mutations within gyrA as well as a third mutation in parC. No mutations in the QRDRs were found in 31 ciprofloxacin susceptible CRKP isolates. Eighty-nine (56.9%) of 149 were found to carry PMQR genes including qnrS1 (43.0%), aac(6')-Ib-cr (16.1%), qnrB4 (6.0%), qnrB2 (2.7%), and qnrB1 (1.3%). Nine isolates contained two or more PMQR genes, with one carrying four [aac(6')-Ib-cr, qnr-S1, qnrB2, and qnrB4]. The co-existence rate of PMQR determinants and mutations in the QRDRs of gyrA and parC reached 68.5% (61/89). Seventy-four (83.1%, 74/89) PMQR-positive isolates harbored extended-spectrum beta-lactamase (ESBL)-encoding genes. Multilocus sequence typing (MLST) analysis demonstrated that the ST11 was the most prevalent STs in our study. CONCLUSIONS Mutations in the QRDRs of gyrA and parC were the key factors leading to the high prevalence of fluoroquinolone resistance among BSI-associated CRKP. The co-existence of PMQR genes and mutations in the QRDRs can increase the resistance level of CRKP to fluoroquinolones in clinical settings. ST11 CRKP isolates with identical QRDR substitution patterns were found throughout hospitals in China.
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Azargun R, Gholizadeh P, Sadeghi V, Hosainzadegan H, Tarhriz V, Memar MY, Pormohammad A, Eyvazi S. Molecular mechanisms associated with quinolone resistance in Enterobacteriaceae: review and update. Trans R Soc Trop Med Hyg 2021; 114:770-781. [PMID: 32609840 DOI: 10.1093/trstmh/traa041] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/09/2020] [Accepted: 05/20/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Quinolones are broad-spectrum antibiotics, which are used for the treatment of different infectious diseases associated with Enterobacteriaceae. During recent decades, the wide use as well as overuse of quinolones against diverse infections has led to the emergence of quinolone-resistant bacterial strains. Herein, we present the development of quinolone antibiotics, their function and also the different quinolone resistance mechanisms in Enterobacteriaceae by reviewing recent literature. METHODS All data were extracted from Google Scholar search engine and PubMed site, using keywords; quinolone resistance, Enterobacteriaceae, plasmid-mediated quinolone resistance, etc. RESULTS AND CONCLUSION The acquisition of resistance to quinolones is a complex and multifactorial process. The main resistance mechanisms consist of one or a combination of target-site gene mutations altering the drug-binding affinity of target enzymes. Other mechanisms of quinolone resistance are overexpression of AcrAB-tolC multidrug-resistant efflux pumps and downexpression of porins as well as plasmid-encoded resistance proteins including Qnr protection proteins, aminoglycoside acetyltransferase (AAC(6')-Ib-cr) and plasmid-encoded active efflux pumps such as OqxAB and QepA. The elucidation of resistance mechanisms will help researchers to explore new drugs against the resistant strains.
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Affiliation(s)
- Robab Azargun
- Department of Microbiology, Faculty of Medicine, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Pourya Gholizadeh
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vahid Sadeghi
- Faculty of Veterinary Medicine, Islamic Azad University, Urmia, Iran
| | - Hasan Hosainzadegan
- Department of Microbiology, Faculty of Medicine, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Vahideh Tarhriz
- Molecular Medicine Research Center, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Yousef Memar
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Pormohammad
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shirin Eyvazi
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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5
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Bandyopadhyay S, Bhattacharyya D, Samanta I, Banerjee J, Habib M, Dutta TK, Dutt T. Characterization of Multidrug-Resistant Biofilm-Producing Escherichia coli and Klebsiella pneumoniae in Healthy Cattle and Cattle with Diarrhea. Microb Drug Resist 2021; 27:1457-1469. [PMID: 33913759 DOI: 10.1089/mdr.2020.0298] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
This study describes comparative occurrence and characterization of multidrug-resistant (MDR) Escherichia coli and Klebsiella pneumoniae (KP) in healthy cattle (HC) and cattle with diarrhea (DC) in India. During 2018-2020, 72 MDR isolates, including 35 E. coli (DC: 27; HC 8) and 37 K. pneumoniae (DC: 34; HC: 3), from 251 rectal swabs (DC: 219; HC: 32) were investigated for extended-spectrum beta-lactamase (ESBL), AmpC type β-lactamase and carbapenemase production, antimicrobial susceptibility profile, biofilm production, and efflux pump activity. Fifty-five MDR isolates were ESBL producers (ESBLPs) (DC: 50; HC: 5) and ESBLPs from DC were coresistant to multiple antibiotics. The blaCTX-M gene (50) was the most frequently detected β-lactamases followed by blaAmpC (22), blaTEM1 (13), blaCMY-6 (6), blaOXA1 (5), blaPER (2), blaDHA, and blaFOX and blaSHV12 (1 each). Plasmid-mediated quinolone resistance determinants qnrB, qnrS, qnrA, and qepA were detected in 18, 16, 2, and 3 isolates, respectively. Twenty three isolates revealed mutation in gyrA and parC genes. Tetracycline-resistance markers tetA, tetB, tetC, and tetE were detected in 33, 10, 3, and 2 isolates, respectively. Only one of the 41 imipenem-resistant isolates harbored blaNDM-5 and two were colistin-resistant. Altogether, 20 MDR isolates were strong biofilm producers and 19 harbored different virulence factors. This is the first ever report from India on the presence of MDR Enterobacteriaceae with resistance to even last-resort antimicrobials in the bovine diarrhea.
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Affiliation(s)
| | | | - Indranil Samanta
- Department of Veterinary Microbiology, Faculty of Veterinary and Animal Sciences, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Jaydeep Banerjee
- ICAR-Indian Veterinary Research Institute, Eastern Regional Station, Kolkata, India
| | - Md Habib
- ICAR-Indian Veterinary Research Institute, Eastern Regional Station, Kolkata, India
| | - Tapan K Dutta
- C.V.Sc. & A.H, Central Agricultural University, Aizawl, India
| | - Triveni Dutt
- Division of Livestock Production and Management, ICAR-Indian Veterinary Research Institute, Izatnagar, India
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6
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Belotindos L, Villanueva M, Miguel J, Bwalya P, Harada T, Kawahara R, Nakajima C, Mingala C, Suzuki Y. Prevalence and Characterization of Quinolone-Resistance Determinants in Escherichia coli Isolated from Food-Producing Animals and Animal-Derived Food in the Philippines. Antibiotics (Basel) 2021; 10:antibiotics10040413. [PMID: 33918946 PMCID: PMC8068814 DOI: 10.3390/antibiotics10040413] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 02/07/2023] Open
Abstract
Antimicrobial resistance to quinolones, which constitutes a threat to public health, has been increasing worldwide. In this study, we investigated the prevalence of quinolone-resistant determinants in Escherichia coli not susceptible to quinolones and isolated from food-producing animals and food derived from them, in the Philippines. A total of 791 E. coli strains were isolated in 56.4% of 601 beef, chicken, pork, egg, and milk samples, as well as environmental, cloacal, and rectal swab-collected samples from supermarkets, open markets, abattoirs, and poultry, swine, and buffalo farms. Using the disc diffusion method, it was determined that 78.6% and 55.4% of the isolates were resistant to at least one antimicrobial and multiple drugs, respectively. In 141 isolates not susceptible to quinolones, 115 (81.6%) harbored quinolone-resistant determinants and had mutations predominantly in the quinolone-resistance determining regions (QRDRs) of gyrA and parC. Plasmid-mediated, quinolone resistance (PMQR) and Qnr family (qnrA1, qnrB4, and qnrS1) genes were detected in all isolates. Forty-eight sequence types were identified in isolates harboring mutations in QRDR and/or PMQR genes by multilocus sequence typing analysis. Moreover, 26 isolates harboring mutations in QRDR and/or PMQR genes belonged mostly to phylogroup B1 and Enteroaggregative E. coli. In conclusion, a high prevalence of E. coli was found in food-producing animals and products derived from them, which could potentially spread high-risk clones harboring quinolone-resistance determinants.
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Affiliation(s)
- Lawrence Belotindos
- Division of Bioresources, International Institute for Zoonosis Control Hokkaido University, Sapporo 001-0020, Japan; (L.B.); (P.B.); (C.N.)
- Biosafety and Environment Section, Philippine Carabao Center, Science City of Muñoz, Nueva Ecija 3120, Philippines; (M.V.); (C.M.)
| | - Marvin Villanueva
- Biosafety and Environment Section, Philippine Carabao Center, Science City of Muñoz, Nueva Ecija 3120, Philippines; (M.V.); (C.M.)
| | - Joel Miguel
- Livestock Biotechnology Center, Philippine Carabao Center, Science City of Muñoz, Nueva Ecija 3120, Philippines;
| | - Precious Bwalya
- Division of Bioresources, International Institute for Zoonosis Control Hokkaido University, Sapporo 001-0020, Japan; (L.B.); (P.B.); (C.N.)
| | - Tetsuya Harada
- Division of Microbiology, Osaka Institute of Public Health, Osaka 537-0025, Japan; (R.K.); (T.H.)
| | - Ryuji Kawahara
- Division of Microbiology, Osaka Institute of Public Health, Osaka 537-0025, Japan; (R.K.); (T.H.)
| | - Chie Nakajima
- Division of Bioresources, International Institute for Zoonosis Control Hokkaido University, Sapporo 001-0020, Japan; (L.B.); (P.B.); (C.N.)
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo 001-0021, Japan
| | - Claro Mingala
- Biosafety and Environment Section, Philippine Carabao Center, Science City of Muñoz, Nueva Ecija 3120, Philippines; (M.V.); (C.M.)
- Livestock Biotechnology Center, Philippine Carabao Center, Science City of Muñoz, Nueva Ecija 3120, Philippines;
| | - Yasuhiko Suzuki
- Division of Bioresources, International Institute for Zoonosis Control Hokkaido University, Sapporo 001-0020, Japan; (L.B.); (P.B.); (C.N.)
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University, Sapporo 001-0021, Japan
- Correspondence: ; Tel.: +81-011-706-7315; Fax: +81-0-706-7310
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7
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Seo KW, Lee YJ. Prevalence and Characterization of Plasmid-Mediated Quinolone Resistance Determinants qnr and aac( 6')- Ib- cr in Ciprofloxacin-Resistant Escherichia coli Isolates from Commercial Layer in Korea. J Microbiol Biotechnol 2020; 30:1180-1183. [PMID: 32423191 PMCID: PMC9728193 DOI: 10.4014/jmb.2003.03058] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 05/14/2020] [Indexed: 12/15/2022]
Abstract
The prevalence and characterization of plasmid-mediated quinolone resistance (PMQR) determinants in ciprofloxacin-resistant Escherichia coli isolated from a Korean commercial layer farm were studied. A total of 45 ciprofloxacin-resistant E. coli isolates were recovered and all isolates were multidrug-resistant. Eight isolates have the PMQR genes aac(6')-Ib-cr, qnrS1, and qnrB4, and seven isolates exhibited double amino acid exchange at both gyrA and parC, and have high fluoroquinolone minimum inhibitory concentrations. Five transconjugants demonstrated transferability of PMQR and β-lactamase genes and similar antimicrobial resistance. Because PMQR genes in isolates from commercial layer chickens could enter the food supply and directly affect humans, control of ciprofloxacin resistance is needed.
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Affiliation(s)
- Kwang Won Seo
- College of Veterinary Medicine and Zoonoses Research Institute, Kyungpook National University, Daegu 41566, Republic of Korea,Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University, MS 39762, USA
| | - Young Ju Lee
- College of Veterinary Medicine and Zoonoses Research Institute, Kyungpook National University, Daegu 41566, Republic of Korea,Corresponding author Phone: +82-53-950-7793 Fax: +82-505-950-7793 E-mail:
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8
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Zhao Y, Zhang J, Fu Y, Li C, Hu K, Su S, Yu L, Guo Y, Fu Y, Zhang X. Molecular characterization of metallo-β-lactamase- producing carbapenem-resistant Enterobacter cloacae complex isolated in Heilongjiang Province of China. BMC Infect Dis 2020; 20:94. [PMID: 32005138 PMCID: PMC6995058 DOI: 10.1186/s12879-020-4768-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 01/07/2020] [Indexed: 11/12/2022] Open
Abstract
Background Enterobacter cloacae complex (ECC) is one of the most common extended-spectrum β-lactamase and carbapenemase-producing pathogen that threatens millions of the elderly and vulnerable sick persons. The objective of this study was to perform the molecular characteristics of the carbapenem-resistant E. cloacae complex (CREC) emerged in Heilongjiang Province of China. Methods Six CREC strains were isolated from the patients with infectious diseases. The identities of ECC isolates were confirmed by sequencing the polymerase chain reaction (PCR) products of 16S rRNA gene. The characterization of the CREC isolates were analyzed by sequencing PCR products of the carbapenemase, ampC and fluoroquinolone resistance genes and performing multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE) and whole genome sequencing. Results All 6 isolates harbored multiple resistance genes. Of them, 5 carried metallo-β-lactamases and one was blaKPC-2-positive. The levofloxacin and ciprofloxacin-resistant strains had substitutions of gyrA83, gyrA87, and parC80 in the quinolone-resistance determining regions. The MLST analyses revealed that 6 isolates belonged to five sequence types (ST520, ST528, ST1119, ST1120, and ST93) while the PFGE patterns of the isolates fallen into four clusters. The strain ST1120 was found to carry two separated plasmids that encode blaNDM-1 and blaIMP-4. Conclusions Our study, for the first time, identified a CREC strain that co-produces blaNDM-1 and blaIMP-4 in the Northeast China. Our finding emphasizes an urgent need for more intensive surveillance and precaution measures to prevent the CERC spread.
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Affiliation(s)
- Yongxin Zhao
- Yongchuan Hospital of Chongqing Medical University, Chongqing, China.,the First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Jisheng Zhang
- Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Yanjun Fu
- the First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Chunjiang Li
- Jiamusi University, Jiamusi, Heilongjiang, China
| | - Kewang Hu
- the First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Shanshan Su
- the First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Lan Yu
- the First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Yuhang Guo
- the First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China
| | - Yu Fu
- Center for Disease Control and Prevention, Jiamusi, Heilongjiang, China
| | - Xiaoli Zhang
- Yongchuan Hospital of Chongqing Medical University, Chongqing, China. .,the First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang, China.
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9
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Benevides VP, Rubio MS, Alves LBR, Barbosa FO, Souza AIS, Almeida AM, Casas MRT, Guastalli EAL, Soares NM, Berchieri Jr A. Antimicrobial Resistance in Salmonella Serovars Isolated From an Egg-Producing Region in Brazil. BRAZILIAN JOURNAL OF POULTRY SCIENCE 2020. [DOI: 10.1590/1806-9061-2020-1259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - MS Rubio
- University of the State of São Paulo, Brazil
| | - LBR Alves
- University of the State of São Paulo, Brazil
| | - FO Barbosa
- University of the State of São Paulo, Brazil
| | - AIS Souza
- University of the State of São Paulo, Brazil
| | - AM Almeida
- University of the State of São Paulo, Brazil
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10
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Characterization of Mechanisms Lowering Susceptibility to Flumequine among Bacteria Isolated from Chilean Salmonid Farms. Microorganisms 2019; 7:microorganisms7120698. [PMID: 31847389 PMCID: PMC6955667 DOI: 10.3390/microorganisms7120698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 11/22/2019] [Accepted: 12/03/2019] [Indexed: 11/17/2022] Open
Abstract
Despite their great importance for human therapy, quinolones are still used in Chilean salmon farming, with flumequine and oxolinic acid currently approved for use in this industry. The aim of this study was to improve our knowledge of the mechanisms conferring low susceptibility or resistance to quinolones among bacteria recovered from Chilean salmon farms. Sixty-five isolates exhibiting resistance, reduced susceptibility, or susceptibility to flumequine recovered from salmon farms were identified by their 16S rRNA genes, detecting a high predominance of species belonging to the Pseudomonas genus (52%). The minimum inhibitory concentrations (MIC) of flumequine in the absence and presence of the efflux pump inhibitor (EPI) Phe-Arg-β-naphthylamide and resistance patterns of isolates were determined by a microdilution broth and disk diffusion assays, respectively, observing MIC values ranging from 0.25 to >64 µg/mL and a high level of multi-resistance (96%), mostly showing resistance to florfenicol and oxytetracycline. Furthermore, mechanisms conferring low susceptibility to quinolones mediated by efflux pump activity, quinolone target mutations, or horizontally acquired resistance genes (qepA, oqxA, aac(6′)-lb-cr, qnr) were investigated. Among isolates exhibiting resistance to flumequine (≥16 µg/mL), the occurrence of chromosomal mutations in target protein GyrA appears to be unusual (three out of 15), contrasting with the high incidence of mutations in GyrB (14 out of 17). Bacterial isolates showing resistance or reduced susceptibility to quinolones mediated by efflux pumps appear to be highly prevalent (49 isolates, 75%), thus suggesting a major role of intrinsic resistance mediated by active efflux.
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11
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Zhao Y, Li C, Zhang J, Fu Y, Hu K, Su S, Wang Y, Li H, Zhang X. The in vitro activity of polymyxin B and tigecycline alone and combination with other antibiotics against carbapenem-resistant Enterobacter cloacae complex isolates, including high-risk clones. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:779. [PMID: 32042795 DOI: 10.21037/atm.2019.11.33] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Background The emergence of carbapenem-resistant Enterobacteriaceae (CRE) has become a significant problem for global public health. Currently, treatments program is minimal. This study aimed to evaluate the molecular mechanisms of carbapenem-resistant Enterobacter cloacae complex isolates (CREC) infections. Methods: Resistance genes were detected using PCR with specific primers. Multilocus sequence typing (MLST) was also performed. Furthermore, we evaluated the effects of polymyxin B (PMB) and tigecycline (TGC) antibiotics (Abs) alone and in combination with meropenem (MEM), amikacin (AMK), and levofloxacin (LEV) against CREC isolates. The results were then compared with in vitro synergy testing results obtained from time-kill assays (TKAs), and the microdilution checkerboard method. Results The synergistic efficiency of PMB + TGC was also evaluated. Abs use clinically achievable concentrations to determine the antibacterial effects of the Ab. Similar sequence type (ST) classifications had a comparably resistant phenotype; PMB-based combination therapy is better than TGC-based combination therapy. Conclusions we found that the combination of PMB + AMK is promising for the treatment of AMK-sensitive CREC. The high-risk ST93 carrying the bla KPC-2 gene should be monitored.
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Affiliation(s)
- Yongxin Zhao
- Department of Microbiology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China.,Department of Microbiology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China
| | - Chunjiang Li
- Department of Pathogenic Biology, Jiamusi University School of Basic Medicine, Jiamusi 154007, China
| | - Jisheng Zhang
- Department of Microbiology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China.,Department of Microbiology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China
| | - Yanjun Fu
- Department of Microbiology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China
| | - Kewang Hu
- Department of Microbiology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China
| | - Shanshan Su
- Department of Microbiology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China.,The First People's Hospital of Jingzhou City, Jingzhou 434000, China
| | - Yong Wang
- Department of Microbiology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China
| | - Huiling Li
- Department of Microbiology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China
| | - Xiaoli Zhang
- Department of Microbiology, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China.,Department of Microbiology, the First Affiliated Hospital of Jiamusi University, Jiamusi 154003, China
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12
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Seo KW, Lee YJ. Characterization of plasmid mediated quinolone resistance determinants in ciprofloxacin resistant-Escherichia coli from chicken meat produced by integrated broiler operations in Korea. Int J Food Microbiol 2019; 307:108274. [PMID: 31404780 DOI: 10.1016/j.ijfoodmicro.2019.108274] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 07/18/2019] [Accepted: 07/26/2019] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to determine the genetic characterization of ciprofloxacin resistant- Escherichia coli recovered from 7 different integrated broiler operations in Korea. Among the 157 E. coli isolated from chicken meat produced by integrated broiler operations, 75 (47.8%) were observed to be ciprofloxacin resistant-E. coli. However, the prevalence varied from 25.0 to 75.0%, in chicken meat, indicating variation in ciprofloxacin resistant E. coli occurrence among the operations. Among the 75 ciprofloxacin resistant-E. coli isolates, 10 showed plasmid-mediated quinolone resistance (PMQR) genes, aac(6')-Ib-cr, qnrS1 and qnrB4. Among the 10 PMQR-positive E. coli, a double amino-acid exchange in both gyrA and parC with ciprofloxacin minimum inhibitory concentrations of ≥16 μg/mL was noted in 8 isolates, and 4 transconjugants (40.0%) expressed similar antimicrobial resistance patterns and revealed the presence of PMQR genes and β-lactamase genes. Our findings suggest that E. coli with resistance to ciprofloxacin can now be found in association with integrated broiler operations, thus highlighting the need for monitoring and prevention programs in integrated operations.
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Affiliation(s)
- Kwang Won Seo
- Department of Basic Sciences, College of Veterinary Medicine, Mississippi State University, Mississippi State 39762, USA
| | - Young Ju Lee
- College of Veterinary Medicine & Zoonoses Research Institute, Kyungpook National University, Daegu 41566, Republic of Korea.
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13
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Seo KW, Lee YJ. Detection of plasmid-mediated quinolone resistance genes in β-lactamase-producing Escherichia coliisolates from layer hens. Poult Sci 2019; 98:1480-1487. [DOI: 10.3382/ps/pey545] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 11/23/2018] [Indexed: 11/20/2022] Open
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14
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Kindle P, Zurfluh K, Nüesch-Inderbinen M, von Ah S, Sidler X, Stephan R, Kümmerlen D. Phenotypic and genotypic characteristics of Escherichia coli with non-susceptibility to quinolones isolated from environmental samples on pig farms. Porcine Health Manag 2019; 5:9. [PMID: 30867937 PMCID: PMC6396500 DOI: 10.1186/s40813-019-0116-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 02/18/2019] [Indexed: 12/16/2022] Open
Abstract
Background In the last decade, the growth of the pig-farming industry has led to an increase in antibiotic use, including several used in human medicine, e.g. (fluoro)quinolones. Data from several studies suggest that there is a link between the agricultural use of antibiotics and the prevalence of antibiotic-resistant bacteria in the pig farm environment, including (fluoro)quinolone resistance. This poses a threat to human and animal health. Our goal was to phenotypically and genotypically characterize 174 E. coli showing non-susceptibility to quinolones isolated from environmental samples from pig farms. Antimicrobial susceptibility testing (AST) was performed using the disk diffusion method. PCR and sequence analysis were performed to identify chromosomal mutations in the quinolone resistance-determining regions (QRDR) of gyrA and the isolates were screened for the presence of the plasmid-mediated quinolone resistance (PMQR) genes aac-(6')-Ib-cr, qepA, qnrA, qnrB, qnrC, qnrD and qnrS. Strain relatedness was assessed by phylogenetic classification and multilocus sequence typing (MLST). Results Of 174 isolates, 81% (n = 141) were resistant to nalidixic acid, and 19% (n = 33) were intermediately resistant. Overall, 68.4% (n = 119) were multidrug resistant. This study revealed a prevalence of 79.9% (n = 139) for gyrA QRDR mutations, and detected 21.8% (n = 38) isolates with at least one PMQR gene. The two most frequently detected PMQR genes were qnrB and qnrS (13.8% (n = 24) and 9.8% (n = 17, respectively). E. coli belonging to phylogenetic group A (48.3%/n = 84) and group B1 (33.3% /n = 58) were the most frequent. E. coli ST10 (n = 20) and ST297 (n = 20) were the most common STs. Conclusions E. coli with non-susceptibility to quinolones are widespread among the environment of Swiss pig farms and are often associated with an MDR phenotype. In several cases these isolates possess at least one PMQR gene, which could spread by horizontal gene transfer. E. coli from pig farms have diverse STs, some of which are associated with human and animal disease. Electronic supplementary material The online version of this article (10.1186/s40813-019-0116-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Patrick Kindle
- 1Vetsuisse Faculty, Institute for Food Safety and Hygiene, University of Zurich, Winterthurerstrasse 272, CH-8057 Zurich, Switzerland
| | - Katrin Zurfluh
- 1Vetsuisse Faculty, Institute for Food Safety and Hygiene, University of Zurich, Winterthurerstrasse 272, CH-8057 Zurich, Switzerland
| | - Magdalena Nüesch-Inderbinen
- 1Vetsuisse Faculty, Institute for Food Safety and Hygiene, University of Zurich, Winterthurerstrasse 272, CH-8057 Zurich, Switzerland
| | - Sereina von Ah
- 2Department of Farm Animals, Division of Swine Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | - Xaver Sidler
- 2Department of Farm Animals, Division of Swine Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
| | - Roger Stephan
- 1Vetsuisse Faculty, Institute for Food Safety and Hygiene, University of Zurich, Winterthurerstrasse 272, CH-8057 Zurich, Switzerland
| | - Dolf Kümmerlen
- 2Department of Farm Animals, Division of Swine Medicine, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, 8057 Zurich, Switzerland
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15
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Prevalence of ST131 Clone Producing Both ESBL CTX-M-15 and AAC(6′)Ib-cr Among Ciprofloxacin-Resistant Escherichia coli Isolates from Yemen. Microb Drug Resist 2018; 24:1537-1542. [DOI: 10.1089/mdr.2018.0024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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16
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van der Putten BCL, Remondini D, Pasquini G, Janes VA, Matamoros S, Schultsz C. Quantifying the contribution of four resistance mechanisms to ciprofloxacin MIC inEscherichia coli: a systematic review. J Antimicrob Chemother 2018; 74:298-310. [DOI: 10.1093/jac/dky417] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/16/2018] [Indexed: 11/13/2022] Open
Affiliation(s)
- Boas C L van der Putten
- Amsterdam UMC, University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Medical Microbiology, Meibergdreef 9, Amsterdam, Netherlands
| | - Daniel Remondini
- Department of Physics and Astronomy (DIFA), University of Bologna, Viale Berti Pichat 6/2, Bologna, Bologna, Italy
| | - Giovanni Pasquini
- Department of Physics and Astronomy (DIFA), University of Bologna, Viale Berti Pichat 6/2, Bologna, Bologna, Italy
| | - Victoria A Janes
- Amsterdam UMC, University of Amsterdam, Department of Medical Microbiology, Meibergdreef 9, Amsterdam, Netherlands
| | - Sébastien Matamoros
- Amsterdam UMC, University of Amsterdam, Department of Medical Microbiology, Meibergdreef 9, Amsterdam, Netherlands
| | - Constance Schultsz
- Amsterdam UMC, University of Amsterdam, Department of Global Health, Amsterdam Institute for Global Health and Development, Meibergdreef 9, Amsterdam, Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Medical Microbiology, Meibergdreef 9, Amsterdam, Netherlands
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17
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Ma G, Wu G, Li X, Wang H, Zhou M. Characterization of Ciprofloxacin Resistance in Laboratory-Derived Mutants of Vibrio parahaemolyticus with qnr Gene. Foodborne Pathog Dis 2018; 15:711-717. [PMID: 30074404 DOI: 10.1089/fpd.2018.2476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Ciprofloxacin, a broad-spectrum fluoroquinolone, is a bactericidal antibiotic targeting DNA gyrase and DNA topoisomerase IV encoded by the gyrA and parC genes. Resistance to fluoroquinolones requires the accumulation of multiple mutations including those that alter target genes and increase drug efflux. To examine the development of fluoroquinolones resistance in Vibrio parahaemolyticus, ciprofloxacin induction and selection was used to obtain several resistant V. parahaemolyticus mutants, which showed decreased susceptibilities to quinolones, and increased or decreased susceptibility to other structurally unrelated antibiotics. Quinolone resistance-determining region mutations were characterized, and it was found that gyrA mutations occurred in some of the high-level resistant mutants although qnr was present in both wild-type susceptible and resistant mutant strains. The mutants showed increased qnr expression and exposure to sub-inhibitory concentrations of ciprofloxacin caused a further increase in qnr expression independently of the SOS system. Two mutants demonstrated increased expression of the VmeCD-VpoC pump gene that promotes quinolone efflux. In addition, some of the high-level resistance mutants significantly decreased bacterial fitness. These data suggested that multiple genes contributed to the enhanced ciprofloxacin resistance appeared in V. parahaemolyticus and that acquisition of ciprofloxacin resistance impaired bacterial fitness.
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Affiliation(s)
- Gengqin Ma
- School of Food Science and Engineering, Wuhan Polytechnic University , Wuhan, China
| | - Gaosheng Wu
- School of Food Science and Engineering, Wuhan Polytechnic University , Wuhan, China
| | - Xiaofang Li
- School of Food Science and Engineering, Wuhan Polytechnic University , Wuhan, China
| | - Hongxun Wang
- School of Food Science and Engineering, Wuhan Polytechnic University , Wuhan, China
| | - Min Zhou
- School of Food Science and Engineering, Wuhan Polytechnic University , Wuhan, China
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18
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Yanat B, Dali Yahia R, Yazi L, Machuca J, Díaz-De-Alba P, Touati A, Pascual Á, Rodríguez-Martínez JM. Occurrence of the Plasmid-Mediated Fluoroquinolone Resistance qepA1 Gene in Two Clonal Clinical Isolates of CTX-M-15-Producing Escherichia coli from Algeria. Microb Drug Resist 2016; 23:497-499. [PMID: 27736309 DOI: 10.1089/mdr.2016.0135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
QepA is a plasmid-mediated quinolone resistance determinant of low prevalence described worldwide, mainly in Enterobacteriaceae. This study describes, for the first time in Algeria, two clonally related, QepA-producing Escherichia coli clinical isolates positive for CTX-M-15. The clonal spread of these multidrug-resistant isolates is a major public health concern.
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Affiliation(s)
- Betitera Yanat
- 1 Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia , Bejaia, Algeria .,2 Department of Microbiology, University of Seville , Seville, Spain
| | - Radia Dali Yahia
- 3 Service de Bactériologie Etablissement Hospitalier et Universitaire d'Oran, Université d'Oran Faculté de Médecine , Oran, Algeria
| | - Leila Yazi
- 3 Service de Bactériologie Etablissement Hospitalier et Universitaire d'Oran, Université d'Oran Faculté de Médecine , Oran, Algeria
| | - Jesús Machuca
- 2 Department of Microbiology, University of Seville , Seville, Spain .,4 Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III , Madrid, Spain .,5 Unidad Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena , Sevilla, Spain
| | - Paula Díaz-De-Alba
- 5 Unidad Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena , Sevilla, Spain
| | - Abdelaziz Touati
- 1 Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia , Bejaia, Algeria
| | - Álvaro Pascual
- 2 Department of Microbiology, University of Seville , Seville, Spain .,4 Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III , Madrid, Spain .,5 Unidad Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena , Sevilla, Spain
| | - José-Manuel Rodríguez-Martínez
- 2 Department of Microbiology, University of Seville , Seville, Spain .,4 Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III , Madrid, Spain
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19
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Plasmid-mediated quinolone resistance: Two decades on. Drug Resist Updat 2016; 29:13-29. [PMID: 27912841 DOI: 10.1016/j.drup.2016.09.001] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/03/2016] [Accepted: 08/29/2016] [Indexed: 11/21/2022]
Abstract
After two decades of the discovery of plasmid-mediated quinolone resistance (PMQR), three different mechanisms have been associated to this phenomenon: target protection (Qnr proteins, including several families with multiple alleles), active efflux pumps (mainly QepA and OqxAB pumps) and drug modification [AAC(6')-Ib-cr acetyltransferase]. PMQR genes are usually associated with mobile or transposable elements on plasmids, and, in the case of qnr genes, are often incorporated into sul1-type integrons. PMQR has been found in clinical and environmental isolates around the world and appears to be spreading. Although the three PMQR mechanisms alone cause only low-level resistance to quinolones, they can complement other mechanisms of chromosomal resistance to reach clinical resistance level and facilitate the selection of higher-level resistance, raising a threat to the treatment of infections by microorganisms that host these mechanisms.
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20
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Del Rio-Avila C, Rosario C, Arroyo-Escalante S, Carrillo-Casas EM, Díaz-Aparicio E, Suarez-Güemes F, Silva-Sanchez J, Xicohtencatl-Cortes J, Maravilla P, Hernández-Castro R. Characterisation of quinolone-resistant Escherichia coli of 1997 and 2005 isolates from poultry in Mexico. Br Poult Sci 2016; 57:494-500. [DOI: 10.1080/00071668.2016.1187716] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- C. Del Rio-Avila
- División de Estudios de Posgrado, Posgrado en Ciencias de la Salud y Producción Animal, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Coyoacan, México
| | - C. Rosario
- Departamento de Medicina y Zootecnia de Aves, Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional Autónoma de México, Coyoacan, México
| | - S. Arroyo-Escalante
- Departamento de Biología Molecular e Histocompatibilidad, Hospital General “Dr. Manuel Gea González”, Tlalpan, México
| | - E. M. Carrillo-Casas
- Departamento de Biología Molecular e Histocompatibilidad, Hospital General “Dr. Manuel Gea González”, Tlalpan, México
| | - E. Díaz-Aparicio
- Departamento de Enfermedades en Pequeños Rumiantes, Instituto Nacional de Investigaciones Forestales, Agrícolas y Pecuarias, Cuajimalpa, México
| | - F. Suarez-Güemes
- Departamento de Microbiología e Inmunología, Universidad Nacional Autónoma de México, Coyoacan, México
| | - J. Silva-Sanchez
- Departamento de Diagnóstico Epidemiológico, Instituto Nacional de Salud Pública, Cuernavaca, México
| | - J. Xicohtencatl-Cortes
- Laboratorio de Bacteriología Intestinal, Hospital Infantil de México, Cuauhtémoc, México
| | - P. Maravilla
- Departamento de Ecología de Agentes Patógenos, Hospital General “Dr. Manuel Gea González”, Tlalpan, México
| | - R. Hernández-Castro
- Departamento de Ecología de Agentes Patógenos, Hospital General “Dr. Manuel Gea González”, Tlalpan, México
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21
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Prevalence of quinolone resistance mechanisms in Enterobacteriaceae producing acquired AmpC β-lactamases and/or carbapenemases in Spain. Enferm Infecc Microbiol Clin 2016; 35:487-492. [PMID: 27345951 DOI: 10.1016/j.eimc.2016.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 05/19/2016] [Accepted: 05/23/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Quinolone resistance in Enterobacteriaceae species has increased over the past few years, and is significantly associated to beta-lactam resistance. The aim of this study was to evaluate the prevalence of chromosomal- and plasmid-mediated quinolone resistance in acquired AmpC β-lactamase and/or carbapenemase-producing Enterobacteriaceae isolates. METHODS The presence of chromosomal- and plasmid-mediated quinolone resistance mechanisms [mutations in the quinolone resistance determining region (QRDR) of gyrA and parC and qnr, aac(6')-Ib-cr and qepA genes] was evaluated in 289 isolates of acquired AmpC β-lactamase- and/or carbapenemase-producing Enterobacteriaceae collected between February and July 2009 in 35 Spanish hospitals. RESULTS Plasmid mediated quinolone resistance (PMQR) genes were detected in 92 isolates (31.8%), qnr genes were detected in 83 isolates (28.7%), and the aac(6')-Ib-cr gene was detected in 20 isolates (7%). qnrB4 gene was the most prevalent qnr gene detected (20%), associated, in most cases, with DHA-1. Only 14.6% of isolates showed no mutations in gyrA or parC with a ciprofloxacin MIC of 0.5mg/L or higher, whereas PMQR genes were detected in 90% of such isolates. CONCLUSION qnrB4 gene was the most prevalent PMQR gene detected, and was significantly associated with acquired AmpC β-lactamase DHA-1. PMQR determinants in association with other chromosomal-mediated quinolone resistance mechanisms, different to mutations in gyrA and parC (increased energy-dependent efflux, altered lipopolysaccharide or porin loss), could lead to ciprofloxacin MIC values that exceed breakpoints established by the main international committees to define clinical antimicrobial susceptibility breakpoints.
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22
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Yanat B, Machuca J, Díaz-De-Alba P, Mezhoud H, Touati A, Pascual Á, Rodríguez-Martínez JM. Characterization of Plasmid-Mediated Quinolone Resistance Determinants in High-Level Quinolone-Resistant Enterobacteriaceae Isolates from the Community: First Report of qnrD Gene in Algeria. Microb Drug Resist 2016; 23:90-97. [PMID: 27115732 DOI: 10.1089/mdr.2016.0031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The objective was to assess the prevalence of plasmid-mediated quinolone resistance (PMQR)-producing isolates in a collection of quinolone-resistant Enterobacteriaceae of community origin isolated in Bejaia, Algeria. METHODS A total of 141 nalidixic acid-resistant Enterobacteriaceae community isolates were collected in Bejaia (Northern Algeria) and screened for PMQR genes using polymerase chain reaction (PCR). For PMQR-positive strains, antimicrobial susceptibility testing was performed by broth microdilution and disk diffusion. Mutations in the quinolone resistance-determining regions of the target genes, gyrA and parC, were detected with a PCR-based method and sequencing. Southern blotting, conjugation and transformation assays and molecular typing by pulsed-field gel electrophoresis (PFGE), and multilocus sequence typing were also performed. RESULTS The prevalence of PMQR-producing Enterobacteriaceae isolates was 13.5% (19/141); 11 of these isolates produced Aac(6')-Ib-cr and 8 were qnr-positive (4 qnrB1-like, 2 qnrS1-like, and 2 qnrD1-like), including the association with aac(6')-Ib-cr gene in three cases. PMQR gene transfer by conjugation was successful in 6 of 19 isolates tested. PFGE revealed that most of the PMQR-positive Escherichia coli isolates were unrelated, except for two groups comprising two and four isolates, respectively, including the virulent multidrug-resistant clone E. coli ST131 that were clonally related. CONCLUSION Our findings indicate that PMQR determinants are prevalent in Enterobacteriaceae isolates from the community studied. We describe the first report of the qnrD gene in Algeria.
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Affiliation(s)
- Betitera Yanat
- 1 Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia , Bejaia, Algeria .,2 Department of Microbiology, University of Seville , Seville, Spain
| | - Jesús Machuca
- 2 Department of Microbiology, University of Seville , Seville, Spain .,3 Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III , Madrid, Spain .,4 Unidad Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena , Sevilla, Spain
| | - Paula Díaz-De-Alba
- 4 Unidad Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena , Sevilla, Spain
| | - Halima Mezhoud
- 1 Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia , Bejaia, Algeria
| | - Abdelaziz Touati
- 1 Laboratoire d'Ecologie Microbienne, FSNV, Université de Bejaia , Bejaia, Algeria
| | - Álvaro Pascual
- 2 Department of Microbiology, University of Seville , Seville, Spain .,3 Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III , Madrid, Spain .,4 Unidad Intercentros de Enfermedades Infecciosas, Microbiología y Medicina Preventiva, Hospital Universitario Virgen Macarena , Sevilla, Spain
| | - José-Manuel Rodríguez-Martínez
- 2 Department of Microbiology, University of Seville , Seville, Spain .,3 Spanish Network for the Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III , Madrid, Spain
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23
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Marchisio M, Porto A, Joris R, Rico M, Baroni MR, Di Conza J. Susceptibility to β-lactams and quinolones of Enterobacteriaceae isolated from urinary tract infections in outpatients. Braz J Microbiol 2015; 46:1155-9. [PMID: 26691475 PMCID: PMC4704613 DOI: 10.1590/s1517-838246420140880] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 03/30/2015] [Indexed: 11/21/2022] Open
Abstract
The antibiotic susceptibility profile was evaluated in 71 Enterobacteriaceae isolates obtained from outpatient urine cultures in July 2010 from two health institutions in Santa Fe, Argentina. The highest rates of antibiotic resistance were observed for ampicillin (AMP) (69%), trimethoprim/sulfamethoxazole (TMS) (33%), and ciprofloxacin (CIP) (25%). Meanwhile, 21% of the isolates were resistant to three or more tested antibiotics families. Thirty integron-containing bacteria (42.3%) were detected, and a strong association with TMS resistance was found. Third generation cephalosporin resistance was detected in only one Escherichia coli isolate, and it was characterized as a blaCMY-2 carrier. No plasmid-mediated quinolone resistance (PMQR) was found. Resistance to fluoroquinolone in the isolates was due to alterations in QRDR regions. Two mutations in GyrA (S83L, D87N) and one in ParC (S80I) were observed in all CIP-resistant E. coli. It was determined to be the main phylogenetic groups in E. coli isolates. Minimum Inhibitory Concentration (MIC) values against nalidixic acid (NAL), levofloxacin (LEV), and CIP were determined for 63 uropathogenic E. coli isolates as MIC50 of 4 μg/mL, 0.03125 μg/mL, and 0.03125 μg/mL, respectively, while the MIC90 values of the antibiotics were determined as 1024 μg/mL, 64 μg/mL, and 16 μg/mL, respectively. An association between the phylogenetic groups, A and B1 with fluoroquinolone resistance was observed. These results point to the importance of awareness of the potential risk associated with empirical treatment with both the families of antibiotics.
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Affiliation(s)
- Martín Marchisio
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa, Fe, Argentina
| | - Ayelén Porto
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa, Fe, Argentina
| | - Romina Joris
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa, Fe, Argentina
| | - Marina Rico
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa, Fe, Argentina
| | - María R Baroni
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa, Fe, Argentina
| | - José Di Conza
- Facultad de Bioquímica y Ciencias Biológicas, Universidad Nacional del Litoral, Santa, Fe, Argentina
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24
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Gomig F, Galvão CW, Freitas DLD, Labas L, Etto RM, Esmerino LA, Lima MAD, Appel MH, Zanata SM, Steffens MBR, Nader HB, Silveira RBD. Quinolone resistance and ornithine decarboxylation activity in lactose-negative Escherichia coli. Braz J Microbiol 2015; 46:753-7. [PMID: 26413057 PMCID: PMC4568878 DOI: 10.1590/s1517-838246320131291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 10/30/2014] [Indexed: 11/28/2022] Open
Abstract
Quinolones and fluoroquinolones are widely used to treat uropathogenic
Escherichia coli infections. Bacterial resistance to these
antimicrobials primarily involves mutations in gyrA and
parC genes. To date, no studies have examined the potential
relationship between biochemical characteristics and quinolone resistance in
uropathogenic E. coli strains. The present work analyzed the
quinolone sensitivity and biochemical activities of fifty-eight lactose-negative
uropathogenic E. coli strains. A high percentage of the isolates
(48.3%) was found to be resistant to at least one of the tested quinolones, and DNA
sequencing revealed quinolone resistant determining region gyrA and
parC mutations in the multi-resistant isolates. Statistical
analyses suggested that the lack of ornithine decarboxylase (ODC) activity is
correlated with quinolone resistance. Despite the low number of isolates examined,
this is the first study correlating these characteristics in lactose-negative
E. coli isolates.
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Affiliation(s)
- Franciane Gomig
- Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Carolina Weigert Galvão
- Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Denis Leandro de Freitas
- Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Larissa Labas
- Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Rafael Mazer Etto
- Departamento de Química, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Luiz Antonio Esmerino
- Departamento de Análises Clínicas, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | | | - Marcia Helena Appel
- Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
| | - Silvio Marques Zanata
- Departamento de Patologia Básica, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | | | - Helena Bonciani Nader
- Departamento de Bioquímica, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Rafael Bertoni da Silveira
- Departamento de Biologia Estrutural, Molecular e Genética, Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil
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25
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Yu T, Jiang X, Fu K, Liu B, Xu D, Ji S, Zhou L. Detection of Extended-Spectrum β-Lactamase and Plasmid-Mediated Quinolone Resistance Determinants inEscherichia coliIsolates from Retail Meat in China. J Food Sci 2015; 80:M1039-43. [PMID: 25864449 DOI: 10.1111/1750-3841.12870] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 01/28/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Tao Yu
- Dept. of Chemistry and Chemical Engineering; Xinxiang Univ; Xinxiang 453000 China
| | - Xiaobing Jiang
- The College of Life Sciences; Henan Normal Univ; Xinxiang 453007 China
| | - Kaifei Fu
- The Central Laboratory of Navy General Hospital; Beijing 100048 China
| | - Biyun Liu
- The Institute of Hydrobiology; Chinese Academy of Sciences; Wuhan China
| | - Dong Xu
- The Institute of Hydrobiology; Chinese Academy of Sciences; Wuhan China
| | - Shengdong Ji
- The College of Life Sciences; Henan Normal Univ; Xinxiang 453007 China
| | - Lijun Zhou
- The Central Laboratory of Navy General Hospital; Beijing 100048 China
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26
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Goto K, Kawamura K, Arakawa Y. Contribution of QnrA, a Plasmid-Mediated Quinolone Resistance Peptide, to Survival of Escherichia coli Exposed to a Lethal Ciprofloxacin Concentration. Jpn J Infect Dis 2015; 68:196-202. [DOI: 10.7883/yoken.jjid.2014.153] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kensuke Goto
- Department of Pathophysiological Laboratory Science, Nagoya University Graduate School of Medicine
| | - Kumiko Kawamura
- Department of Pathophysiological Laboratory Science, Nagoya University Graduate School of Medicine
| | - Yoshichika Arakawa
- Department of Bacteriology, Nagoya University Graduate School of Medicine
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27
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Piekarska K, Wołkowicz T, Zacharczuk K, Rzeczkowska M, Chróst A, Bareja E, Olak M, Gierczyński R. Co-existence of plasmid-mediated quinolone resistance determinants and mutations in gyrA and parC among fluoroquinolone-resistant clinical Enterobacteriaceae isolated in a tertiary hospital in Warsaw, Poland. Int J Antimicrob Agents 2014; 45:238-43. [PMID: 25468717 DOI: 10.1016/j.ijantimicag.2014.09.019] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 08/25/2014] [Accepted: 09/27/2014] [Indexed: 10/24/2022]
Abstract
Plasmid-mediated quinolone resistance (PMQR) determinants and the distribution of mutations in the quinolone resistance-determining regions (QRDRs) of gyrA and parC were investigated in 215 ciprofloxacin-resistant (MIC>1mg/L) clinical Enterobacteriaceae collected during a 6-month prospective study in a tertiary hospital in Warsaw, Poland. PMQR determinants were present in 49 isolates (22.8%), among which aac(6')-Ib-cr and qnrB1 predominated (85.7% and 26.5%, respectively). Mutations in gyrA and parC QRDRs were detected among 89.8% of isolates (MIC≥4mg/L). Changes in Ser-83, Ala-84 and Asp-87 in GyrA and Ser-80 and Glu-84 in ParC were detected. Five isolates with ciprofloxacin MICs in the range 1.5-16 mg/L were found to have unaltered QRDRs, with PMQR as the only fluoroquinolone (FQ) resistance trait detected. The remaining 44 PMQR-positive isolates were found to carry altered QRDRs. Three substitutions (two in GyrA and one in ParC) were detected in 23 isolates, whilst 8 isolates carried four mutations (two in GyrA and two in ParC). One isolate of Klebsiella pneumoniae with two amino acid substitutions in the ParC QRDR in the presence of aac(6')-Ib-cr and qnrB1 had a ciprofloxacin MIC of 16mg/L. The results presented here show that FQ resistance in these clinical Enterobacteriaceae is a complex interplay between PMQR determinants and mutations in gyrA and parC rather than a single stepwise accumulation of mutations in the gyrase and topoisomerase subunits. In addition, these results show the role of PMQR determinants in promoting QRDR mutations and the acquisition of high-level FQ resistance in clinical settings.
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Affiliation(s)
- Katarzyna Piekarska
- Department of Bacteriology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland.
| | - Tomasz Wołkowicz
- Department of Bacteriology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland
| | - Katarzyna Zacharczuk
- Department of Bacteriology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland
| | - Magdalena Rzeczkowska
- Department of Bacteriology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland
| | - Anna Chróst
- Department of Bacteriology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland
| | - Elżbieta Bareja
- Department of Laboratory Diagnostics, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland
| | - Monika Olak
- Department of Laboratory Diagnostics, Military Institute of Medicine, Szaserów 128, 04-141 Warsaw, Poland
| | - Rafał Gierczyński
- Department of Bacteriology, National Institute of Public Health - National Institute of Hygiene, Chocimska 24, 00-791 Warsaw, Poland
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28
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Ferjani S, Saidani M, Amine FS, Boutiba-Ben Boubaker I. Prevalence and characterization of plasmid-mediated quinolone resistance genes in extended-spectrum β-lactamase-producing Enterobacteriaceae in a Tunisian hospital. Microb Drug Resist 2014; 21:158-66. [PMID: 25247633 DOI: 10.1089/mdr.2014.0053] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The objective of the study was to assess the prevalence of plasmid-mediated quinolone resistance (PMQR) genes (qnrA, qnrB, qnrC, qnrD, qnrS, aac(6')-Ib-cr, qepA, and oqxAB) in a collection of 120 extended-spectrum β-lactamases (ESBLs)-producing enterobacteria and to characterize them. Overall, PMQR determinants were detected in 72 (60%) isolates (20 Escherichia coli, 32 Klebsiella pneumoniae, and 20 Enterobacter cloacae). PMQR frequencies were as follows: qnr genes (25.8%), oqxAB (21.6%), and aac(6')-Ib-cr variant (19.2%). Four qnr alleles were identified as qnrB1 (83.8%), qnrB4 (6.4%), qnrB2 (3.2%), and qnrS1 (6.4%). qnr genes were mainly detected in E. cloacae (50%), aac(6')-Ib-cr in E. coli (47.5%), and oqxAB in K. pneumoniae (65%). Overall, blaCTX-M-15 (90.3%) was the most prevalent blaESBL type followed by blaSHV-12 (6.4%) and blaSHV-27 (2.7%). Rates of mutations in gyrA and parC genes were 75% for E. coli, 72.8% for K. pneumoniae, and 50% for E. cloacae. Isolates with mutations in their quinolone resistance-determining regions exhibited high fluoroquinolones resistance levels compared to those with wild ones. Genetic study of PMQR-harboring isolates revealed a great genomic diversity among each Enterobacteriaceae species. Our findings indicate the high prevalence of PMQR determinants among ESBL-producing Enterobacteriaceae isolates from our hospital and their diffusion in various unrelated CTX-M-15-producing clones.
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Affiliation(s)
- Sana Ferjani
- 1 LR99ES09 Laboratoire de Résistance aux antimicrobiens, Faculté de Médecine de Tunis, Université de Tunis El Manar , Tunis, Tunisie
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29
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Machuca J, Briales A, Labrador G, Díaz-de-Alba P, López-Rojas R, Docobo-Pérez F, Martínez-Martínez L, Rodríguez-Baño J, Pachón ME, Pascual A, Rodríguez-Martínez JM. Interplay between plasmid-mediated and chromosomal-mediated fluoroquinolone resistance and bacterial fitness in Escherichia coli. J Antimicrob Chemother 2014; 69:3203-15. [PMID: 25139837 DOI: 10.1093/jac/dku308] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES The aim of this study was to analyse the interplay among plasmid-mediated qnr genes, alone or in combination with multiple chromosomal-mediated fluoroquinolone (FQ) resistance determinants, susceptibility to FQs and bacterial fitness in an isogenic Escherichia coli collection. METHODS E. coli ATCC 25922 was used to modify or delete chromosomal genes. qnr genes were cloned into the pBK-CMV vector. The MICs of FQs were determined by microdilution. Mutant prevention concentration and frequency of mutants were evaluated. Bacterial fitness was analysed using ΔlacZ system competition assays using in vitro and in vivo models. RESULTS The relationships between the number of resistance mutations and bacterial fitness were complex. With specific combinations of resistance mechanisms the addition of a new resistance mutation was shown to improve bacterial fitness. qnrA1 caused a decrease in fitness (7%-21%) while qnrS1 caused an increase in fitness (9%-21%) when combined with chromosomal mutations. We identified susceptible triple mutants in which the acquisition of a fourth resistance mutation significantly increased fitness and at the same time reached the clinical resistance level (the acquisition of qnrS1 in a S83L + D87N + ΔmarR genetic background). A strong correlation with the production of reactive oxygen species, as well as changes in susceptibility, was observed following treatment with ciprofloxacin. CONCLUSIONS Our data indicate that there may be critical stages (depending on the genotype) in resistance development, including chromosomal- and plasmid-mediated mechanisms, at which some low-fitness mutants below the resistance breakpoint are able to evolve clinical resistance with just one or two mutations, and show increased fitness.
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Affiliation(s)
- Jesús Machuca
- Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain
| | - Alejandra Briales
- Department of Microbiology, University of Seville, Seville, Spain Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
| | - Gema Labrador
- Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain Institute of Biomedicine of Seville (IBiS), University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain
| | | | - Rafael López-Rojas
- Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain Institute of Biomedicine of Seville (IBiS), University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain
| | - Fernando Docobo-Pérez
- Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
| | - Luis Martínez-Martínez
- Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain University Hospital Marques de Valdecilla and Valdecilla Biomedical Research Institute (IDIVAL), Santander, Spain Department of Molecular Biology, University of Cantabria, Santander, Spain
| | - Jesús Rodríguez-Baño
- Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain Medicine Department, University of Seville, Seville, Spain
| | - Maria Eugenia Pachón
- Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain Institute of Biomedicine of Seville (IBiS), University Hospital Virgen del Rocío/CSIC/University of Seville, Seville, Spain
| | - Alvaro Pascual
- Infectious Diseases and Clinical Microbiology Unit, University Hospital Virgen Macarena, Seville, Spain Department of Microbiology, University of Seville, Seville, Spain Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
| | - José-Manuel Rodríguez-Martínez
- Department of Microbiology, University of Seville, Seville, Spain Spanish Network for Research in Infectious Diseases (REIPI RD12/0015), Instituto de Salud Carlos III, Madrid, Spain
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30
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Chandran S, Diwan V, Tamhankar A, Joseph B, Rosales-Klintz S, Mundayoor S, Lundborg C, Macaden R. Detection of carbapenem resistance genes and cephalosporin, and quinolone resistance genes along with oqxAB
gene in Escherichia coli
in hospital wastewater: a matter of concern. J Appl Microbiol 2014; 117:984-95. [DOI: 10.1111/jam.12591] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2014] [Revised: 06/07/2014] [Accepted: 06/25/2014] [Indexed: 01/22/2023]
Affiliation(s)
- S.P. Chandran
- Division of Infectious Diseases; St. John's Research Institute; Bangalore India
- Department of Microbiology; St. John's Medical College; Bangalore India
| | - V. Diwan
- Department of Public Health Sciences; Global Health/IHCAR; Karolinska Institutet; Stockholm Sweden
- Department of Public Health and Environment; R.D. Gardi Medical College; Ujjain India
- International Center for Health Research; R.D. Gardi Medical College; Ujjain India
| | - A.J. Tamhankar
- Department of Public Health Sciences; Global Health/IHCAR; Karolinska Institutet; Stockholm Sweden
- Department of Environmental Medicine; Indian Initiative for Management of Antibiotic Resistance (IIMAR); R D Gardi Medical College; Ujjain India
| | - B.V. Joseph
- Departments of Biotechnology; Christ University; Bangalore India
| | - S. Rosales-Klintz
- Department of Public Health Sciences; Global Health/IHCAR; Karolinska Institutet; Stockholm Sweden
| | - S. Mundayoor
- Mycobacterial Research Group; Department of Molecular Microbiology; Rajiv Gandhi Centre for Biotechnology; Thiruvananthapuram India
| | - C.S. Lundborg
- Department of Public Health Sciences; Global Health/IHCAR; Karolinska Institutet; Stockholm Sweden
| | - R. Macaden
- Division of Infectious Diseases; St. John's Research Institute; Bangalore India
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31
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High rates of intestinal colonisation with fluoroquinolone-resistant ESBL-harbouring Enterobacteriaceae in hospitalised patients with antibiotic-associated diarrhoea. Eur J Clin Microbiol Infect Dis 2014; 33:2215-21. [DOI: 10.1007/s10096-014-2193-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/22/2014] [Indexed: 10/25/2022]
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32
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Jiang X, Yu T, Wu N, Meng H, Shi L. Detection of qnr, aac(6')-Ib-cr and qepA genes in Escherichia coli isolated from cooked meat products in Henan, China. Int J Food Microbiol 2014; 187:22-5. [PMID: 25036771 DOI: 10.1016/j.ijfoodmicro.2014.06.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/21/2014] [Accepted: 06/28/2014] [Indexed: 10/25/2022]
Abstract
Antimicrobial resistance in Escherichia coli has increased in recent years in China. Antimicrobial resistant isolates and resistance genes of E. coli can be transferred to humans through the food chain and this presents a public health risk. However, few studies have investigated the prevalence of antimicrobial resistance-encoding genes in E. coli isolated from food samples in China. The aim of this study was to investigate the presence of quinolone resistance genes (QRGs) and extended-spectrum β-lactamases (ESBLs) in E. coli isolated from cooked meat products in Henan, China. A total of 75 E. coli isolates (12.1%) were detected from 620 samples. High rates of resistance to the following drugs were observed: tetracycline (56.0%), trimethoprim/sulfamethoxazole (41.3%), streptomycin (29.3%), ampicillin (26.7%) and nalidixic acid (14.7%). Of the 75 isolates, QRGs were present in 10 isolates (13.3%), with qnr and aac(6')-Ib-cr detected alone or in combination in five (6.7%) and eight isolates (10.7%). The qnr genes detected in this study included qnrS (n=3) and qnrA (n=2). The qepA gene was absent among these isolates. Three types of β-lactamase genes were identified in the five ESBL-producing E. coli isolates: blaCTX-M-1, blaCTX-M-9, and blaTEM-1. The qnrS gene was found to be co-transferred with blaCTX-M-1 and blaTEM-1 in one isolate. Our data suggest that cooked meat products may act as reservoirs for multi-resistant bacteria and facilitate the dissemination of antimicrobial resistance genes.
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Affiliation(s)
- Xiaobing Jiang
- College of Life Sciences, Henan Normal University, Xinxiang 453007, China
| | - Tao Yu
- Department of Chemistry and Chemical Engineering, Xinxiang University, Xinxiang 453000, China; Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China.
| | - Nan Wu
- Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
| | - Hecheng Meng
- College of Light Industry and Food Sciences, South China University of Technology, Guangzhou 510640, China
| | - Lei Shi
- College of Light Industry and Food Sciences, South China University of Technology, Guangzhou 510640, China
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33
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Martínez-Martínez L, Eliecer Cano M, Manuel Rodríguez-Martínez J, Calvo J, Pascual Á. Plasmid-mediated quinolone resistance. Expert Rev Anti Infect Ther 2014; 6:685-711. [DOI: 10.1586/14787210.6.5.685] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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34
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Rodríguez-Martínez JM, Cano ME, Calvo J, Pascual Á, Martínez-Martínez L. Plasmid-mediated quinolone resistance. Microb Drug Resist 2013. [DOI: 10.2217/ebo.12.362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- José Manuel Rodríguez-Martínez
- José Manuel Rodríguez-Martínez is a Researcher in molecular microbiology aspects related to mechanisms of antimicrobial resistance and resistance gene dissemination. His doctoral thesis focused on the characterization of plasmid-mediated quinolone resistance in Enterobacteriaceae. He is Professor at the University of Seville, Spain
| | - María Eliecer Cano
- María Eliecer Cano is a Clinical Microbiologist at the University Hospital Marqués de Valdecilla (Santander, Spain). She is applying and developing molecular methods for typing of clinically relevant microorganisms and for detection of genes involved in antimicrobial resistance
| | - Jorge Calvo
- Jorge Calvo is a Clinical Microbiologist at the University Hospital Marqués de Valdecilla. His area of expertise is susceptibility testing (including automatic devices) and interpretation of antibiogram data. He is also involved in surveillance of antimicrobial resistance
| | - Álvaro Pascual
- Álvaro Pascual is Professor of Microbiology at the University of Seville and Head of the Clinical Microbiology Laboratory at University Hospital Virgen Macarena (Seville, Spain). He is an expert on the genetic basis of antimicrobial resistance and epidemiology of infections caused by multidrug-resistant Gram-negative bacteria
| | - Luis Martínez-Martínez
- Luis Martínez-Martínez is Professor of Microbiology at the University of Cantabria (Santander, Spain) and Head of Clinical Microbiology of the University Hospital Marqués de Valdecilla. His research is focused on molecular aspects of antimicrobial resistance, particularly in multidrug-resistant bacteria
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35
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Guan X, Xue X, Liu Y, Wang J, Wang Y, Wang J, Wang K, Jiang H, Zhang L, Yang B, Wang N, Pan L. Plasmid-mediated quinolone resistance--current knowledge and future perspectives. J Int Med Res 2013; 41:20-30. [PMID: 23569126 DOI: 10.1177/0300060513475965] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Quinolones are a group of antimicrobial agents that were serendipitously discovered as byproducts of the synthesis of chloroquine. Chemical modifications, such as the addition of fluorine or piperazine, resulted in the synthesis of third- and fourth-generation fluoroquinolones, with broad-spectrum antimicrobial actions against aerobic or anaerobic, Gram-positive or Gram-negative bacteria. The efficacy and consequent widespread use of quinolones and fluoroquinolones has led to a steady global increase in resistance, mediated via gene mutations, alterations in efflux or cell membranes and plasmid-conferred resistance. The first plasmid-mediated quinolone resistance gene, qnrA1, was detected in 1998. Since then, many other genes have been identified and the underlying mechanisms of resistance have been elucidated. This review provides an overview of quinolone resistance, with particular emphasis on plasmid-mediated resistance.
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Affiliation(s)
- Xizhou Guan
- Department of Respiratory Diseases, Chinese PLA General Hospital, Beijing, China
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Rodríguez-Martínez JM, Díaz de Alba P, Briales A, Machuca J, Lossa M, Fernández-Cuenca F, Rodríguez Baño J, Martínez-Martínez L, Pascual Á. Contribution of OqxAB efflux pumps to quinolone resistance in extended-spectrum-β-lactamase-producing Klebsiella pneumoniae. J Antimicrob Chemother 2012; 68:68-73. [PMID: 23011289 DOI: 10.1093/jac/dks377] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES The aims of this study were to analyse the presence of oqxA and oqxB genes in a collection of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae strains, to determine their chromosomal and/or plasmidic locations and to analyse expression levels in relation to susceptibility or resistance to quinolones. METHODS A collection of 114 non-repetitive isolates of ESBL-producing K. pneumoniae was used. K. pneumoniae ATCC 27799 and K. pneumoniae ATCC 700603 were also included. Detection of oqxA and oqxB genes was performed by PCR. Testing for chromosomal and/or plasmidic location was carried out using plasmid DNA and subsequent hybridization. oqxA gene expression was analysed using real-time RT-PCR. Transfer of the plasmid-encoded OqxAB was evaluated. RESULTS The prevalence of both oqxA and oqxB detected in K. pneumoniae was high: 76% and 75%, respectively. Hybridization assays showed that oqxA (16%) and oqxB (13%) were simultaneously present in locations on the chromosome and on large plasmids. The plasmids were transferable by transformation into K. pneumoniae. RT-PCR assays showed higher expression (4-fold) in strains with reduced susceptibility to quinolones than in susceptible strains. Interestingly, K. pneumoniae ATCC 700603 showed an 18-fold higher expression than K. pneumoniae ATCC 27799. These differences were in accordance with quinolone susceptibility. CONCLUSIONS The prevalence of the OqxAB efflux pump (both chromosomal and plasmid encoded) in ESBL-producing K. pneumoniae is high in Spain and represents a potential reservoir for the spread of these genes. High expression of this pump contributes to reduced susceptibility to quinolones in clinical isolates of ESBL-producing K. pneumoniae.
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Transferable mechanisms of quinolone resistance. Int J Antimicrob Agents 2012; 40:196-203. [DOI: 10.1016/j.ijantimicag.2012.02.011] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 02/20/2012] [Accepted: 02/21/2012] [Indexed: 11/20/2022]
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Guo Q, Wang P, Ma Y, Yang Y, Ye X, Wang M. Co-production of SFO-1 and DHA-1 -lactamases and 16S rRNA methylase ArmA in clinical isolates of Klebsiella pneumoniae. J Antimicrob Chemother 2012; 67:2361-6. [DOI: 10.1093/jac/dks244] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Prevalence of plasmid-mediated quinolone resistance determinants qnr and aac(6′)-Ib-cr in Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β-lactamases in Spain. Int J Antimicrob Agents 2012; 39:431-4. [DOI: 10.1016/j.ijantimicag.2011.12.009] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Revised: 12/16/2011] [Accepted: 12/23/2011] [Indexed: 11/18/2022]
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Magesh H, Kamatchi C, Vaidyanathan R, Sumathi G. Identification of plasmid-mediated quinolone resistance genes qnrA1, qnrB1 and aac(6')-1b-cr in a multiple drug-resistant isolate of Klebsiella pneumoniae from Chennai. Indian J Med Microbiol 2011; 29:262-8. [PMID: 21860107 DOI: 10.4103/0255-0857.83910] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE Resistance to fluoroquinolones, a commonly prescribed antimicrobial for Gram-negative and Gram-positive microorganisms, is of importance in therapy. The purpose of this study was to screen for the presence of Plasmid-Mediated Quinolone Resistance (PMQR) determinants in clinical isolates of Klebsiella pneumoniae. MATERIALS AND METHODS Extended-Spectrum Beta-Lactamase (ESBL) isolates of K. pneumoniae collected during October 2009 were screened by the antimicrobial susceptibility test. The plasmids from these isolates were analysed by specific Polymerase chain Reaction (PCR) for qnrA, qnrB and aac(6')-1b. The amplified products were sequenced to confirm the allele. RESULTS Our analysis showed that 61% out of the 23 ESBL K. pneumoniae isolates were resistant to ciprofloxacin and 56% to levofloxacin. The PMQR was demonstrated by transforming the plasmids from two isolates P12 and P13 into E. coli JM109. The PMQR gene qnrA was found in 16 isolates and qnrB in 11 isolates. The plasmid pKNMGR13 which conferred an minimum inhibitory concentration (MIC) of more than 240 μg/ml in sensitive E. coli was found to harbour the qnrA1 and qnrB1 allele. Furthermore, the gene aac(6')-1b-cr encoding a variant aminoglycoside 6'-N Acetyl transferase which confers resistance to fluoroquinolones was found in the same plasmid. CONCLUSIONS Our report shows the prevalence of PMQR mediated by qnrA and qnrB in multidrug-resistant K. pneumoniae isolates from Chennai. A multidrug-resistant plasmid conferring high resistance to ciprofloxacin was found to harbour another PMQR gene, aac(6')-1b-cr mutant gene. This is the first report screening for PMQR in K. pneumoniae isolates from India.
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Affiliation(s)
- H Magesh
- Department of Biotechnology, Dr. MGR Educational and Research Institute, Maduravoyal, Chennai - 600 095, Tamil Nadu, India
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Correlation of Fluoroquinolone Resistance with Expression ofqnrAGene inKluyveraSpp. Foodborne Pathog Dis 2011; 8:1039-44. [DOI: 10.1089/fpd.2011.0839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Rodríguez-Martínez JM, Velasco C, Pascual Á, Cano ME, Martínez-Martínez L, Martínez-Martínez L, Pascual Á. Plasmid-mediated quinolone resistance: an update. J Infect Chemother 2011; 17:149-82. [DOI: 10.1007/s10156-010-0120-2] [Citation(s) in RCA: 181] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2010] [Indexed: 01/27/2023]
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In vitro effect of qnrA1, qnrB1, and qnrS1 genes on fluoroquinolone activity against isogenic Escherichia coli isolates with mutations in gyrA and parC. Antimicrob Agents Chemother 2010; 55:1266-9. [PMID: 21173174 DOI: 10.1128/aac.00927-10] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This article provides an analysis of the in vitro effect of qnrA1, qnrB1, and qnrS1 genes, combined with quinolone-resistant Ser83Leu substitutions in GyrA and/or Ser80Arg in ParC, on fluoroquinolone (FQ) resistance in isogenic Escherichia coli strains. The association of Ser83Leu substitution in GyrA, Ser80Arg substitution in ParC, and qnr gene expression increased the MIC of ciprofloxacin to 2 μg/ml. qnr genes present in E. coli that harbored a Ser83Leu substitution in GyrA increased mutant prevention concentration (MPC) values to 8 to 32 μg/ml. qnr gene expression in E. coli may play an important role in selecting for one-step FQ-resistant mutants.
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Han C, Yang Y, Wang M, Wang A, Lu Q, Xu X, Wang C, Liu L, Deng Q, Shen X. The prevalence of plasmid-mediated quinolone resistance determinants among clinical isolates of ESBL or AmpC-producingEscherichia colifrom Chinese pediatric patients. Microbiol Immunol 2010; 54:123-8. [DOI: 10.1111/j.1348-0421.2010.00200.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Although plasmid-mediated quinolone resistance (PMQR) was thought not to exist before its discovery in 1998, the past decade has seen an explosion of research characterizing this phenomenon. The best-described form of PMQR is determined by the qnr group of genes. These genes, likely originating in aquatic organisms, code for pentapeptide repeat proteins. These proteins reduce susceptibility to quinolones by protecting the complex of DNA and DNA gyrase or topoisomerase IV enzymes from the inhibitory effect of quinolones. Two additional PMQR mechanisms were recently described. aac(6')-Ib-cr encodes a variant aminoglycoside acetyltransferase with two amino acid alterations allowing it to inactivate ciprofloxacin through the acetylation of its piperazinyl substituent. oqxAB and qepA encode efflux pumps that extrude quinolones. All of these genes determine relatively small increases in the MICs of quinolones, but these changes are sufficient to facilitate the selection of mutants with higher levels of resistance. The contribution of these genes to the emergence of quinolone resistance is being actively investigated. Several factors suggest their importance in this process, including their increasing ubiquity, their association with other resistance elements, and their emergence simultaneous with the expansion of clinical quinolone resistance. Of concern, these genes are not yet being taken into account in resistance screening by clinical microbiology laboratories.
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Han C, Yang Y, Wang M, Wang A, Lu Q, Xu X, Wang C, Liu L, Deng Q, Shen X. The prevalence of plasmid-mediated quinolone resistance determinants among clinical isolates of ESBL or AmpC-producing Escherichia coli from Chinese pediatric patients. Microbiol Immunol 2009. [DOI: 10.1111/j.1348-0421.2009.00200.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Characterization of small ColE-like plasmids mediating widespread dissemination of the qnrB19 gene in commensal enterobacteria. Antimicrob Agents Chemother 2009; 54:678-82. [PMID: 20008783 DOI: 10.1128/aac.01160-09] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
In this work, we have characterized two small ColE-like plasmids (pECY6-7, 2.7 kb in size, and pECC14-9, of 3.0 kb), encoding the QnrB19 quinolone resistance determinant, that were carried by several clonally unrelated quinolone-resistant commensal Escherichia coli strains isolated from healthy children living in different urban areas of Peru and Bolivia. The two plasmids are closely related to each other and carry the qnrB19 gene as the sole resistance determinant, located in a conserved genetic context between the plasmid RNAII sequence (which controls plasmid replication) and the plasmid Xer site (involved in plasmid dimer resolution). ISEcp1-like or other putative insertion sequences are not present in the qnrB19-flanking regions or elsewhere on the plasmids. Since we previously observed a high prevalence (54%) of qnrB genes in the metagenomes of commensal enterobacteria from the same population of healthy children, the presence of pECY6-7- and pECC14-9-like plasmids in those qnrB-positive metagenomes was investigated by PCR mapping. Both plasmids were found to be highly prevalent (67% and 16%, respectively) in the qnrB-positive metagenomes, suggesting that dissemination of these small plasmids played a major role in the widespread dissemination of qnrB genes observed in commensal enterobacteria from healthy children living in those areas.
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Huang SY, Dai L, Xia LN, Du XD, Qi YH, Liu HB, Wu CM, Shen JZ. Increased Prevalence of Plasmid-Mediated Quinolone Resistance Determinants in Chicken Escherichia coli Isolates from 2001 to 2007. Foodborne Pathog Dis 2009; 6:1203-9. [DOI: 10.1089/fpd.2009.0348] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Si-Yang Huang
- National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Lei Dai
- National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Li-Ning Xia
- National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Xiang-Dang Du
- College of Veterinary Medicine and Animal Husbandry, Henan Agricultural University, Zhengzhou, People's Republic of China
| | - Yong-Hua Qi
- National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
- College of Animal Science, Henan Institute of Science and Technology, Xinxiang, People's Republic of China
| | - He-Bing Liu
- College of Veterinary Medicine and Animal Husbandry, Henan Agricultural University, Zhengzhou, People's Republic of China
| | - Cong-Ming Wu
- National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
| | - Jian-Zhong Shen
- National Center for Veterinary Drug Safety Evaluation, College of Veterinary Medicine, China Agricultural University, Beijing, People's Republic of China
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Fang H, Huang H, Shi Y, Hedin G, Nord CE, Ullberg M. Prevalence of qnr determinants among extended-spectrum β-lactamase-positive Enterobacteriaceae clinical isolates in southern Stockholm, Sweden. Int J Antimicrob Agents 2009; 34:268-70. [DOI: 10.1016/j.ijantimicag.2009.03.016] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 03/24/2009] [Indexed: 11/29/2022]
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50
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The SOS response promotes qnrB quinolone-resistance determinant expression. EMBO Rep 2009; 10:929-33. [PMID: 19556999 DOI: 10.1038/embor.2009.99] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2008] [Revised: 03/20/2009] [Accepted: 04/09/2009] [Indexed: 11/08/2022] Open
Abstract
The qnr genes are plasmid-borne fluoroquinolone-resistance determinants widespread in Enterobacteriaceae. Three families of qnr determinants (qnrA, B and S) have been described, but little is known about their expression and regulation. Two new determinants, qnrC and qnrD, have been found recently. Here, we describe the characterization of the qnrB2 promoter and the identification of a LexA-binding site in the promoter region of all qnrB alleles. LexA is the central regulator of the SOS response to DNA damage. We show that qnrB2 expression is regulated through the SOS response in a LexA/RecA-dependent manner, and that it can be induced by the quinolone ciprofloxacin, a known inducer of the SOS system. This is the first description of direct SOS-dependent regulation of an antibiotic-resistance mechanism in response to the antibiotic itself.
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