Molecular basis of quinolone resistance in Enterobacterial isolates

Yıl 2016, Cilt: 6 Sayı: 3, 97 - 102, 01.09.2016

Nivedita Dasgupta

https://doi.org/10.5799/jmid.328959

Öz

Objective: Fluoroquinolones are the commonly prescribed antimicrobial for Gram-negative and Gram-positive microorganisms.
The resistance against these antibiotics is of importance in therapy. The current study aimed at determination
of aac(6’)-Ib-cr gene within the Enterobacterial isolates and their transmission dynamics.
Materials and Methods: Ninety-seven isolates of Enterobacteriaceae collected during May 2013 to October 2013 were
screened by the antimicrobial susceptibility test. The plasmids from these isolates were analysed by specific Polymerase
chain Reaction (PCR) for qnrA, qnrB, qnrD, qnrC, and aac(6’)-1b-cr and the horizontal dissemination of these plasmid
mediated quinolone determinants and aac(6’)-1b-cr genes were determined by transformation.
Results: Our analysis showed that 94 out of 97 phenotypically screened positive isolates, 85.57% (n = 83), 84.53%
(n=82) were resistant to norfloxacin, ciprofloxacin respectively. Coexisting qnrD genes was identified in 11isolates carrying
aac(6’)-Ib-cr gene. The PMQR and aac(6’)-Ib-cr was demonstrated by transforming the plasmid carrying qnrD and
aac(6’)-Ib-cr gene into E. coli strain DH5ɑ. PCR assay confirmed that aac(6’)-Ib-cr was present in all the transformants.
Conclusion: Our report shows the presence of heterogenous resistance mechanism can lead to worrisome condition at
the nosocomial level and community acquired infection. So aac(6’)-Ib-cr containing strains should be promptly detected
and referred to clinicians so that the treatment with non-hydrophilic FQs, such as levofloxacin and ofloxacin, or other
classes of antibiotics to prevent high level resistance onset and spread. J Microbiol Infect Dis 2016;6(3): 97-102

Aac(6′)-1b-cr, Enterobacteriaceae, plasmid-mediated quinolone resistance, qnrD; qnrC,

Anahtar Kelimeler

Aac(6′)-1b-cr, Enterobacteriaceae, plasmid-mediated quinolone resistance, qnrD; qnrC

Kaynakça

• 1. Jacoby GA Mechanisms of resistance to quinolones. Clin Infect Dis 2005; 41(2):120-126.
• 2. Martinez-Martinez L, Pascual A, and Jacoby GA. Quinolone resistance from a transferable plasmid. Lancet 1998; 351:797–799.
• 3. Strahilevitz J, Jacoby GA, Hooper DC, Robicsek A. Plasmidmediated quinolone resistance: a multifaceted threat. Clin Microbiol Rev 2009; 22:664-689.
• 4. Ma J, Zeng Z, Chen Z, et al. High prevalence of plasmid-mediated quinolone resistance determinants qnr, aac(6=)-Ib-cr, and qepA among ceftiofur resistant Enterobacteriaceae isolates from companion and food-producing animals. Antimicrob Agents Chemother 2009; 53:519–524.
• 5. Pu X, Pan J, Wang H, Zhang W, Huang C, Gu Y. Characterization of fluoroquinolone-resistant Shigella flexneri in Hangzhou area of China. J Antimicrob Chemother 2009; 63: 917-920.
• 6. Carattoli A. Resistance plasmid families in Enterobacteriaceae. Antimicrob Agents Chemother 2009; 53: 2227-2238.
• 7. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: twenty-first informational supplement M100-S21. CLSI. 2012.
• 8. Crichton PB, Collee JG, Fraser AG, Marmion BP, Simmons A. Enterobacteriaceae: Escherichia, Klebsiella, Proteus and other genera. Mackie and McCartney, in Practical Medical Microbiology 1996; 14th ed. 361-384.
• 9. Cattoir V, Poirel L, Rotimi V, Soussy CJ, Nordmann P. Multiplex PCR for detection of plasmid-mediated quinolone resistance qnr genes in ESBL-producing enterobacterial isolates. J Antimicrob Chemother 2007; 60:394-7.
• 10. Li S, Anderson ML, Yang.H. Heat shock method. Applied Physics Letters 2007; 91, 013902
• 11. Oktem IM, Gulay Z, Bicmen M, Gur D; HITIT Project Study Group. qnrA prevalence in extended-spectrum beta-lactamasepositive Enterobacteriaceae isolates from Turkey. Jpn J Infect Dis 2008; 61: 13-17.
• 12. Versalovic J, Koeuth T, and Lupski JR. Distribution of repetitive DNA sequences in eubacteria and application to fingerprinting of bacterial genomes. Nucleic Acids Res 1991; 19: 6823-6831.
• 13. Bouchakour M, Zerouali K, Claude J, Amarouch H, Mdaghri N, Courvalin P, Mohammed T. Plasmid-mediated quinolone resistance in expanded spectrum beta lactamase producing Enterobacteriaceae in Morocco. J Infect Dev Ctries 2010; 4(12):799-803.
• 14. Chaudhary MP. Resistance Patterns and Prevalence of the Aminoglycoside Modifying Enzymes in Clinical Isolates of Gram Negative Pathogens, Glob J Pharmacol 2014; 8(1): 73-79.
• 15. Pu X, Pan J, WangH, Zhang W, Huang C, Gu Y. Characterization of fluoroquinolone-resistant Shigella flexneri in Hangzhou area of China. J Antimicrob Chemother 2009; 63: 917-920.
• 16. Park CH, Robicsek A, Jacoby GA, Sahm D, Hooper DC. Prevalence in the United States of aac(6′)-Ib-cr encoding a ciprofloxacin-modifying enzyme. Antimicrob Agents Chemother 2006; 50:3953-3955
• 17. Eftekhar F, Seyedpour SM. Prevalence of qnr and aac(6’)- Ib-cr Genes in clinical isolates of Klebsiella Pneumoniae from Imam Hussein Hospital in Tehran.Iran J Med Sci 2015; 40(6):515-521.
• 18. 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.
• 19. Tripathi A, Dutta SK, Majumdar M, Dhara L, Banerjee D, Roy K. High prevalence and significant association of ESBL and QNR genes in pathogenic Klebsiella pneumonia isolates of patients from Kolkata, India. Indian J Microbiol. 2012; 52(4):557-564.
• 20. Geetha VK, Harish BN, Srinivasan R, Yugendran T. Plasmidmediated quinolone resistance in typhoidal Salmonellae: A preliminary report from South India. Indian J Med Microbiol. 2014; 32(1):31-34.
• 21. Karah N, Poirel L, Bengtsonn S, Sundqvist M, Kahlmeter G, Nordmann P. Plasmid-mediated quinolone resistance determinant qnr and aac(6’)-Ib-cr in Escherichia coli and Klebsiella spp from Norway and Sweden. Diag Microbiol Infect Dis2010; 66:425–31.
• 22. Martinez-Martinez L, Pascual A, Jacoby GA. Quinolone resistance from a transferable plasmid. Lancet 1998; 351:797- 799.
• 23. Ilaria Frasson, Antonietta Cavallaro, Cristina Bergo, Sara N Richter1, and Giorgio P. Prevalence of aac(6’)-Ib-cr plasmid-mediated and chromosome-encoded fluoroquinolone resistance in Enterobacteriaceae in Italy. Gut Pathogens 2011;3:12.
• 24. Wang M, Guo Q, Xu X, et al. New Plasmid-mediated Quinolone resistance gene, qnrC, found in a clinical isolate of Proteus mirabilis. Antimicrob.Agents Chemother 2009; 53 (5):1892-1897.
• 25. Cavaco LM.,Hasman, H, Xia S, Aarestrup FM. qnrD, a novel gene conferring transferable quinolone resistance in Salmonella enterica serovars Kentucky and Bovismorbificans of human origin. Antimicrob. Agents Chemother 2009; 53:603- 608.
• 26. Hata M, Suzuki M, Matsumoto M, Takahashi M, Sato K, Ibe S, Sakae. Cloning of novel gene for quinolone resistance from a transferable plasmid in Shigella flexneri 2b. Antimicrob. Agents Chemother 2005; 49:801-803.