scholarly journals Prevalence of Plasmid-Mediated Quinolone Resistance Determinants and OqxAB Efflux Pumps among Extended-Spectrumβ-Lactamase ProducingKlebsiella pneumoniaeIsolated from Patients with Nosocomial Urinary Tract Infection in Tehran, Iran

Scientifica ◽  
2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Mehdi Goudarzi ◽  
Mehdi Azad ◽  
Sima Sadat Seyedjavadi
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Antimicrobial Agents ◽  
Quinolone Resistance ◽  
Beta Lactam ◽  
Beta Lactam Antibiotics ◽  
Nosocomial Urinary Tract Infection ◽  
Clinical Resistance ◽  
Synergy Test

Objective. Plasmid-mediated quinolone resistance (PMQR) plays an important role in the development of clinical resistance to quinolone. The aim of this study was to investigate PMQR determinants among extended-spectrumβ-lactamases- (ESBL-) producingKlebsiella pneumoniaerecovered from patients with nosocomial urinary tract infection (UTI).Methods. A total of 247 ESBL-producingK. pneumoniaeisolates were collected from 750 patients with UTI. ESBL production was confirmed by double disc synergy test and combined disc diffusion test. The prevalence of PMQR determinants among ESBL-producingK. pneumoniaewas assessed using PCR method.Results. The rates of resistance to antimicrobial agents in present study varied from 14.2% to 98.8%. In comparison with other PMQR genotypes, the frequency ofaac(6′)-Ib(68.8%) was strikingly high. Of the 247 isolates tested,qnrA, qnrB, qnrS,andqepAgenes were present in 3.6%, 1.6%, 1.2, and 2%, respectively.oqxAandoqxBwere detected in 56.7% and 54.6% of isolates. The predominant coexisting ESBL and PMQR profile among our isolates includedblaCTX-Mandaac(6′)-Ib, oqxA, oqxB(28.3%) andblaTEM,blaSHVandaac(6′)-Ib, oqxA,andoqxB(19.4%) profile.  Conclusion. Given the linkage observed between resistance to quinolones and beta lactam antibiotics, therapeutic protocol with fluoroquinolones and beta lactam antibiotics should be seriously revised in Tehran hospitals.

Co-transfer of plasmid-mediated blaAmpC and fluoroquinolone resistance genes in Klebsiella pneumoniae isolates causing nosocomial urinary tract infection

2020 ◽  
Author(s):  
Yilin Xiong ◽  
Cong Zhang ◽  
Wenting Gao ◽  
Yong Ma ◽  
Qingqing Zhang ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Klebsiella Pneumoniae ◽  
Resistance Genes ◽  
Tertiary Care ◽  
Quinolone Resistance ◽  
Care Hospital ◽  
Nosocomial Urinary Tract Infection ◽  
Genetic Context

Abstract Background: Klebsiella pneumoniae is a pathogen that frequently causes nosocomial urinary tract infection (UTI), and the prevalence of plasmid-mediated resistance determinants among clinical isolates of K. pneumoniae leads to the appearance of resistance to antibiotics. The aim of this study was to investigate the prevalence of plasmid-mediated quinolone resistance (PMQR) genes in acquired AmpC (ac-AmpC) β‑lactamase‑producing K. pneumoniae isolates from patients with nosocomial UTI and to characterize the transmissibility of plasmids co-harbouring blaAmpC and PMQR genes.Methods: From January 2017 to June 2018, we collected 46 AmpC-producing K. pneumoniae isolates causing nosocomial UTI from a tertiary care hospital in China. β-lactamase, PMQR and virulence genes were detected by PCR and sequencing. Clonal relatedness was assessed using ERIC-PCR and multilocus sequence typing (MLST). Plasmids carrying multiple blaAmpC and PMQR genes were characterized by PCR-based replicon typing (PBRT) and S1-PFGE. Conjugation and electroporation experiments were carried out to assess resistance transfer mediated by plasmids. Overlapping PCR was used to map the genetic context of the blaAmpC genes. Results: In the studied isolates, non-susceptibility of third-generation cephalosporin and fluoroquinolone was very high (>80%). blaCMY-2, blaDHA-1, and quinolone resistance gene (qnr) were detected in 11, 41 and 33 isolates, respectively. Among the isolates, 6 strains co-harboured multiple AmpC and qnrB genes. The blaAmpC and qnrB genes from these six isolates were co-transferrable to recipients via conjugation or electroporation, with IncFIA, IncFIB and IncA/C being the dominant replicons (sizes from ~78 to 217 kb). Forty-six isolates were categorized into 25 ERIC types, and the 6 isolates harbouring multiple blaAmpC and qnrB genes belonged to ST1/STnew1. The conserved genetic structures in blaCMY-2 and blaDHA-1 were identical to those described in the pNF4656 and pSAL-1 plasmids, respectively.Conclusion: This work reports that qnrB is highly prevalent in AmpC-producing K. pneumoniae isolates and illustrates the emergence of plasmids co-harbouring multiple acquired blaAmpC and qnrB genes in K. pneumoniae causing UTI in China. We determined that the IncFIA, IncFIB and IncA/C plasmids carrying blaAmpC with qnrB resistance genes and several mobile genetic elements mediate the local prevalence in K. pneumoniae UTI. The genetic context of blaAmpC was highly conserved.

Decreasing Nosocomial Urinary Tract Infection in a Large Academic Community Hospital

2001 ◽  
Vol 6 (3) ◽  
pp. 127-136 ◽  
Author(s):  
Barbara Doyle ◽  
Zubina Mawji ◽  
Margaret Horgan ◽  
Paula Stillman ◽  
Amy Rinehart ◽  
...  
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Tract Infection ◽  
Community Hospital ◽  
Academic Community ◽  
Nosocomial Urinary Tract Infection
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