Yara El-sayed Marei, Omayma Mohamed Aboul-Ola, SaharZakaria El-Azab, Rania Mohammad Kishk* and Marwa Mohammad Fouad
Department of Medical Microbiology and Immunology, Suez Canal University, EgyptFulltext PDF
Background: Plasmid-mediated quinolone resistance determinants have been identified in Enterobacteriaceae, with varying prevalence rates worldwide. In addition, the emergence of PMQR and its association in ESBL producing Enterobacteriaceae are raising public health concerns. Aim: To assess the prevalence of PMQR genes among ESBL and ESBL non-producing Enterobacteriaceae isolated from patients with UTIs. Methods: All the ESBL and non-ESBL Enterobacteriaceae that were phenotypically resistant to nalidixic acid, ciprofloxacin and levofloxacin were tested by PCR for the presence of five PMQR determinants. Results: The study showed that 28.2% of the Enterobacteriaceae isolates were confirmed to be ESBL producers while 71.8% were ESBL non-producers with significant difference (P<0.05). PMQR genes were detected in 93.1% of the ESBL producers and in 76% of the ESBL non-producers with no significant difference. qnrA gene showed the highest association with ESBL (58.6%) followed by qnrB gene (51.7%), while qnrB and aac(6’)-Ib-cr genes showed the highest association with nonESBL (32% each) followed by qnrA and qnrS (28% each). There were no statistically significant differences regarding the association between ESBL production and the presence of the different PMQR genes except for qnrA. Coexistence of more than one PMQR gene in each of the 54 phenotypic quinolone resistance isolates was detected; 4 genes in 2 isolates (3.7%), 3 genes in 7 (12.9%) and 2 genes in 27 (50%) isolates. Conclusion: Our results suggest high frequencies of PMQR genes among both ESBL producing and ESBL non-producing Enterobacteriaceae isolates.
Quinolones; ESBL; Enterobacteriaceae; PMQR gene
El-sayed Marei Y, Mohamed AboulOla O, Zakaria El-Azab S, Mohammad Kishk R, Mohammad Fouad M. Detection of Plasmid-Mediated Quinolone Resistance Determinants in ESBLs and Non-ESBLs Producing Enterobacteriaceae from Urinary Tract Infections. Ann Clin Immunol Microbiol. 2019;1(2):1008..