Frequency of Quinolone Resistance and qnrB and qnrC Genes in Clinical Isolates of Klebsiella pneumoniae
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Abstract
Background: Klebsiella pneumoniae is among the most common and significant agents of community and hospital-acquired infections. Plasmid mediated quinolone resistance (PMQR) was increasingly identified in Enterobacteriaceae family worldwide. Plasmid-mediated quinolone resistance (PMQR) was first reported in 1998 from a Klebsiella pneumoniae isolate in the USA. Till date, five Qnr proteins have been identified; QnrA, QnrB, QnrC, QnrD and QnrS. Quinolone are broad spectrum antibiotics the resistant to which has increasingly been reported among many bacterial species including Klebsiella. The aim of this study was the antibiotic resistance profile was determined based on resistance and molecular characterization of qnrB and qnrC genes in Klebsiella pneumoniae clinical isolated.
Methods: In this cross sectional study, 94 samples of K. pneumoniae were collected. Isolates were screened for quinolone antibiotics resistance using disk diffusion method according to clinical and laboratory standards institute (CLSI) guidelines. Isolates with resistance to at least one of the quinolone antibiotics, examined for presence of the qnrB and qnrC genes.
Results: Based on the obtained results by the Agar disk diffusion test, 29.78%, 27.65%, 28.72% and 27.65% of the isolates were resistant to nalidixic acid, ciprofloxacin, norfloxacin and ofloxacin, respectively. Of these 46.66% carried qnrB, 3.33% carried qnrC genes.
Conclusion: The identification of qnrB gene among quinolone-resistant K. pneumoniae isolates shows that the emergence of PMQR in this region requires serious preventive measures.
Heiat M, Rezaeimehr M, Moghaddam M, et al. Molecular genetic analysis of quinolone resistance-determining region of DNA Gyrase-A in fluoroquinolones resistant Klebsiella pneumoniae based on GenBank data and reported studies. Mol Genet Microbiol Virol 2014; 29(4): 211-5.
Podschun R, Ullmann U. Klebsiella spp. as nosocomial pathogens: epidemiology, taxonomy, typing methods, and pathogenicity factors. Clin Microbiol Rev 1998; 11(4): 589-603.
Ko W-C, Paterson DL, Sagnimeni AJ, et al. Community-acquired Klebsiella pneumoniae bacteremia: global differences in clinical patterns. Emerg Infect Diseases 2002; 8(2): 160-6.
Padilla E, Llobet E, omenech-Sanchez A, et al. Klebsiella pneumoniae AcrAB efflux pump contributes to antimicrobial resistance and virulence. Antimicrob Agents Chemother 2010; 54(1): 177-83.
Paterson DL, Hujer KM, Hujer AM, et al. Extended-spectrum β-lactamases in Klebsiella pneumoniae bloodstream isolates from seven countries: dominance and widespread prevalence of SHV-and CTX-M-type β-lactamases. Antimicrob Agents Chemother 2003; 47(11): 3554-60.
Yousefi Mashour R, Alijani P, Saidijam M, et al. Study of antibiotic resistance pattern and phenotypic detection of ESBLs in Klebsiella pneumoniae strains isolated from clinical samples and determination of minimum inhibitory concentrations of imipenem and ceftazidim antibiotics. Scientific Journal of Hamadan University of Medical Sciences 2014; 20(4): 295-302.
Jacoby GA. Mechanisms of resistance to quinolones. Clin Infect Dis 2005; 41(2): 120-6.
Oliphant CM, Green GM. Quinolones: a comprehensive review. Am Fam Physician 2002; 65(3): 455-64.
Poirel L, Cattoir V, Nordmann P. Plasmid-mediated quinolone resistance; interactions between human, animal, and environmental ecologies. Front Microbiol 2012; 3(24): 1-7.
Rodríguez-Martínez JM, Cano ME, Velasco C, Martínez-Martínez L, et al. Plasmid-mediated quinolone resistance: an update. J Infect Chemother 2011; 17(2): 149-82.
Strahilevitz J, Jacoby GA, Hooper DC, et al. Plasmid-mediated quinolone resistance: a multifaceted threat. Clin Microbiol Rev 2009; 22(4): 664-89.
Moghbelli M, Behnood V, Ranjbar R. A Study to determine antibiotic resistance and recognition qnr genes in Shigella strains isolated from patients admitted to mofid's children Medical center, Tehran. JMW. 2014; 7(1): 49-57.
Corkill JE, Anson JJ, Hart CA. High prevalence of the plasmid-mediated quinolone resistance determinant qnrA in multidrug-resistant Enterobacteriaceae from blood cultures in Liverpool, UK. J Antimicrob Chemoth 2005; 56(6): 1115-7.
Cattoir V, Poirel L, Rotimi V, et al. Multiplex PCR for detection of plasmid-mediated quinolone resistance qnr genes in ESBL-producing enterobacterial isolates. J Antimicrob Chemoth 2007; 60(2): 394-7.
Elmer KW, Allen SD, William MJ, CS P, CW. W. Color atlas and textbook of diagnostic microbiology. 5th ed. Philadelphia: Lippincott; 1992. p. 1-1154.
Patel JB, Cockerill ER, Alder J, et al. Clinical and Laboratory Standards Institute (CLSI). M100-S24. Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement. 2014; 34(1): 1-226.
Cremet L, Caroff N, Dauvergne S, et al. Prevalence of plasmid-mediated quinolone resistance determinants in ESBL Enterobacteriaceae clinical isolates over a 1-year period in a French hospital. Pathol Biol 2011; 59(3): 151-6.
Chen X, Zhang W, Pan W, et al. Prevalence of qnr, aac(6′)-Ib-cr, qepA, and oqxAB in Escherichia coli Isolates from Humans, Animals, and the Environment. Antimicrob Agents Chemother 2012; 56(6): 3423-7.
Pallecchi L, Riccobono E, Mantella A, et al. High prevalence of qnr genes in commensal enterobacteria from healthy children in Peru and Bolivia. Antimicrob Agents Chemother 2009; 53(6): 2632-5.
Lamikanra A, Crowe JL, Lijek RS, et al. Rapid evolution of fluoroquinolone-resistant Escherichia coli in Nigeria is temporally associated with fluoroquinolone use. BMC Infect Dis 2011; 11(1): 1-10.
Robicsek A, Jacoby GA, Hooper DC. The worldwide emergence of plasmid-mediated quinolone resistance. Lancet Infect Dis 2006; 6(10): 629-40.
Soltan Dalal MM, Miremadi SA, Sharify Yazdi MK, et al. Antimicrobial resistance trends of Klebsiella spp. isolated from patients in Imam Khomeini hospital. Payavard Salamat 2012; 6(4): 275-81.
Amin A, Ghumro P, Hussain S, Hameed A. Prevalence of antibiotic resistance among clinical isolates of Klebsiella pneumoniae isolated from a Tertiary Care Hospital in Pakistan. Malays J Microbiol 2009; 5(2): 81-6.
Mahmoudjanlou H, Moradi A, Shakeri F, et al. Minimum Inhibitory Concentration of Cefotaxime by E-test Method on Klebsiella in Gorgan. Medical Lab J 2012; 6(2): 16-20.
Kim HB, Park CH, Kim CJ, et al. Prevalence of plasmid-mediated quinolone resistance determinants over a 9-year period. Antimicrob Agents Chemother 2009; 53(2): 639-45.
Minarini LA, Poirel L, Cattoir V, et al. Plasmid-mediated quinolone resistance determinants among enterobacterial isolates from outpatients in Brazil. J Antimicrob Chemoth 2008; 62(3): 474-8.
Azadpour M, Soleimani Y, Rezaie F, et al. Prevalence of qnr Genes and Antibiotic Susceptibility Patterns among Clinical Isolates of Klebsiella pneumoniae in West of Iran. J Bacteriol Parasitol 2014; 5(5): 1-4.
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| Issue | Vol 5 No 5-6 (2016) | |
| Section | Original Articles | |
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| Klebsiella pneumoniae Quinolone Resistance qnr Genes | ||
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