Clinical isolates of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum -lactamases or plasmid-mediated AmpC -lactamases were screened for qnrA and qnrB genes. QnrB was present in 54 of 54 DHA-1-producing K. pneumoniae isolates and 10 of 45 SHV-12-producing ones, suggesting that the distribution of plasmids conferring resistance to extended-spectrum cephalosporins and quinolones in clinical isolates of K. pneumoniae is widespread.Since the first plasmid-mediated quinolone resistance-conferring gene (qnr) was discovered in a Klebsiella pneumoniae isolate from Alabama (7), Qnr determinants have been identified worldwide (2,9,13,15). A frequent association of quinolone resistance with the production of extended-spectrum -lactamases (ESBLs) has been noticed and was explained by the selective pressures of multiple antibiotics and plasmidmediated qnr (3,9,12,15,17). At present, several qnrA-positive isolates have been found to express ESBLs, such as SHV-5, SHV-7, CTX-M-15, and VEB-1, or plasmid-mediated AmpC enzymes, such as DHA-1 (9, 17). The association of qnrB and SHV-12 was recently described (3).In order to study the prevalence of Qnr determinants and to identify ESBLs or plasmid-mediated AmpC -lactamases associated with qnr genes, we screened 239 isolates of Escherichia coli and K. pneumoniae producing variable ESBLs or plasmidmediated AmpC -lactamases for qnrA and qnrB.(This study was presented at the 44th IDSA meeting, Toronto, Ontario, Canada, 2006.) Twenty-seven E. coli strains and 62 K. pneumoniae strains were obtained from the blood isolate collection of Seoul National University Children's Hospital (SNUCH). These isolates were collected from 1993 to 2005 and were identified as producers of an ESBL or a plasmid-mediated AmpC -lactamase (part of these data were published previously [6]). Forty-nine isolates of K. pneumoniae known to produce ESBLs or to have a plasmid-mediated AmpC enzyme were recruited from the blood isolate collection of Seoul National University Hospital (SNUH) during the 5 years from 1998 to 2002 (10). Fifty-four E. coli strains and 23 K. pneumoniae strains, selected for resistance to cefoxitin and extended-spectrum cephalosporins (ESCs), were obtained from Hanyang University Hospital (HUH), a tertiary-care teaching hospital in Seoul, from 2003 to 2005. Twenty-four K. pneumoniae isolates were collected from Korea University Hospital (KUH), Seoul, in 2005 and were chosen because of their ESC resistance. Only one isolate from each patient was included in all collections. Thus, a total of 81 E. coli strains and 158 K. pneumoniae strains which produced an ESBL or a plasmid-mediated AmpC were included in this study.Isoelectric focusing (IEF) was performed by the method of Mathew et al. (8) by using a Mini IEF cell system (Bio-Rad, Hercules, CA). Strains carrying plasmids encoding -lactamases TEM-1 (R1), TEM-4 (pUD16), SHV-2 (pMG229), SHV-5 (pAFF2), and CMY-1 (pMVP-1) served as the IEF standards (6). The -lactamase genes from the clinical isolates were amplified a...