Distribution of plasmid-mediated quinolone resistance in Gram-negative bacteria from a tertiary hospital in Nigeria

Ogbolu, David Olusoga; Alli, A. O. Terry; Anorue, M C; Daini, OA; Oluwadun, Afolabi

doi:10.4103/0377-4929.188108

“…Regional FQR rates were 23.5% in North America, 29.4% in Europe, 33.2% in Asia, 38.7% in Latin America, and 25.5% in the South Pacific (32). Studies across Nigeria also reported various degree of FQR up to 50% which is almost comparable to the present study (33)(34)(35). Over the counter use of these drugs in Nigeria has probably led to such low degree of sensitivity of uropathogens to this drug.…”

Section: Discussionsupporting

confidence: 87%

Asymptomatic bacteriuria in an apparently healthy population and its relation to hypertension

Odetoyin¹,

Olaniran²,

Afolayan³

et al. 2018

Af J Clin Exp Micro

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Background Hypertension is a major health problem in sub-Sahara Africa. Several studies have suggested a role of asymptomatic bacteriuria (ASB) in the aetiology of hypertension, but there is a dearth of information on this association in Africa where the burden of hypertension is high. We investigated the prevalence of asymptomatic bacteriuria, its association with hypertension and determined the antibiotic resistance patterns of implicated bacterial isolates in an urban community of Ile-Ife. Methods One hundred and seventy-four apparently healthy individuals were investigated for ASB. Relevant information was obtained from them with standard proforma. Their Blood pressure was measured with a standard mercury sphygmomanometer. All samples were processed on cysteine lactose electrolyte deficient medium and chocolate agar. Antimicrobial susceptibility testing was done using Kirby-Bauer disk diffusion technique. Results Fifty (28.7%) individuals were positive for ASB. ASB was commonly detected among the female subjects (χ 2 =5.619; p-value = 0.01777), and among individuals in the age group of 50-59 years. Those that were hypertensive were two and a half times more likely to have ASB (Odd ratio=2.5; p-value=0.01369; CI=1.19-5.35). The highest percentage of hypertensive female participants with ASB was found in the age group of 30-39 years (33.3%) while among the male participants, the highest percentage was found in the age group of 60-69 years (9.5%). Escherichia coli (n=13; 26%) and Staphylococcus aureus (n=13; 26%) were the commonest organisms implicated in ASB. The majority of the isolates (>90%) were multidrug resistant. Isolates of Escherichia coli were commonly resistant to ampicillin (83.3%), ceftriaxone (72.7%) and cefepime (66.7%). Isolates of Staphylococcus aureus were all (100%) resistant to erythromycin, cloxacillin and streptomycin. All isolates were least resistant to cotrimoxazole (<8%). Conclusion Women as well as men in the age group of 50-59 years were more likely to develop ASB. ASB could be contributing to the rising incidence of hypertension in this environment. Co-occurrence of hypertension and ASB portends a grave problem for apparently healthy individuals in this environment.

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“…This is similar to ndings from studies done across regions in sub-sahara Africa which also found a high prevalence of PMQR determinants among quinolone resistant organisms with e ux pumps and drug-modyfying mechanisms being more common than target protection mechanism. 21 The few studies available on PMQR in Nigeria have also shown a high prevalence of the e ux and drug modifying genes in clinical isolates from humans, 14,16,21,29 also contrary to earlier reports and distribution of target site protection, drug-modifying and e ux determinants are rather of greater signi cance. Studies done outside the continent also showed a high prevalence of PMQR in clinical isolates.…”

Section: Discussionmentioning

confidence: 92%

“…13 More recently, there are reports of high level resistance to quinolones in Nigeria as well as neighbouring countries in West Africa. [13][14][15][16][17][18][19][20] Though, target protection mechanism (qnr proteins) were the rst to be discovered, previous studies suggested aac(6′)-Ib-cr to be the commonest PMQR gene followed by qepA and the qnr genes 11,14 and a more recent systematic review of published articles on uoroquinoloneresistant enteric bacteria in sub-Saharan Africa found a high prevalence of PMQR genes as well as an upregulation in e ux pumps and also the drug-modifying mechanism across several species of bacteria. 21 In view of the need for continuous antimicrobial resistance surveillance as part of global efforts to contain the emergence and dissemination of antimicrobial resistance, we determined the distribution of PMQR genes in Gram negative bacilli from a tertiary healthcare institution in South-West Nigeria.…”

Section: Introductionmentioning

confidence: 99%

High Level Plasmid-Mediated Quinolone Resistance in Clinical Infections at a Tertiary Healthcare Institution in South-West Nigeria

Ojewuyi

¹

,

Odetoyin

²

,

Aboderin

³

2020

Preprint

0

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Background Plasmid-mediated quinolone resistance (PMQR) has become a growing clinical concern worldwide. Recent reports from Nigeria revealed that qunolone resistant clinical isolates have become commomplace. However, few reports regarding the prevalence of PMQR are available. Hence, this study aimed to determine the prevalence of PMQR genes in qunolone resistant clinical isolates from a tertiary care hospital in Nigeria. Methods This was a cross-sectional hospital based study involving 390 non-repetitive Gram negative bacilli from diverse clinical infections. The isolates were characterized by the MicrobactTM identification kit and their susceptibility patterns determined by the Kirby-Bauer disc diffusion technique. All quinolone resistant isolates were investigated for the carriage of PMQR genes by multiplex polymerase chain reaction (PCR). Data analysis was with appropriate descriptive and inferential statistics.Results The isolates were distributed as Escherichia coli (n=121; 31.0%), Klebsiella species (n= 112;28.7%), Pseudomonas aeruginosa (n=59;15.1%), Proteus species (n=43;11.0%), Salmonella species (n=6;1.3%) and others. They were commonly resistant to nalidixic (62.6%), co-amoxiclav (57.7%); norfloxacin (52.3%), ofloxacin(52.1%) and ciprofloxacin(51.0%), but were least resistant to imipenem; (n=36; 9.2%). Out of 244 isolates that were resistant to at least one quinolone, 180 (73.8%) harboured one or more PMQR gene with a high prevalence of efflux-mediating determinants (qepA, 22.5%; oqxAB, 21.1%), and the aminoglycoside acetyltransferase (aac(6’)-Ib-cr, 19.7%). Proportionately low level of target-protecting determinants; qnrB, 13.2%; qnrS, 8.7%; qnrA, 5.9%; qnrD, 4.5% and qnrC, 4.2% were found in these isolates.Conclusion There is high level quinolone resistance and wide distribution of PMQR genes in clinical isolates in Nigeria with a preponderance of Efflux-mediating determinants and the aminoglycoside acetyltransferase. This emphasizes the need for regular resistance surveillance and antimicrobial stewardship to guide the appropriate and judicious use of antibiotics.

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“…13 More recently, there are reports of high level resistance to quinolones in Nigeria as well as neighbouring countries in West Africa. [13][14][15][16][17][18][19][20] Though, target protection mechanism (qnr proteins) were the rst to be discovered, previous studies suggested aac(6′)-Ib-cr to be the commonest PMQR gene followed by qepA and the qnr genes 11,14 and a more recent systematic review of published articles on uoroquinoloneresistant enteric bacteria in sub-Saharan Africa found a high prevalence of PMQR genes as well as an upregulation in e ux pumps and also the drug-modifying mechanism across several species of bacteria. 21 In view of the need for continuous antimicrobial resistance surveillance as part of global efforts to contain the emergence and dissemination of antimicrobial resistance, we determined the distribution of PMQR genes in Gram negative bacilli from a tertiary healthcare institution in South-West Nigeria.…”

Section: Introductionmentioning

confidence: 99%

High Level Plasmid-Mediated Quinolone Resistance in Clinical Infections at a Tertiary Healthcare Institution in South-West Nigeria

Ojewuyi¹,

Odetoyin²,

Aboderin³

2021

Preprint

1

0

View full text Add to dashboard Cite

Background Plasmid-mediated quinolone resistance (PMQR) has become a growing clinical concern worldwide. Recent reports from Nigeria revealed that qunolone resistant clinical isolates have become commomplace. However, few reports regarding the prevalence of PMQR are available. Hence, this study aimed to determine the prevalence of PMQR genes in qunolone resistant clinical isolates from a tertiary care hospital in Nigeria. Methods This was a cross-sectional hospital based study involving 390 non-repetitive Gram negative bacilli from diverse clinical infections. The isolates were characterized by the MicrobactTM identification kit and their susceptibility patterns determined by the Kirby-Bauer disc diffusion technique. All quinolone resistant isolates were investigated for the carriage of PMQR genes by multiplex polymerase chain reaction (PCR). Data analysis was with appropriate descriptive and inferential statistics.Results The isolates were distributed as Escherichia coli (n=121; 31.0%), Klebsiella species (n= 112;28.7%), Pseudomonas aeruginosa (n=59;15.1%), Proteus species (n=43;11.0%), Salmonella species (n=6;1.3%) and others. They were commonly resistant to nalidixic (62.6%), co-amoxiclav (57.7%); norfloxacin (52.3%), ofloxacin(52.1%) and ciprofloxacin(51.0%), but were least resistant to imipenem; (n=36; 9.2%). Out of 244 isolates that were resistant to at least one quinolone, 180 (73.8%) harboured one or more PMQR gene with a high prevalence of efflux-mediating determinants (qepA, 22.5%; oqxAB, 21.1%), and the aminoglycoside acetyltransferase (aac(6’)-Ib-cr, 19.7%). Proportionately low level of target-protecting determinants; qnrB, 13.2%; qnrS, 8.7%; qnrA, 5.9%; qnrD, 4.5% and qnrC, 4.2% were found in these isolates.Conclusion There is high level quinolone resistance and wide distribution of PMQR genes in clinical isolates in Nigeria with a preponderance of Efflux-mediating determinants and the aminoglycoside acetyltransferase. This emphasizes the need for regular resistance surveillance and antimicrobial stewardship to guide the appropriate and judicious use of antibiotics.

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Distribution of plasmid-mediated quinolone resistance in Gram-negative bacteria from a tertiary hospital in Nigeria

Abstract: This study further confirms high level resistance to many antimicrobials in different species of Gram-negative bacteria including fluoroquinolones and spread of PMQR genes in Southern Nigeria.

Cited by 10 publications

References 0 publications

Asymptomatic bacteriuria in an apparently healthy population and its relation to hypertension

Asymptomatic bacteriuria in an apparently healthy population and its relation to hypertension

High Level Plasmid-Mediated Quinolone Resistance in Clinical Infections at a Tertiary Healthcare Institution in South-West Nigeria

High Level Plasmid-Mediated Quinolone Resistance in Clinical Infections at a Tertiary Healthcare Institution in South-West Nigeria

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