Background
The purpose of this study was to look into the presence of plasmid-mediated quinolone resistance (PMQR) genes and biofilm formation in several species of clinical
Shigella
isolates that were resistant to quinolones.
Methods
The stool samples of 150 patients (younger than 10 years) with diarrhea were collected in this cross-sectional study (November 2020 to December 2021). After cultivation of samples on Hektoen Enteric agar and xylose lysine deoxycholate agar, standard microbiology tests, VITEK 2 system, and polymerase chain reaction (PCR) were utilized to identify
Shigella
isolates. The broth microdilution method was used to determine antibiotic susceptibility. PMQR genes including
qnrA
,
qnrB
,
qnrC
,
qnrD
,
qnrE
,
qnrS
,
qnrVC
,
qepA
,
oqxAB
,
aac(6′)-Ib-cr
, and
crpP
and biofilm formation were investigated in quinolone-resistant isolates by PCR and microtiter plate method, respectively. An enterobacterial repetitive intergenic consensus polymerase chain reaction (ERIC-PCR) technique was used to determine the clonal relatedness of quinolone-resistant isolates.
Results
A total of 95
Shigella
isolates including
S. sonnei
(53, 55.8%),
S. flexneri
(39, 41.1%), and
S. boydii
(3, 3.2%) were identified. The highest resistance rates of the isolates were against ampicillin (92.6%, n = 88/95). Overall, 42 of 95 (44.2%) isolates were simultaneously resistant against two or more quinolones including 26 (61.9%)
S. sonnei
and 16 (38.1%)
S. flexneri
. All isolates were multidrug-resistant (resistance to more than 3 antibiotics). The occurrence of PMQR genes was as follows:
qnrS
(52.4%),
qnrA
and
aac(6′)-Ib-cr
(33.3%), and
qnrB
(19.0%). The prevalence in species was as follows: 61.5% and 37.5% (
qnrS
), 19.2% and 56.3% (
qnrA
), 38.5% and 25.0 (
aac(6′)-Ib-cr
), and 19.2% and 18.8% (
qnrB
) for
S. sonnei
and
S
.
flexneri
, respectively. The other PMQR genes were not detected. In total, 52.8% (28/53) of quinolone-susceptible and 64.3% (27/42) of quinolone-resistant isolates were biofilm producers. Biofilm formation was not significantly different between quinolone-resistant and quinolone-susceptible isolates (
P
-value ...