Identification of plasmid-mediated quinolone resistance genes qnrA1, qnrB1 and aac(6’)-1b-cr in a multiple drug-resistant isolate of Klebsiella pneumoniae from Chennai

Magesh, H; Kamatchi, C.; Vaidyanathan, Rama; Sumathi, G

doi:10.4103/0255-0857.83910

Cited by 21 publications

(17 citation statements)

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“…In studies conducted by Lautenbach in USA (2001), Shahcheraghi (2007) in Iran and Tumbarello in Italy (2006), 60%, 48% and 32% of ESBL producing isolates of K. pneumoniae were resistant to ciprofloxacin, respectively (16-18). A report from India also showed that 61% of K. pneumoniae ESBL producers were resistant to ciprofloxacin and 52% to levofloxacin (19). Resistance to ciprofloxacin has also been observed in ESBL producing E. coli compared to non-ESBL isolates in Iran (10).…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Quinolone Resistance Among Extended-Spectrum β -Lactamase Producing Uropathogenic Klebsiella pneumoniae

Raei

Eftekhar

Feizabadi

2014

Jundishapur J Microbiol

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Background:Extended-spectrum β-lactamase (ESBL) production is the major resistance mechanism to β-lactam antibiotics in Enterobacteriaceae. In addition, emergence of plasmid-mediated quinolone resistance (PMQR) in ESBL-producing isolates has become a global threat for treatment of these infections.Objectives:We investigated the association between ESBL production and quinolone resistance in urinary isolates of K. pneumoniae.Patients and Methods:A total of 196 urinary isolates of K. pneumoniae were collected from Imam Hussein Hospital in Tehran during a four year period (2008-2012). Antibiotic susceptibility was determined by disc diffusion and ESBL production was screened using the phenotypic confirmatory test (PCT).Results:All isolates were susceptible to imipenem. Resistance to piperacillin and cefotaxime were 66.3% and 50.5%, respectively. Resistance to ceftazidime, amoxiclave, aztreonam, ceftriaxone, cefepime, nitrofurantoin, gentamicin, ciprofloxacin, nalidixic acid, ofloxacin, norfloxacin, levofloxacin, amikacin and pipracilin/tazobactam were less than 50%. ESBL production was detected in 92 isolates (46.9%) of which, 61.9% were resistant to nalidixic acid and 65.2% to ciprofloxacin. Multidrug-resistance was observed in 96.7% of ESBL producers.Conclusions:Our results showed coexistence of ESBL and quinolone resistance in the majority of the uropathogenic K. pneumoniae test isolates suggesting that care should be taken for the choice of antibiotic therapy.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Quinolone Resistance Among Extended-Spectrum β -Lactamase Producing Uropathogenic Klebsiella pneumoniae

Raei

Eftekhar

Feizabadi

2014

Jundishapur J Microbiol

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“…Despite such high fluoroquinolone resistance rates, fewer than ten studies from India have reported the prevalence of PMQR genes. ( Pazhani et al, 2011 ; Geetha et al, 2014 ; Magesh et al, 2011 ; Bhattacharya et al, 2011 ). Data analysis in the diagnostic microbiology laboratory attached to Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India, a teaching hospital with a bed strength of 1,500, revealed 75% of the Enterobacteriaceae isolates to be resistant to ciprofloxacin in the year 2012 (T Yugendran, 2013, unpublished data).…”

Section: Introductionmentioning

confidence: 99%

High incidence of plasmid-mediated quinolone resistance genes among ciprofloxacin-resistant clinical isolates of Enterobacteriaceae at a tertiary care hospital in Puducherry, India

Yugendran

Harish

2016

PeerJ

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Background. Plasmid-mediated quinolone resistance (PMQR) has received considerable attention recently. Data analysis in Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER) revealed 75% of the Enterobacteriaceae isolates to be ciprofloxacin-resistant in 2012. Few reports regarding the prevalence of PMQR are available from India. Hence, the present study was carried out to ascertain the prevalence of PMQR genes among clinical isolates of ciprofloxacin-resistant Enterobacteriaceae in JIPMER.Methods. The study included 642 ciprofloxacin-resistant clinical Enterobacteriaceae isolates. JIPMER hospital’s annual consumption data for fluoroquinolones were retrieved from the Department of Pharmacy. The test isolates were screened for the presence of qnr A, B, D, S and aac(6′)-Ib-cr genes. PMQR-positive isolates alone were tested for the presence of class I (intI1) and class II (intI2) integrons. Randomly selected PCR amplicons were sequenced and analysed using MEGA software. A total of 30 PMQR strains chosen at random were assessed for the transferability of the PMQR genes.Results. A majority of the strains exhibited high MIC values with 106 strains exhibiting MIC values >256 µg/mL. The aac(6′)-Ib-cr gene had the highest prevalence at 64% (414) while, qnrB and qnrS genes were present in 15% (97) and 10% (64) of the isolates respectively. None of the strains were positive for qnrA and qnrD. All PMQR-positive isolates were screened for class I (intI1) and class II (intI2) integrons. Class I integron was found to be predominant among the test isolates with a few of them carrying both the classes of integrons. Transferability of PMQR genes to transconjugants was identified.Conclusion. The incidence of PMQR genes in the tertiary-care setup of the JIPMER hospital was found to be high which could be probably due to the increased prescription of fluoroquinolones. Thus, there is a need for rational usage of fluoroquinolones.

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“…In another study, Andrea Endimiani et al have reported quinolone resistance due to qnr B and aac (6')-Ib gene in Klebsiella pneumoniae [25]. In a South Indian study, prevalence of PMQR mediated by qnrA (48%) and qnr A and qnr B (24%) in multidrug-resistant K. pneumoniae isolates have been reported [26].…”

Section: Discussionmentioning

confidence: 99%

A study on prevalence of plasmid mediated quinolone resistant genes in Klebsiella pneumoniae

2019

Trop J Pathol Microbiol

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Introduction: Fluoroquinolone resistance is increasingly been reported in Enterobacteriaceae. Resistance to quinolones among Enterobacteriaceae is mediated by point mutations in chromosomal genes that encode the subunits of DNAgyrase and topoisomerase IV. Objectives: The present study was done to identify quinolone resistant Klebsiella pneumoniae isolates from clinical samples and to detect the prevalence of plasmid mediated quinolone resistance genes. Materials & Methods: A total of 63 isolates from various clinical samples were identified by standard biochemical methods. Antimicrobial resistance pattern of these isolates were performed by disk diffusion method as per guidelines of CLSI. Minimum Inhibitory Concentration for Ciprofloxacin was determined by E test strips with concentration gradient of 0.002-32 µg/ml. Detection of plasmid mediated quinolone resistance genes was performed by PCR. Results: By disk diffusion, 90.99% isolates were found to be resistant to Ciprofloxacin. The sensitivity of isolates to Imipenem was found to be 99.10%. About 50.74% isolates were resistant to Aminoglycosides and 61.19% were resistant to third generation Cephalosporins. By E test, 80.95% isolates were resistant for Ciprofloxacin with MIC of >1µg/ml. By PCR, out of 63 isolates, 6 (9.52%) showed aac (6')-Ib-cr gene, 7 (11.11%) were positive for qnr A gene, 29 (46.03%) for both qnr B and aac (6')-Ib-cr gene and 8 (12.70%) for qnr B gene. Conclusion: The transferrable nature of Plasmid mediated fluoroquinolone resistant genes favours the dissemination of the resistant genes between different bacterial genera and limit therapeutic options available. The prevalence of plasmid mediated quinolone resistance mediated by qnr A, qnrB and aac (6')-Ib-cr gene results in multidrug resistance among Klebsiella pneumoniae.

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Identification of plasmid-mediated quinolone resistance genes qnrA1, qnrB1 and aac(6’)-1b-cr in a multiple drug-resistant isolate of Klebsiella pneumoniae from Chennai

Cited by 21 publications

References 20 publications

Prevalence of Quinolone Resistance Among Extended-Spectrum β -Lactamase Producing Uropathogenic Klebsiella pneumoniae

Prevalence of Quinolone Resistance Among Extended-Spectrum β -Lactamase Producing Uropathogenic Klebsiella pneumoniae

High incidence of plasmid-mediated quinolone resistance genes among ciprofloxacin-resistant clinical isolates of Enterobacteriaceae at a tertiary care hospital in Puducherry, India

A study on prevalence of plasmid mediated quinolone resistant genes in Klebsiella pneumoniae

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