Plasmid-mediated quinolone resistance determinants among Gram-negative bacteraemia isolates: a hidden threat

Margaritis, Athanasios; Galani, Irene; Chatzikonstantinou, Marianthi; Petrikkos, George; Souli, María

doi:10.1099/jmm.0.000397

Cited by 16 publications

(9 citation statements)

References 33 publications

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“…Plasmid-mediated quinolone resistance has been shown to compromise the bactericidal activity of fluoroquinolones when expressed in Enterobacteriaceae [72]. For example, plasmidic transfer of genes has resulted in spread of resistant strains among E. coli , K. pneumoniae , and Proteus species [73].…”

Section: Discussionmentioning

confidence: 99%

Resistance profile of clinically relevant bacterial isolates against fluoroquinolone in Ethiopia: a systematic review and meta-analysis

Sisay

Weldegebreal

Tesfa

et al. 2018

BMC Pharmacol Toxicol

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BackgroundFluoroquinolones are among the most frequently utilized antibacterial agents in developing countries like Ethiopia. Ciprofloxacin has become the most prescribed drug within this class and remains as one of the top three antibacterial agents prescribed in Ethiopia. However, several studies indicated that there is a gradual increase of antibacterial resistance. Therefore, this meta-analysis aimed to quantitatively estimate the prevalence of ciprofloxacin resistance bacterial isolates in Ethiopia.MethodsLiterature search was conducted from electronic databases and indexing services including EMBASE (Ovid interface), PubMed/MEDLINE, Google Scholar, Science Direct and WorldCat. Data were extracted with structured format prepared in Microsoft Excel and exported to STATA 15.0 software for the analyses. Pooled estimation of outcomes was performed with DerSimonian-Laird random-effects model at 95% confidence level. Degree of heterogeneity of studies was presented with I2 statistics. Publication bias was conducted with comprehensive meta-analysis version 3 software and presented with funnel plots of standard error supplemented by Begg’s and Egger’s tests. The study protocol has been registered on PROSPERO with reference number ID: CRD42018097047.ResultsA total of 37 studies were included for this study. The pooled prevalence of resistance in selected gram-positive bacterial isolates against ciprofloxacin was found to be 19.0% (95% confidence interval [CI]: 15.0, 23.0). The degree of resistance among Staphylococcus aureus, Coagulase negative Staphyloccoci (CoNS), Enterococcus faecalis and Group B Streptococci (GBS) was found to be 18.6, 21.6, 23.9, and 7.40%, respectively. The pooled prevalence of resistance in gram-negative bacteria was about 21.0% (95% CI: 17, 25). Higher estimates were observed in Neisseria gonorrhea (48.1%), Escherichia coli (24.3%) and Klebsiella pneumonia (23.2%). Subgroup analysis indicated that blood and urine were found to be a major source of resistant S. aureus isolates. Urine was also a major source of resistant strains for CoNS, Klebsiella and Proteus species.ConclusionAmong gram-positive bacteria, high prevalence of resistance was observed in E. faecalis and CoNS whereas relatively low estimate of resistance was observed among GBS isolates. Within gram-negative bacteria, nearly half of isolates in N. gonorrhoea were found ciprofloxacin resistant. From enterobacteriaceae isolates, K. pneumonia and E. coli showed higher estimates of ciprofloxacin resistance.Electronic supplementary materialThe online version of this article (10.1186/s40360-018-0274-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Resistance profile of clinically relevant bacterial isolates against fluoroquinolone in Ethiopia: a systematic review and meta-analysis

Sisay

Weldegebreal

Tesfa

et al. 2018

BMC Pharmacol Toxicol

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“…Resistance is attributed to plasmids as a source of the resistant genes [12] and can be categorized based on of prevalence of antimicrobial resistance genes as extended-spectrum β-lactamase (ESBLs) [13], plasmid-mediated quinolone resistance (PMQR) genes [14] especially involving Qnr proteins and the aminoglycoside acetyltransferase variant determinant (AAC(6')-Ib-cr), which has emerged and is now described worldwide [15] and 16S rRNA methylase (16S-RMTase)…”

Section: Introduction Backgroundmentioning

confidence: 99%

Antimicrobial Resistance Patterns and Molecular Characterization of <i>Klebsiella pneumoniae</i> in Clinical Isolates at Mbarara Regional Referral Hospital

Turugurwa¹,

Mu²,

Kassaza³

et al. 2019

AID

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Background: Klebsiella pneumoniae is one of the most frequent opportunistic pathogens causing a range of infections and being resistant for beta-lactamases (ESBL) and Carbapenemases. Aim: The aim of the present study was to determine the antimicrobial resistance patterns and molecular characterization establishing the phenotypes and genotypes associated with drug resistance, an antibiogram of genotypically positive isolates for resistance of Klebsiella pneumoniae in clinical isolates at MRRH. Materials and Methods: A laboratory-based descriptive cross-sectional study that was conducted from September 2018 to May 2019 at MRRH. Klebsiella pneumoniae was identified by cultural and biochemical methods. Antibiotic sensitivity test was performed by modified Kirby-Bauer disc diffusion technique. ESBL production in Klebsiella pneumoniae was tested by double-disc synergy test, Carbapenemase production by MHT, Boronic Acid or EDTA test using Meropenem phenotypically and both resistance confirmed genotypically by Multiplex PCR. Results: Out of 1055 clinical isolates, 298 (28.2%) were found positive for Klebsiella.spp, 175 isolates were subcultured among which 22 (12.57%) were K. pneumoniae based on API 20E. Overall Sensitivity patterns of these Klebsiella pneumoniae isolates to Ceftriaxone, (Amoxicillin/Clavulanate), Gentamicin, Cefepime, Ciprofloxacin, Cefoxitin, Nitrofurantoin, Cefuroxime, piperacillin/tazobactam, Meropenem, Ceftazidime and cefotaxime were 72.7%,

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“…Moreover, although inoculum size effects for levofloxacin, amikacin, and carbapenems were apparent for some isolates in our study, the inoculum size effects for levofloxacin and amikacin were not significant in the conjugation experiments. Margaritis et al have reported that half of the transconjugants of PMQRs (2/4 strains) showed inoculum size effects for levofloxacin (1-, 2-, 4-, and 16-fold: MIC of 10 7 CFU/mL per MIC of 10 5 CFU/mL) (9). However, they also showed that the inoculum size effects for quinolone were significant for laboratory strains which did not harbor acquired quinolone resistance genes.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, the inoculum size effect for the action of quinolone on bacteria expressing PMQR genes has also been described (9,13). However, in one of these studies, it was reported that only half of the transconjugants of PMQRs (2/4 strains) showed an inoculum size effect for quinolone (9). There has been no study describing the inoculum size effect for strains expressing both MBL and PMQRs.…”

Section: Introductionmentioning

confidence: 99%

Inoculum size effects in bla_IMP-6 and plasmid-mediated quinolone resistance gene-positive Enterobacteriaceae in Japan

Ogawa

Nakano

Kasahara

et al. 2019

Preprint

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34The aim of this study was to examine the resistance genes in clinical isolates which 35 produced IMP-6 type metallo-β-lactamase lactamase (MBL) and had mildly reduced 36 susceptibilities to levofloxacin and/or amikacin. The inoculum size effect was also 37 assessed. A total of 14 Enterobacteriaceae isolates (2 Escherichia coli and 12 Klebsiella 38 pneumoniae) which produced IMP-6 MBL, and had mild increases in their MICs for 39 levofloxacin and amikacin were examined. Thirteen out of 14 isolates harbored 40 CTX-M-2, with the remaining isolate co-harboring CTX-M-2 and CTX-M-1 as ESBLs. 41All isolates carried one or more PMQRs; aac(6′)-Ib-cr was the most prevalent (92.8%), 42 followed by oqxA (64.3%), qnrS (42.9%) , oqxAB (21.4%), and qnrB (14.3%). The 43 inoculum size effects were significant in all strains for meropenem, 13 for imipenem, 7 44 for levofloxacin, and 3 for amikacin. Conjugation was successfully performed with 8 45 isolates and 11 strains were obtained. Eleven of the experimental strains (100%), and 8 46 strains (72.7%) showed inoculum size effects for meropenem and imipenem, 47

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Plasmid-mediated quinolone resistance determinants among Gram-negative bacteraemia isolates: a hidden threat

Cited by 16 publications

References 33 publications

Resistance profile of clinically relevant bacterial isolates against fluoroquinolone in Ethiopia: a systematic review and meta-analysis

Resistance profile of clinically relevant bacterial isolates against fluoroquinolone in Ethiopia: a systematic review and meta-analysis

Antimicrobial Resistance Patterns and Molecular Characterization of <i>Klebsiella pneumoniae</i> in Clinical Isolates at Mbarara Regional Referral Hospital

Inoculum size effects in bla_IMP-6 and plasmid-mediated quinolone resistance gene-positive Enterobacteriaceae in Japan

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Plasmid-mediated quinolone resistance determinants among Gram-negative bacteraemia isolates: a hidden threat

Cited by 16 publications

References 33 publications

Resistance profile of clinically relevant bacterial isolates against fluoroquinolone in Ethiopia: a systematic review and meta-analysis

Resistance profile of clinically relevant bacterial isolates against fluoroquinolone in Ethiopia: a systematic review and meta-analysis

Antimicrobial Resistance Patterns and Molecular Characterization of &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt; in Clinical Isolates at Mbarara Regional Referral Hospital

Inoculum size effects in blaIMP-6 and plasmid-mediated quinolone resistance gene-positive Enterobacteriaceae in Japan

Contact Info

Product

Resources

About

Antimicrobial Resistance Patterns and Molecular Characterization of <i>Klebsiella pneumoniae</i> in Clinical Isolates at Mbarara Regional Referral Hospital

Inoculum size effects in bla_IMP-6 and plasmid-mediated quinolone resistance gene-positive Enterobacteriaceae in Japan