Prevalence of Quinolone Resistance Genes Among Extended-Spectrum B-Lactamase-Producing Escherichia coli in Mashhad, Iran

Abstract

Background:Escherichia coli is an important bacterial species based on incidence and associated infection severity. Some E. coli strains produce extended-spectrum beta lactamase (ESBL) and are called ESBL-producing E. coli. These strains are resistant to most classes of cephalosporin and a number of other classes of antibiotics. Plasmids carrying qnr genes have been found to transmit quinolone resistance.Objectives:The aim of this study was to determine the frequency of qnr genes in ESBL-producing and non-ESBL-producing E. coli isolated from outpatient and hospitalized patient clinical specimens from Imam Reza hospital in Mashhad, Iran.Materials and Methods:Two hundred E. coli strains, isolated from different clinical specimens were used. ESBL-producing E. coli were detected by determining susceptibility to ceftazidime, cefotaxime, and cefpodoxime with the phenotypic confirmatory test (PCT). PCR analysis was employed to detect the qnrA, qnrB, qnrS, blaTEM, and blaSHV genes.Results:Eighty-six (43%) isolates were ciprofloxacin-resistant. The PCT identified 85 (42.5%) of 200 E. coli isolates as ESBL-producing. The blaTEM, blaSHV, qnrA, qnrB, and qnrS gene were found in 65 (76.47%), 23 (27%), 63 (31%), 34 (17%), and 14 (7%) isolates, respectively.Conclusions:The high prevalence of quinolone resistance genes, which indicates antibiotic resistance, in the Imam Reza Hospital of Mashhad is a major concern. Hence, the antibiotics prescription policy should be revised, and infection control measures should be improved.

Plasmid-Mediated Ampicillin, Quinolone, and Heavy Metal Co-Resistance among ESBL-Producing Isolates from the Yamuna River, New Delhi, India

“…Our results are in accordance with the study of Bajaj et al, where 50% of CTX-M-producing isolates were positive for the qnrS gene [14]. Co-occurrence of PMQR and other antibiotic resistance genes has been reported in similar studies from China, Iran, and Austria [55,58,59]. The presence of PMQR genes among bacteria is a cause for concern, because these resistance genes are thought to create an optimum environment for selection of chromosomal resistance determinants [60,61].…”

Bacterial isolates harboring antibiotics and heavy-metal resistance genes co-existing with mobile genetic elements in natural aquatic water bodies

“…The results of this finding correlated with the results of clinical specimens from SKIMS Kashmir, where 27.1% of AmpC producing isolates were obtained ( Ahmad et al, 2010 ). qnrS gene was obtained in 63% isolates in this study, similarly, the occurrence of PMQR and ESBL genes have been reported in studies from China and Iran ( Li et al, 2014 , Mood et al, 2015 ). We found that the co-existence of bla TEM and heavy metal resistance elements viz.…”

“…Isolates having bla TEM were checked for integron analysis using PCR amplification of a conserved segment (CS 3′/5′) along with IntI , Sul1 using published primers ( Galimand et al, 2003 , M73819, U12338) and simultaneously (insertion sequence, transposons) ISecp1, TN3, and TN21 ( Mood et al, 2015 , Sheikh et al, 2014 , Brown et al, 1985 ) were also analyzed using a specific set of primers.…”

Prevalence of Resistance to Quinolone and Fluoroquinolone Antibiotics and Screening of qnr Genes Among Escherichia coli Isolates From Urinary Tract Infection

“…30 In Mashhad, 200 clinical isolates were studied by Harifi Mood et al and qnrA, qnrB, and qnrS genes were found in 31.5%, 17% and 7% of the isolates, respectively. 31 Vasilaki et al in Greece showed that 11 isolates (10%) carried qnrS gene and none of the isolates harbored qnrA and qnrB genes. 32 The 2 recent studies are in contrast with our results.…”