High prevalence of acquired quinolone-resistance genes among Enterobacteriaceae from Saudi Arabia with CTX-M-15 β-lactamase

The prevalence of plasmid-mediated quinolone resistance genes [qnr, aac(6′)-Ib-cr and qepA] was sought among Enterobacteriaceae strains obtained from the Children’s Hospital of Tunis (Tunisia). Non-duplicate isolates (n = 278) with resistance to extended-spectrum cephalosporins and collected in 2003, 2007, 2008 and 2009 were screened for qnr genes. Forty (14.4 %) isolates were qnr positive and were screened for the presence of the aac(6′)-Ib-cr and qepA genes. qnrB was detected in 21 Klebsiella pneumoniae, 11 Escherichia coli and 6 Enterobacter cloacae isolates. Sequence analysis of the qnrB amplicons revealed variants including 24 qnrB1, 11 qnrB2 and 3 qnrB6. qnrS (qnrS1 allele) was detected only in K. pneumoniae isolates, either alone (two isolates) or with the qnrB gene (one isolate). The qnrA, qnrC and qnrD genes were not found in any of the 278 isolates. No qnr-positive isolates carried the qepA gene. Pyrosequencing results showed that aac(6′)-Ib-cr, a variant of the aac(6′)-Ib gene, was present in 31 qnr-positive isolates (21 K. pneumoniae isolates, seven Escherichia coli isolates and three Enterobacter cloacae isolates). aac(6′)-Ib was also found either alone (two isolates) or in association with aac(6′)-Ib-cr (one isolate). Of the 40 qnr-positive isolates, 92.5, 82.5, 57.5, 85 and 82.5 % were non-susceptible to nalidixic acid, ciprofloxacin, levofloxacin, ofloxacin and norfloxacin, respectively, and all were extended-spectrum β-lactamase producers. Random amplified polymorphic DNA-PCR typing of these isolates showed 16, 8 and 5 different genotypes in K. pneumoniae, Escherichia coli and Enterobacter cloacae isolates, respectively. Our study highlights the high prevalence of qnr in association with aac(6′)-Ib-cr among Enterobacteriaceae isolates, even from children, who are patients not overtreated with quinolones.

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Characterization of Integrons and Quinolone Resistance in Clinical Escherichia coli Isolates in Mansoura City, Egypt

International Journal of Microbiology ◽

10.1155/2021/6468942 ◽

2021 ◽

Vol 2021 ◽

pp. 1-11

Author(s):

Shaymaa H. Abdel-Rhman ◽

Rehab M. Elbargisy ◽

Dina E. Rizk

Keyword(s):

Escherichia Coli ◽

Resistance Genes ◽

Efflux Pump ◽

Quinolone Resistance ◽

Aminoglycoside Resistance ◽

Variable Regions ◽

Active Efflux ◽

E Coli ◽

High Prevalence ◽

Class I Integrons

Escherichia coli is a common pathogen in both humans and animals. Quinolones are used to treat infections caused by Gram-negative bacteria, but resistance genes emerged. Only scarce studies investigated the association between plasmid-mediated quinolone resistance (PMQR) genes and integrons in clinical isolates of E. coli. The current study investigated the prevalence of quinolone resistance and integrons among 134 clinical E. coli isolates. Eighty (59.70%) isolates were quinolone-resistant, and 60/134 (44.77%) isolates were integron positive with the predominance of class I integrons (98.33%). There was a significant association between quinolone resistance and the presence of integrons ( P < 0.0001 ). Isolates from Urology and Nephrology Center and Gastroenterology Hospital were significantly quinolone-resistant and integron positive ( P ≤ 0.0005 ). Detection of PMQR genes on plasmids of integron-positive isolates showed that the active efflux pump genes oqxAB and qepA had the highest prevalence (72.22%), followed by the aminoglycoside acetyltransferase gene (aac(6′)-Ib-cr, 66.67%) and the quinolone resistance genes (qnr, 61.11%). Amplification and sequencing of integrons’ variable regions illustrated that no quinolone resistance genes were detected, and the most predominant gene cassettes were for trimethoprim and aminoglycoside resistance including dfrA17, dfrB4, and dfrA17-aadA5. In conclusion, this study reported the high prevalence of PMQR genes and integrons among clinical E. coli isolates. Although PMQR genes are not cassette-born, they were associated with integrons’ presence, which contributes to the widespread of quinolone resistance in Egypt.

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Investigation of six plasmid-mediated quinolone resistance genes among clinical isolates of pseudomonas: a genotypic study in Saudi Arabia

Infection and Drug Resistance ◽

10.2147/idr.s203288 ◽

2019 ◽

Vol Volume 12 ◽

pp. 915-923 ◽

Cited By ~ 1

Author(s):

Mohamed F El-Badawy ◽

Majed M Alrobaian ◽

Mohamed M Shohayeb ◽

Sayed F Abdelwahab

Keyword(s):

Saudi Arabia ◽

Resistance Genes ◽

Quinolone Resistance ◽

Clinical Isolates

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Plasmid-Mediated Quinolone Resistance Genes in Enterobacteriaceae from American Crows: High Prevalence of Bacteria with VariableqnrBGenes

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01849-13 ◽

2013 ◽

Vol 58 (2) ◽

pp. 1257-1258 ◽

Cited By ~ 13

Author(s):

Dana Halová ◽

Ivo Papoušek ◽

Ivana Jamborova ◽

Martina Masarikova ◽

Alois Cizek ◽

...

Keyword(s):

Resistance Genes ◽

Quinolone Resistance ◽

High Prevalence ◽

American Crows

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High Prevalence of Plasmid-Mediated Quinolone Resistance Genes qnr and aac(6′)-Ib-cr in Clinical Isolates of Enterobacteriaceae from Nine Teaching Hospitals in China

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.00830-08 ◽

2008 ◽

Vol 52 (12) ◽

pp. 4268-4273 ◽

Cited By ~ 66

Author(s):

Hong Yang ◽

Hongbin Chen ◽

Qiwen Yang ◽

Minjun Chen ◽

Hui Wang

Keyword(s):

Resistance Genes ◽

Direct Sequencing ◽

Quinolone Resistance ◽

Clinical Isolates ◽

Teaching Hospitals ◽

E Coli ◽

The Family ◽

High Prevalence ◽

Large Plasmids ◽

Widespread Dissemination

ABSTRACT Quinolone resistance is an emerging problem in China. To investigate the prevalence of the plasmid-mediated quinolone resistance genes qnr and aac(6′)-Ib-cr, a total of 265 clinical isolates of Escherichia coli, Klebsiella pneumoniae, Citrobacter freundii, and Enterobacter cloacae with ciprofloxacin MICs of ≥0.25 μg/ml were screened at nine teaching hospitals in China. The qnrA, qnrB, qnrS, and aac(6′)-Ib genes were detected by PCR. The aac(6′)-Ib-cr gene was further identified by digestion with BtsCI and/or direct sequencing. The qnr gene was present in significantly smaller numbers of isolates with cefotaxime MICs of <2 μg/ml than isolates with higher MICs (≥2.0 μg/ml) (20.6% and 42.1%, respectively; P < 0.05). aac(6′)-Ib-cr was present in 17.0% of the isolates tested, and 7.9% of the isolates carried both the qnr and the aac(6′)-Ib-cr genes. Among the isolates with cefotaxime MICs of ≥2.0 μg/ml, qnr and aac(6′)-Ib-cr were present in 65.7% and 8.6% of E. cloacae isolates, respectively; 65.5% and 21.8% of K. pneumoniae isolates, respectively; 63.3% and 26.7% of C. freundii isolates, respectively; and 6.5% and 16.9% of E. coli isolates, respectively. The 20 transconjugants showed 16- to 128-fold increases in ciprofloxacin MICs, 14 showed 16- to 2,000-fold increases in cefotaxime MICs, and 5 showed 8- to 32-fold increases in cefoxitin MICs relative to those of the recipient due to the cotransmission of bla CTX-M-14, bla CTX-M-3, bla DHA-1, bla SHV-2, and bla SHV-12 with the qnr and aac(6′)-Ib-cr genes. Southern hybridization analysis showed that these genes were located on large plasmids of different sizes (53 to 193 kb). These findings indicate the high prevalence of qnr and aac(6′)-Ib-cr in members of the family Enterobacteriaceae and the widespread dissemination of multidrug resistance in China.

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High prevalence rate of left superior vena cava determined by echocardiography in patients with congenital heart disease in Saudi Arabia

Libyan Journal of Medicine ◽

10.3402/ljm.v8i0.21679 ◽

2013 ◽

Vol 8 (1) ◽

pp. 21679 ◽

Cited By ~ 5

Author(s):

Ghada Shiekh Eldin ◽

Milad El-Segaier ◽

Mohammed Omer Galal

Keyword(s):

Congenital Heart Disease ◽

Saudi Arabia ◽

Heart Disease ◽

Superior Vena Cava ◽

Prevalence Rate ◽

Congenital Heart ◽

Superior Vena ◽

Vena Cava ◽

Left Superior Vena Cava ◽

High Prevalence

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High fecal carriage of blaCTX-M, blaCMY-2, and plasmid-mediated quinolone resistance genes among healthy Korean people in a metagenomic analysis

Scientific Reports ◽

10.1038/s41598-021-84974-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jieun Kim ◽

Kye-Yeung Park ◽

Hoon-Ki Park ◽

Hwan-Sik Hwang ◽

Mi-Ran Seo ◽

...

Keyword(s):

Resistance Genes ◽

Gut Microbiome ◽

Antibiotic Resistance Genes ◽

Quinolone Resistance ◽

Upper Respiratory Tract ◽

Healthy Individuals ◽

Carriage Rate ◽

Fecal Carriage ◽

Metagenome Sequencing ◽

Tract Infections

AbstractTo characterize the carriage of antibiotic resistance genes (ARGs) in the gut microbiome of healthy individuals. Fecal carriage of ARGs was investigated in 61 healthy individuals aged 30 to 59 years through whole metagenome sequencing of the gut microbiome and a targeted metagenomic approach. The number of ARGs in the gut microbiome was counted and normalized per million predicted genes (GPM). In the Korean population, the resistome ranged from 49.7 to 292.5 GPM (median 89.7). Based on the abundance of ARGs, the subjects were categorised into high (> 120 GPM), middle (60‒120 GPM), and low (< 60 GPM) ARG groups. Individuals in the high ARG group tended to visit hospitals more often (P = 0.065), particularly for upper respiratory tract infections (P = 0.066), and carried more blaCTX-M (P = 0.008). The targeted metagenome approach for bla and plasmid-mediated quinolone resistance (PMQR) genes revealed a high fecal carriage rate; 23% or 13.1% of the subjects carried blaCTX-M or blaCMY-2, respectively. Regarding PMQR genes, 59% of the subjects carried PMQR, and 83% of them harboured 2‒4 PMQR genes (qnrB 44.3%, qnrS 47.5% etc.). The presence of blaCTX-M correlated with ARG abundance in the gut resistome, whereas PMQR genes were irrelevant to other ARGs (P = 0.176). Fecal carriage of blaCTX-M and PMQR genes was broad and multiplexed among healthy individuals.

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