Detection of plasmid-mediated IMP-1 metallo-β-lactamase and quinolone resistance determinants in an ertapenem-resistant Enterobacter cloacae isolate

ABSTRACT Fourteen out of 16 carbapenem-resistant quinolone-susceptible Enterobacter cloacae isolates were found to carry qnrB2 and bla KPC-2 genes encoded on the same plasmid. One isolate also carried the aac(6′)-Ib-cr gene. Coexistence of quinolone resistance determinants and bla KPC-2 on the same plasmid in quinolone-susceptible E. cloacae isolates may have important clinical implications.

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O207 Plasmid-mediated quinolone resistance determinants, QnrA, QnrB, and QnrS, among clinical isolates of Enterobacter cloacae in a Taiwanese hospital

International Journal of Antimicrobial Agents ◽

10.1016/s0924-8579(07)70140-1 ◽

2007 ◽

Vol 29 ◽

pp. S44

Author(s):

J. Yan ◽

J. Wu ◽

W. Ko ◽

S. Tsai

Keyword(s):

Enterobacter Cloacae ◽

Quinolone Resistance ◽

Clinical Isolates ◽

Resistance Determinants

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Prevalence of Plasmid-Mediated Quinolone Resistance Determinants QnrA, QnrB, and QnrS among Clinical Isolates of Enterobacter cloacae in a Taiwanese Hospital

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.01195-06 ◽

2007 ◽

Vol 51 (4) ◽

pp. 1223-1227 ◽

Cited By ~ 93

Author(s):

Jiunn-Jong Wu ◽

Wen-Chien Ko ◽

Shu-Huei Tsai ◽

Jing-Jou Yan

Keyword(s):

Gel Electrophoresis ◽

Enterobacter Cloacae ◽

Pulsed Field Gel Electrophoresis ◽

Quinolone Resistance ◽

Clinical Isolates ◽

University Hospital ◽

Restriction Patterns ◽

Resistance Determinants ◽

High Prevalence ◽

Similar Restriction

ABSTRACT The prevalence of three plasmid-mediated quinolone resistance determinants, QnrA, QnrB, and QnrS, among 526 nonreplicate clinical isolates of Enterobacter cloacae collected at a Taiwanese university hospital in 2004 was determined by PCR and colony hybridization, and the association of Qnr with the IMP-8 metallo-β-lactamase was investigated. Eighty-six (16.3%) of all isolates were qnr positive, and the qnrA1-like, qnrB2-like, and qnrS1-like genes were detected alone or in combination in 3 (0.6%), 53 (10.1%), and 34 (6.5%) isolates, respectively. Among 149 putative extended-spectrum-β-lactamase-producing isolates, 59 (39.6%) isolates, all of which were SHV-12 producers, harbored qnrA (0.7%; 1 isolate), qnrB (28.9%; 43 isolates), or qnrS (12.1%; 18 isolates). Forty-four (78.6%) of 56 IMP-8 producers carried qnrB (58.9%; 33 isolates), qnrS (25.0%; 14 isolates), or both. PCR and sequence analysis revealed that qnrA1 was located in a complex sul1-type integron that contains dhr15, aadA2, qacEΔ1, sul1, orf513, qnrA1, ampR, and qacEΔ1. Conjugation experiments revealed the coexistence of qnrB and bla IMP-8 on the transferred plasmids and the absence of β-lactamase content on the transferred qnrS-positive plasmids. The transferred bla IMP-8-positive plasmids with and without qnrB had very similar restriction patterns, suggesting the horizontal mobility of qnrB. Pulsed-field gel electrophoresis showed six major patterns among the 44 qnr-positive IMP-8-producing isolates. Thus, the extremely high prevalence of qnr among the metallo-β-lactamase-producing E. cloacae isolates in the hospital may be due mainly to the intrahospital spread of a few clones and the dissemination of plasmids containing both qnrB and bla IMP-8.

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Prevalence of Plasmid-Mediated Quinolone Resistance and Aminoglycoside Resistance Determinants among Carbapeneme Non-Susceptible Enterobacter cloacae

PLoS ONE ◽

10.1371/journal.pone.0047636 ◽

2012 ◽

Vol 7 (10) ◽

pp. e47636 ◽

Cited By ~ 32

Author(s):

Shifeng Huang ◽

Wei Dai ◽

Shan Sun ◽

Xiaojiao Zhang ◽

Liping Zhang

Keyword(s):

Enterobacter Cloacae ◽

Quinolone Resistance ◽

Aminoglycoside Resistance ◽

Resistance Determinants

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First description of NDM-1-, KPC-2-, VIM-2- and IMP-4-producing Klebsiella pneumoniae strains in a single Chinese teaching hospital

Epidemiology and Infection ◽

10.1017/s0950268814000995 ◽

2014 ◽

Vol 143 (2) ◽

pp. 376-384 ◽

Cited By ~ 27

Author(s):

Y. LIU ◽

L.-G. WAN ◽

Q. DENG ◽

X.-W. CAO ◽

Y. YU ◽

...

Keyword(s):

16S Rrna ◽

Klebsiella Pneumoniae ◽

Teaching Hospital ◽

Multidrug Resistant ◽

The Other ◽

Quinolone Resistance ◽

Resistance Determinants ◽

Carbapenem Resistant ◽

Extended Spectrum ◽

Chinese Teaching

SUMMARYA total of 180 non-duplicate carbapenem-resistant Klebsiella pneumoniae isolates were recovered from patients hospitalized between December 2010 and January 2012 at a Chinese hospital. Eight KPC-2, four NDM-1, one VIM-2, and five KPC-2 plus IMP-4 producers were identified and all were multidrug resistant due to the presence of other resistance determinants, including extended-spectrum β-lactamases (CTX-M-15, SHV-12), 16S rRNA methylases (armA, rmtB) and plasmid-mediated quinolone-resistance determinants (qnrA, B, S, aac(6′)-Ib-cr). Nine K. pneumoniae clones (Kpn-A1/ST395, Kpn-A3/ST11, Kpn-A2/ST134, Kpn-B/ST263, Kpn-C/ST37, Kpn-D/ST39, Kpn-E/ST1151, Kpn-F/ST890, Kpn-G/ST1153) were identified. blaKPC-2 was located on transferable ~65 kb IncL/M (ST395, ST11, ST134, ST39) and ~100 kb IncA/C (ST37, ST1153, ST890) plasmids, respectively. On the other hand, blaNDM-1 was associated with a ~70 kb IncA/C plasmid (ST263). However, non-typable plasmids of ~40 kb containing blaVIM-2 were detected in the ST1151 clone. This work reports the first co-occurrence of four diverse types of carbapenemase of K. pneumoniae clones from a single hospital in China. IncA/C, IncL/M, and other successful plasmids may be important for the dissemination of carbapenemases, producing a complex epidemiological picture.

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