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Detection of Plasmid Mediated Qnr Genes in Clinical Isolates of ESBL Producing Enterobacteriaceae from Tertiary Care Hospital in Rawalpindi, Pakistan

Muhammad Uzair Mansoor, Naureen Ehsan Ilahi, Muhammad Tamour Ashiq, Saima Ishtiaq, Muhammad Arshad Malik

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Int. J. Biosci.18(1), 53-59, January 2021

DOI: http://dx.doi.org/10.12692/ijb/18.1.53-59


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ESBL producing Enterobacteriacae harbouring multidrug-resistant plasmids is an emerging worldwide threat. One of the major concerns is the prevalence of plasmid-mediated quinolone resistance (PMQR) to Quinolones which has hindered the viability of these antibiotics. To date, very little data is available regarding the co-existence of ESBL and PMQR in Pakistan. This study aimed to detect PMQR genes in clinical isolates of ESBL producing Enterobacteriaceae in the city of Rawalpindi. A total of 60 clinical ESBL positive Enterobacteriaceae isolates were obtained from hospitalized patients at Holy family Hospital, Rawalpindi. It included strains of E. coli (n=24), K. pneumoniae (n=25), and Enterobacter spp (n=11). Antimicrobial susceptibility was determined by the standard disk diffusion method. Genes encoding quinolone resistance (qnrA, qnrB and qnrS) were detected using PCR. Out of 60 tested strains, 38 (63%) yielded PMQR determinants. QnrB was the most prevalent occurring alone and in combination with other qnr genes in about 89% (34/38) of the ESBL producing isolates. It was followed by qnrS (22/38 i.e 58%) and qnrA (12/38 i.e 32%). E.coli was the predominant qnrA (43%) and qnrS (69%) harbouring species.


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Detection of Plasmid Mediated Qnr Genes in Clinical Isolates of ESBL Producing Enterobacteriaceae from Tertiary Care Hospital in Rawalpindi, Pakistan

Alikhani MY, Hashemi SH, Aslani MM, Farajnia S. 2013. Prevalence and antibiotic resistance patterns of diarrheagenic Escherichia coli isolated from adolescents and adults in Hamedan, Western Iran. Iranian Journal of Microbiology 5:42-47.

Ambrozic Avgustin J, Keber R, Zerjavic K, Orazem T, Grabnar M. 2007. Emergence of the quinolone resistance-mediating gene aac(6′)-Ib-cr in extended-spectrum-beta-lactamase-producing Klebsiella isolates collected in Slovenia between 2000 and 2005. Antimicrobial Agents and Chemotherapy 51, 4171-4173. http://dx.doi.org/AAC.01480-06[pii]10.1128/AAC.01480-06

Azargun R, Sadeghi MR, Soroush Barhaghi MH, Samadi Kafil H, Yeganeh F, Ahangar Oskouee M, Ghotaslou R. 2018. The prevalence of plasmid-mediated quinolone resistance and ESBL-production in Enterobacteriaceae isolated from urinary tract infections. Infection and Drug Resistance 11, 1007-1014. http://dx.doi.org/10.2147/IDR.S160720idr-11-1007

Briales A, Rodriguez-Martinez JM, Velasco C, de Alba PD, Rodriguez-Bano J, Martinez-Martinez L, Pascual A. 2012. Prevalence of plasmid-mediated quinolone resistance determinants qnr and aac(6′)-Ib-cr in Escherichia coli and Klebsiella pneumoniae producing extended-spectrum beta-lactamases in Spain. International Journal of Antimicrobial Agents 39, 431-434. http://dx.doi.org/10.1016/j.ijantimicag.2011.12.009S0924-8579(12)00028-3

CLS I. 2016. Performance standards for antimicrobial susceptibility testing. 26th ed CLSI.

Dalhoff A. 2012. Global fluoroquinolone resistance epidemiology and implictions for clinical use. Interdisciplinary Perspectives on Infectious Diseases 2012, 976273. http://dx.doi.org/10.1155/2012/976273

Ewers C, Bethe A, Semmler T, Guenther S, Wieler LH. 2012. Extended-spectrum beta-lactamase-producing and AmpC-producing Escherichia coli from livestock and companion animals, and their putative impact on public health: a global perspective. Clinical Microbiology and Infection 18, 646-655. http://dx.doi.org/10.1111/j.1469-0691.2012.03850.xS1198-743X(14)64559-6

García-Fulgueiras V, Bado I, Mota MI, Robino L, Cordeiro NF, Varela A, Algorta G, Gutkind G, Ayala JA, Vignoli R. 2011. Extended-spectrum beta-lactamases and plasmid-mediated quinolone resistance in enterobacterial clinical isolates in the paediatric hospital of Uruguay. Journal of Antimicrobial Chemotherapy 66, 1725-1729. http://dx.doi.org/10.1093/jac/dkr222dkr222

Harifi Mood E, Meshkat Z, Izadi N, Rezaei M, Amel Jamehdar S, Naderi Nasab M. 2015. Prevalence of Quinolone Resistance Genes Among Extended-Spectrum B-Lactamase-Producing Escherichia coli in Mashhad, Iran. Jundishapur Journal of Microbiology 8, e16217. http://dx.doi.org/10.5812/jjm.16217

Hooper DC. 1999. Mechanisms of fluoroquinolone  resistance. Drug Resistance Updates 2, 38-55. http://dx.doi.org/10.1054/drup.1998.0068S1368-7646(98)90068-1

Izadi N, Naderi Nasab M, Harifi Mood E, Meshkat Z. 2017. The Frequency of qnr Genes in Extended-Spectrum beta-lactamases and non-ESBLs Klebsiella pneumoniae Species Isolated from Patients in Mashhad, Iran. Iranian Journal of Pathology 12, 377-383.

Jacoby GA, Gacharna N, Black TA, Miller GH, Hooper DC. 2009. Temporal appearance of plasmid-mediated quinolone resistance genes. Antimicrobial Agents and Chemotherapy 53, 1665-1666. http://dx.doi.org/10.1128/AAC.01447-08AAC.01447-08

Kim HB, Park CH, Kim CJ, Kim EC, Jacoby GA, Hooper DC. 2009. Prevalence of plasmid-mediated quinolone resistance determinants over a 9-year period. Antimicrobial Agents and Chemotherapy 53, 639-645. http://dx.doi.org/10.1128/AAC.01051-08AAC.01051-08[pii]

Martinez-Martinez L, Pascual A, Jacoby GA. 1998. Quinolone resistance from a transferable plasmid. Lancet 351, 797-799. http://dx.doi.org/S0140-6736(97)07322-4      http://dx.doi.org/10.1016/S0140-6736(97)07322-4

Muhammad I, Uzma M, Yasmin B, Mehmood Q, Habib B. 2011. Prevalence of antimicrobial resistance and integrons in Escherichia coli from Punjab, Pakistan. Brazilian Journal of Microbiology 42, 462-466. http://dx.doi.org/10.1590/S1517-83822011000200008S1517-83822011000200008

Okubo T, Sato T, Yokota S, Usui M, Tamura Y. 2014. Comparison of broad-spectrum cephalosporin-resistant Escherichia coli isolated from dogs and humans in Hokkaido, Japan. Journal of Infection and Chemotherapy 20, 243-249. http://dx.doi.org/10.1016/j.jiac.2013.12.003S1341-321X(13)00064-0

Pakzad I, Ghafourian S, Taherikalani M, Sadeghifard N, Abtahi H, Rahbar M, Mansory Jamshidi N. 2011. qnr Prevalence in Extended Spectrum Beta-lactamases (ESBLs) and None-ESBLs Producing Escherichia coli Isolated from Urinary Tract Infections in Central of Iran. Iranian Journal of Basic Medical Sciences 14, 458-464.

Rodriguez-Martinez JM, Cano ME, Velasco C, Martinez-Martinez L, Pascual A. 2011. Plasmid-mediated quinolone resistance: an update. Journal of Infection and Chemotherapy 17, 149-182. http://dx.doi.org/10.1007/s10156-010-0120-2S1341-321X(11)70513-X[pii]

Slama TG. 2008. Gram-negative antibiotic resistance: there is a price to pay. Critical Care 12 Suppl 4, S4. http://dx.doi.org/10.1186/cc6820cc6820

Takahashi S, Nagano Y. 1984. Rapid procedure for isolation of plasmid DNA and application to epidemiological analysis. Journal of Clinical Microbiology 20, 608-613.

Tran JH, Jacoby GA. 2002. Mechanism of plasmid-mediated quinolone resistance. Proceedings of the National Academy of Sciences of the United States of America A 99, 5638-5642. http://dx.doi.org/10.1073/pnas.082092899082092899

Tran JH, Jacoby GA, Hooper DC. 2005a. Interaction of the plasmid-encoded quinolone resistance protein Qnr with Escherichia coli DNA gyrase. Antimicrobial Agents and Chemotherapy 49, 118-125. http://dx.doi.org/49/1/118     http://dx.doi.org/10.1128/AAC.49.1.118-125.2005

Tran JH, Jacoby GA, Hooper DC. 2005b. Interaction of the plasmid-encoded quinolone resistance protein QnrA with Escherichia coli topoisomerase IV. Antimicrobial Agents and Chemotherapy 49, 3050-3052. http://dx.doi.org/49/7/3050     http://dx.doi.org/10.1128/AAC.49.7.3050-3052.2005

Tripathi A, Dutta SK, Majumdar M, Dhara L, Banerjee D, Roy K. 2012. High Prevalence and Significant Association of ESBL and QNR Genes in Pathogenic Klebsiella pneumoniae Isolates of Patients from Kolkata, India. Indian Journal of Microbiology 52, 557-564. http://dx.doi.org/10.1007/s12088-012-0281-z281[pii]

Wang A, Yang Y, Lu Q, Wang Y, Chen Y, Deng L, Ding H, Deng Q, Wang L, Shen X. 2008. Occurrence of qnr-positive clinical isolates in Klebsiella pneumoniae producing ESBL or AmpC-type beta-lactamase from five pediatric hospitals in China. FEMS Microbiology Letters 283, 112-116. http://dx.doi.org/10.1111/j.15746968.2008.01163.xFML1163


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