Plasmid-Mediated Quinolone Resistance Genes, aac(6')-Ib-cr, qnrS, qnrB, and qnrA, in Urinary Isolates of Escherichia coli and Klebsiella pneumoniae at a Teaching Hospital, Thailand

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  • Pasom Woravit
    Graduate School, Khon Kaen University
  • Chanawong Aroonwadee
    Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University
  • Lulitanond Aroonlug
    Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University
  • Wilailuckana Chotechana
    Centre for Research and Development of Medical Diagnostic Laboratories, Faculty of Associated Medical Sciences, Khon Kaen University
  • Kenprom Suthida
    Clinical Microbiology Laboratory, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University
  • Puang-Ngern Pirom
    Clinical Microbiology Laboratory, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University

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タイトル別名
  • Plasmid-Mediated Quinolone Resistance Genes, <i>aac</i>(<i>6</i>′)-<i>Ib-cr</i>, <i>qnrS</i>, <i>qnrB</i>, and <i>qnrA</i>, in Urinary Isolates of <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> at a Teaching Hospital, Thailand
  • Plasmid-Mediated Quinolone Resistance Genes, <i>aac</i>(<i>6</i>&prime;)-<i>Ib-cr</i>, <i>qnrS</i>, <i>qnrB</i>, and <i>qnrA</i>, in Urinary Isolates of <i>Escherichia coli</i> and <i>Klebsiella pneumoniae</i> at a Teaching Hospital, Thailand

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A total of 121 Escherichia coli (47 extended-spectrum β-lactamase [ESBL] and 74 non-ESBL producers) and 75 Klebsiella pneumoniae isolates (49 ESBL and 26 non-ESBL producers) were collected from urine samples between October 2010 and April 2011 at a university hospital and assessed for the presence of plasmid-mediated quinolone resistance (PMQR) genes. Twenty-seven E. coli (22.3%) and 49 K. pneumoniae (65.3%) isolates harbored PMQR genes, which mostly consisted of aac(6′)-Ib-cr and qnrS, followed by qnrB and qnrA. Among the 76 PMQR-positive isolates, 15 (19.7%) and 2 (2.6%) carried 2 and 3 different PMQR genes, respectively. However, qnrC, qnrD, and qepA were not found in any isolate. The PMQR genes were more prevalent in ESBL producers than in non-ESBL producers (42.6% versus 9.5% in E. coli and 81.6% versus 34.6% in K. pneumoniae). Approximately 35%–60% of the PMQR-positive isolates were susceptible or intermediately susceptible to fluoroquinolones. The enterobacterial repetitive intergenic consensus-PCR method revealed that most PMQR-positive isolates belonged to different strains, indicating the spread of these resistance determinants. PMQR gene transfer by conjugation was successful in 10%–25% of the test donors. This study showed a high prevalence of PMQR genes among both organisms. Clinical use of fluoroquinolones for the treatment of infections caused by fluoroquinolone-susceptible strains harboring PMQR genes may lead to decreased therapeutic efficacy.

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