Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Prevalence of Plasmid-mediated Quinolone Resistance and Its Association with Extended-spectrum Beta-lactamase and AmpC Beta-lactamase in Enterobacteriaceae

  • Jeong, Haeng-Soon (Department of Laboratory Medicine, Inje University College of Medicine) ;
  • Bae, Il-Kwon (Research Institute of Bacterial Resistance, Yonsei University College of Medicine) ;
  • Shin, Jeong-Hwan (Department of Laboratory Medicine, Inje University College of Medicine) ;
  • Jung, Hee-Jung (Department of Laboratory Medicine, Inje University College of Medicine) ;
  • Kim, Si-Hyun (Department of Laboratory Medicine, Inje University College of Medicine) ;
  • Lee, Ja-Young (Department of Laboratory Medicine, Inje University College of Medicine) ;
  • Oh, Seung-Hwan (Department of Laboratory Medicine, Inje University College of Medicine) ;
  • Kim, Hye-Ran (Department of Laboratory Medicine, Inje University College of Medicine) ;
  • Chang, Chul-Hun Ludgerus (Department of Laboratory Medicine, Pusan National University School of Medicine) ;
  • Kho, Weon-Gyu (Paik Institute for Clinical Research, Inje University College of Medicine) ;
  • Lee, Jeong-Nyeo (Department of Laboratory Medicine, Inje University College of Medicine)
  • Published : 2011.10.30
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Abstract

Background: We investigated the prevalence of plasmid-mediated quinolone resistance and its association with extended-spectrum beta-lactamase (ESBL) and AmpC beta-lactamase in Enterobacteriaceae. Methods: A total of 347 non-duplicated isolates of Enterobacteriaceae were collected between August and October 2006 from 2 hospitals. Qnr determinant screening was conducted using PCR amplification, and all positive results were confirmed by direct sequencing. Qnr-positive strains were determined on the basis of the presence of ESBL and AmpC beta-lactamase genes. Results: The qnr gene was detected in 47 of 347 clinical Enterobacteriaceae isolates. Among the 47 qnr-positive strains, Klebsiella pneumoniae (N=29) was the most common, followed by Escherichia coli (N=6), Enterobacter cloacae (N=6), Citrobacter freundii (N=5), and Enterobacter aerogenes (N=1). These isolates were identified as qnrA1 (N=6), 8 qnrB subtypes (N=40), and qnrS1 (N= 1). At least 1 ESBL was detected in 38 of the 47 qnr-positive strains. Qnr-positive strains also showed high positive rates of ESBL or AmpC beta-lactamase, such as TEM, SHV, CTX-M, and DHA. DHA-1 was detected in 23 of 47 qnr-positive strains, and this was coproduced with 1 qnrA1 and 22 qnrB4. Strains harboring MIR-1T and CMY were also detected among the qnr-positive strains. Antimicrobial- resistance rates of qnr-positive strains to ciprofloxacin, levofloxacin, norfloxacin, nalidixic acid, and moxifloxacin were 51.1%, 46.8%, 46.8%, 74.5%, and 53.2%, respectively. Conclusions: The qnr genes were highly prevalent in Enterobacteriaceae, primarily the qnrB subtypes. They were closely associated with EBSL and AmpC beta-lactamase.

Keywords

References

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