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EVALUATION OF PLASMID-MEDIATED QUINOLONE RESISTANCE ASSOCIATED WITH THE QNR GENES IN CLINICAL ISOLATES OF SHIGELLA SPP. IN BAGHDAD

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Abstract

Background:Although quinolone resistance results mostly from chromosomal mutations in Enterobacteriaceae, it may also be mediated by plasmid-encoded qnr determinants. Shigella harboring the novel qnr plasmid-mediated mechanism of quinolone resistance has been described worldwide.Objective:To understand the distribution of serogroup of Shigella spp, as well as antimicrobial susceptibility and to investigate the plasmid mediated quinolone-resistant qnr genes in clinical isolates of Shigella spp. resistant to quinolone.Methods:Fifty nine clinical isolates of Shigella spp. were collected from two hospitals in Baghdad. Antimicrobial susceptibility tests were performed using disk diffusion test and minimum inhibitory concentration. The isolates were screened for the plasmid-mediated qnr genes of qnrA, qnrB, and qnrS by Multiplex polymerase chain reaction.Results:The isolation rate of Shigella spp. was 14% and observed to be high among children < 10 years and low in teenagers and adults. The highest percentage was Sh. flexneri (54.2%) followed by Sh. sonnei (37.3%) then Sh. dysenteriae (8.5%), while no Sh. boydii was found in this study. Antimicrobial susceptibility tests revealed that 54.23% and 49.2% of both Sh. flexneri and Sh. sonnei were resistant to nalidixic acid and ciprofloxacin, respectively, while Sh. dysenteriae isolates were fully susceptible to these antibiotics. The minimum inhibitory concentration value of resistant isolates of Sh. flexneri and Sh. sonnei ranged between 2-64 μg/ml and 32-512 μg/ml for ciprofloxacin and nalidixic acid, respectively. Multiplex polymerase chain reaction amplification of plasmid-borne qnrA, qnrB, qnrS genes revealed that the overall percentage of qnr-genes were (52.9%) distributed as (29.4%) qnrA, (20.6%) qnrS and (2.94%) qnrB detected alone or in combination. The genes were identified in (44.1%, 15/34) of quinolone resistance Shigella isolates.Conclusion:To our knowledge, this is the first report detected fluoroquinolone resistance due to the qnr gene among Shigella isolates in Iraq which is indicated that plasmid-mediated quinolone resistance has emerged in Iraqi pediatric patients.Keywords:Drug resistance, Shigella spp., Plasmid; Quinolone, qnr


Article
Prevalence of Plasmid-Mediated Quinolone Resistance Genes (qnr) in Clinical Isolates of K. pneumoniae in Najaf
انتشار جينات مقاومة الكينولون بوساطة البلازميد (qnr) في العزلة السريرية للالتهاب الرئوي K في النجف

Authors: Ali Muhsin Almohana علي محسن المحنة --- Samer Abdulsahib Mahammad Hassein سامر عبد الصاحب محمد --- Zainab Jaber Hadi زينب جابر هادي
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2016 Volume: 12 Issue: 22 Pages: 155-160
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Introduction: The main purpose of this study was to investigating the presence of qnr-genes among clinical isolates of K. pneumoniae recovered from Najaf hospitals. Material and methods: A total of 1590 clinical specimens were obtained from three main hospitals. The Klebsiella spp. were identified by traditional biochemical tests, and confirmed by API 20E system.Theisolates that exhibited reduce susceptibility to quinolones were examined for the presence of PMQR qnr (qnrA, qnrB, and qnrS qnrC, and qunD). Results: The qnr genes were detected in 20 (63.5%) isolates qnrB, qnrA and qnrS were identified in 17 (23%), 2 (2.7%) and 1 (1.4%) respectively. Conclusion: K. pneumoniae isolates harboring PMQR are currently widely distributed in Najaf hospitals.

مقدمة: كان الهدف الرئيسي من هذه الدراسة هو التحقيق في وجود جينات qnr بين العزلات السريرية للالتهاب الرئوي K. المستردة من مستشفيات النجف.المواد والطرق: تم الحصول على ما مجموعه 1590 عينة سريرية من ثلاثة مستشفيات رئيسية. و Klebsiella النيابة. تم التعرف عليها من خلال الاختبارات الكيميائية الحيوية التقليدية ، وأكدها نظام API 20E. تم فحص المواد العازلة التي عرضت تقليل قابلية الكينولون لوجود PMQR qnr (qnrA ، qnrB ، و qnrS qnrC ، و qunD).النتائج: تم اكتشاف جينات qnr في 20 (63.5 ٪) تم تحديد qnrB ، qnrA و qnrS في 17 (23 ٪) ، 2 (2.7 ٪) و 1 (1.4 ٪) على التوالي.الخلاصة: إن العزلات الرئوية المزمنة التي تؤوي PMQR يتم توزيعها على نطاق واسع في مستشفيات النجف.

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