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Genomic and phenotypic characterisation of fluoroquinolone resistance mechanisms in Enterobacteriaceae in Durban, South Africa

Resistance to fluoroquinolones (FQ) is being increasingly reported and found to be mediated by efflux pumps, plasmid-mediated quinolone resistance genes (PMQR) and mutations in gyrA, gyrB, parC and parE. However, studies reporting on FQ resistance mechanisms (FQRM), particularly in Africa, are focus...

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Published in:PloS one 2017-06, Vol.12 (6), p.e0178888-e0178888
Main Authors: Osei Sekyere, John, Amoako, Daniel Gyamfi
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description Resistance to fluoroquinolones (FQ) is being increasingly reported and found to be mediated by efflux pumps, plasmid-mediated quinolone resistance genes (PMQR) and mutations in gyrA, gyrB, parC and parE. However, studies reporting on FQ resistance mechanisms (FQRM), particularly in Africa, are focused mostly on Salmonella. This study used a whole-genome-based approach to describe FQRM in forty-eight clinical Enterobacteriaceae isolates comprising of Klebsiella pneumoniae (n = 21), Serratia marcescens (n = 12), Enterobacter spp. (n = 10), Citrobacter freundii (n = 3), Escherichia coli (n = 1), and Klebsiella michiganensis (n = 1) with reduced susceptibility to FQ in Enterobacteriaceae. All the isolates exhibited exceptionally high-level resistance (MIC of 4-512mg/L) to all three FQs, which could not be reversed by carbonyl cyanide m-chlorophenyl hydrazine (CCCP), verapamil (VRP) or reserpine (RSP). PMQR genes such as oqxAB (n = 43), aac(6')-Ib-cr (n = 28), and qnr(S1, B1, B2, B9, B49, B66) (n = 23) were identified without transposons or integrons in their immediate environments. Multiple and diverse mutations were found in gyrA (including S83I/Y and T/I83I/T), gyrB, parC and parE, which were clonally specific. There were vertical and horizontal transmission of high-level FQ resistance in Enterobacteriaceae in hospitals in Durban, South Africa, which are mediated by efflux, PMQR genes, and gyrA, gyrB, parC and parE mutations.
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However, studies reporting on FQ resistance mechanisms (FQRM), particularly in Africa, are focused mostly on Salmonella. This study used a whole-genome-based approach to describe FQRM in forty-eight clinical Enterobacteriaceae isolates comprising of Klebsiella pneumoniae (n = 21), Serratia marcescens (n = 12), Enterobacter spp. (n = 10), Citrobacter freundii (n = 3), Escherichia coli (n = 1), and Klebsiella michiganensis (n = 1) with reduced susceptibility to FQ in Enterobacteriaceae. All the isolates exhibited exceptionally high-level resistance (MIC of 4-512mg/L) to all three FQs, which could not be reversed by carbonyl cyanide m-chlorophenyl hydrazine (CCCP), verapamil (VRP) or reserpine (RSP). PMQR genes such as oqxAB (n = 43), aac(6')-Ib-cr (n = 28), and qnr(S1, B1, B2, B9, B49, B66) (n = 23) were identified without transposons or integrons in their immediate environments. 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1932-6203
language eng
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source Publicly Available Content Database; PubMed Central
subjects Anti-Bacterial Agents - pharmacology
Antibiotics
Bacteria
Bacterial infections
Bacterial Proteins - genetics
Biology and Life Sciences
Carbonyls
Citrobacter
Complications and side effects
Cyanides
Disease transmission
DNA topoisomerase
DNA topoisomerase IV
Dosage and administration
Drug Resistance, Bacterial - genetics
E coli
Efflux
Enterobacteriaceae
Enterobacteriaceae - drug effects
Enterobacteriaceae - genetics
Enterobacteriaceae - isolation & purification
Enterobacteriaceae Infections - microbiology
Epidemiology
Fluoroquinolones
Fluoroquinolones - pharmacology
Genes
Genetic aspects
Genomes
Genomics - methods
Health sciences
Hospitals
Humans
Hydrazine
Klebsiella
Medicine and Health Sciences
Microbial drug resistance
Microbial Sensitivity Tests
Mutation
Pharmaceutical sciences
Phenotype
Physiological aspects
Plasmids
Pneumonia
Pumps
Reserpine
Salmonella
South Africa
Staphylococcus infections
Studies
Transcription
Transposons
Verapamil
title Genomic and phenotypic characterisation of fluoroquinolone resistance mechanisms in Enterobacteriaceae in Durban, South Africa
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