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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 |
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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. 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.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0178888</identifier><identifier>PMID: 28636609</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>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</subject><ispartof>PloS one, 2017-06, Vol.12 (6), p.e0178888-e0178888</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Osei Sekyere, Amoako. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Osei Sekyere, Amoako 2017 Osei Sekyere, Amoako</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-26a184bf0d317b68b2c1da033370306c9057e69f1d209d493e5b96987be60c953</citedby><cites>FETCH-LOGICAL-c692t-26a184bf0d317b68b2c1da033370306c9057e69f1d209d493e5b96987be60c953</cites><orcidid>0000-0002-9508-984X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/1912162244/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/1912162244?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,25734,27905,27906,36993,36994,44571,53772,53774,74875</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28636609$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Galdiero, Massimiliano</contributor><creatorcontrib>Osei Sekyere, John</creatorcontrib><creatorcontrib>Amoako, Daniel Gyamfi</creatorcontrib><title>Genomic and phenotypic characterisation of fluoroquinolone resistance mechanisms in Enterobacteriaceae in Durban, South Africa</title><title>PloS one</title><addtitle>PLoS One</addtitle><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.</description><subject>Anti-Bacterial Agents - pharmacology</subject><subject>Antibiotics</subject><subject>Bacteria</subject><subject>Bacterial infections</subject><subject>Bacterial Proteins - genetics</subject><subject>Biology and Life Sciences</subject><subject>Carbonyls</subject><subject>Citrobacter</subject><subject>Complications and side effects</subject><subject>Cyanides</subject><subject>Disease transmission</subject><subject>DNA topoisomerase</subject><subject>DNA topoisomerase IV</subject><subject>Dosage and administration</subject><subject>Drug Resistance, Bacterial - genetics</subject><subject>E coli</subject><subject>Efflux</subject><subject>Enterobacteriaceae</subject><subject>Enterobacteriaceae - drug effects</subject><subject>Enterobacteriaceae - genetics</subject><subject>Enterobacteriaceae - 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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. 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.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28636609</pmid><doi>10.1371/journal.pone.0178888</doi><tpages>e0178888</tpages><orcidid>https://orcid.org/0000-0002-9508-984X</orcidid><oa>free_for_read</oa></addata></record> |
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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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