Prevalence and characterization of quinolone resistance and integrons in clinical Gram-negative isolates from Gaza strip, Palestine

• Published in: Molecular biology reports 2024-12, Vol.51 (1), p.855, Article 855
• Main Authors: Tayh, Ghassan, Fhoula, Imene, Said, Mourad Ben, Boudabous, Abdellatif, Slama, Karim Ben
• Format: Article
• Language: English
• Subjects: Animal Anatomy; Animal Biochemistry; Anti-Bacterial Agents - pharmacology; Antimicrobial agents; Antimicrobial resistance; beta-Lactamases - genetics; Biomedical and Life Sciences; Clinical isolates; Drug resistance; Drug Resistance, Bacterial - genetics; Drug Resistance, Multiple, Bacterial - genetics; Gram-negative bacteria; Gram-Negative Bacteria - drug effects; Gram-Negative Bacteria - genetics; Gram-Negative Bacteria - isolation & purification; Gram-Negative Bacterial Infections - epidemiology; Gram-Negative Bacterial Infections - microbiology; Histology; Hospitals; Humans; Integrons - genetics; Life Sciences; Microbial Sensitivity Tests; Middle East - epidemiology; Morphology; Multidrug resistance; Original Article; Plasmids - genetics; Prevalence; Quinolones; Quinolones - pharmacology; Trimethoprim; β Lactamase
• ISSN: 0301-4851; 1573-4978; 1573-4978
• DOI: 10.1007/s11033-024-09721-0

Background Gram-negative bacteria with quinolone resistance and extended-spectrum beta-lactamases (ESBLs) present significant treatment challenges. This study evaluated the prevalence and characteristics of quinolone resistance in Gram-negative strains, investigating the relationship between plasmid-mediated quinolone resistance (PMQR), ESBLs, and integrons. Methods and results We collected 146 Gram-negative isolates from patients in three Palestinian hospitals. For quinolone resistance isolates, the presence and characterization of PMQR, β-lactamase genes and integrons were studied by PCR and sequencing. Out of 146 clinical isolates, 64 (43.8%) were resistant to quinolones, with 62 (97%) being multidrug-resistant (MDR) and 33 (51.5%) ESBL-producers. PMQR-encoding genes were present in 45 (70.3%) isolates, including aac(6′)-Ib-cr (26.6%), qnrA (18.8%), qnrS1 (20.8%), and qnrB (6.4%). Bla CTX−M genes were detected in 50% (32/64) of isolates, with bla CTX−M−15 being the most common. Bla TEM−1 , bla SHV−1 and bla VIM genes were found in 13, 6, and 4 isolates, respectively. Class I integrons were found in 31/64 (48%) of isolates, with 14 containing gene cassettes conferring resistance to trimethoprim ( dhfr17, dfrA12, dfrA1 ) and aminoglycosides resistance genes ( aadA1 , aadA2 , aadA5 , and aadA6 ). Conclusions This study found a high rate of quinolone resistance, ESBL and integrons in clinical Gram-negative isolates from our hospitals. Urgent measures are crucial, including implementing an antimicrobial resistance surveillance system, to control and continuously monitor the development of antimicrobial resistance.