High incidence of plasmid-mediated quinolone resistance genes among ciprofloxacin-resistant clinical isolates of Enterobacteriaceae at a tertiary care hospital in Puducherry, India
- Published
- Accepted
- Subject Areas
- Microbiology, Public Health
- Keywords
- aac(6’)-Ib-cr, PMQR, qnr, Enterobacteriaceae, Fluoroquinolone resistance
- Copyright
- © 2016 Yugendran et al.
- Licence
- This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ PrePrints) and either DOI or URL of the article must be cited.
- Cite this article
- 2016. High incidence of plasmid-mediated quinolone resistance genes among ciprofloxacin-resistant clinical isolates of Enterobacteriaceae at a tertiary care hospital in Puducherry, India. PeerJ PrePrints 4:e1682v1 https://doi.org/10.7287/peerj.preprints.1682v1
Abstract
Background: Plasmid-mediated quinolone resistance (PMQR) has received considerable attention recently. Data analysis in JIPMER revealed 75% of the Enterobacteriaceae isolates to be ciprofloxacin-resistant in 2012. Few reports regarding the prevalence of PMQR are available from India. Hence, the present study was carried out to ascertain the prevalence of PMQR genes among clinical isolates of ciprofloxacin-resistant Enterobacteriaceae in JIPMER. Methods: The study included 642 ciprofloxacin-resistant clinical Enterobacteriaceae isolates. JIPMER hospital’s annual consumption data for fluoroquinolones were retrieved from the Department of Pharmacy. The test isolates were screened for the presence of qnr A, B, D, S and aac(6’)-Ib-cr genes. PMQR-positive isolates alone were tested for the presence of class I (intI1) and class II (intI2) integrons. Randomly selected PCR amplicons were sequenced and analysed using MEGA software. A total of 30 PMQR strains chosen at random were assessed for the transferability of the PMQR genes. Results: Majority of the strains exhibited high MIC values with 106 strains exhibiting MIC value ˃256µg/mL. The aac(6’)-Ib-cr gene had the highest prevalence at 64% (414) while, qnrB and qnrS genes were present in 15% (97) and 10% (64) of the isolates respectively. None of the strains were positive for qnrA and qnrD. All PMQR-positive isolates were screened for class I (intI1) and class II (intI2) integrons. Class I integron was found to be predominant among the test isolates with a few of them carrying both the classes of integrons. Transferability of PMQR genes to transconjugants was identified. Discussion: PMQR genes were found to exhibit an increasing trend of prevalence among the clinical isolates in this study. Thus, the need for rational usage of fluoroquinolones and reconsideration of their clinical breakpoints has arisen.
Author Comment
This manuscript has been submitted to PeerJ for review.
Supplemental Information
Annual Fluoroquinolone Consumption Data
Table S1 - Annual consumption data of fluoroquinolone drugs prsecribed in JIPMER hospital.
Phylogenetic Relativeness of aac(6')-Ib-cr gene
Table S2 - The relatedness of the various randomly selected aac(6')-Ib-cr gene identified in this study.