High Prevalence of Plasmid-Mediated Quinolone Resistance Determinants in Escherichia coli and Klebsiella pneumoniae Isolates from Pediatric Patients in China
High Prevalence of Plasmid-Mediated Quinolone Resistance Determinants in Escherichia coli and Klebsiella pneumoniae Isolates from Pediatric Patients in China
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中国儿科患者中大肠杆菌和肺炎克雷伯菌分离株中质粒介导的喹诺酮类耐药决定因素的高患病率
DOI：
10.1089/mdr.2016.0004
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发表时间：
2017
影响因子：
2.6
通讯作者：
Sun Hongmei
中科院分区：
文献类型：
--
作者：
Xue Guanhua;Li Jing;Feng Yanling;Xu Wenjian;Li Shaoli;Yan Chao;Zhao Hanqing;Sun Hongmei
本研究调查了儿科临床分离的大肠埃希菌和肺炎克雷伯菌中质粒介导的喹诺酮类耐药（PMQR）基因的流行情况。共检测了243株非重复的大肠埃希菌临床分离株。coliandK. 2010年1月至2012年12月期间从中国北京收集的肺炎病例进行了研究。PMQR基因阳性55株（22.63%），其中qnrS基因阳性率最高（13.2%），其次为aac（6′）-Ib-cr（6.2%）和qnrB（3.7%）。未检测到qnrA和qepA基因。产超广谱β-内酰胺酶（ESBLs）的占92.73%（51/55），对喹诺酮类药物耐药的占21.82%（12/55）。DNA测序结果显示，14.55%（8/55）的菌株在喹诺酮类药物耐药决定区（QRDR）存在gyrA突变，1.82%（1/55）的菌株存在parC突变。转化接合子对萘啶酸或环丙沙星的耐药性增加了2 ~ 32倍。肠杆菌重复基因间共有序列聚合酶链反应分型表明大多数分离株与克隆无关。我们的研究结果表明，在儿科临床分离的E。coliandK.肺炎在中国是高发的。PMQR阳性菌株在产ESBL和环丙沙星敏感菌株中更常见。接合实验表明，这些菌株可以水平转移。本研究强调了PMQR在未接受喹诺酮类药物治疗的中国儿科患者中的高患病率。
In this study, the prevalence of the plasmid-mediated quinolone resistance (PMQR) genes among pediatric clinical isolates ofEscherichia coliandKlebsiella pneumoniaewas investigated. A total of 243 nonduplicate clinical isolates ofE. coliandK. pneumoniaecollected between January 2010 and December 2012 from Beijing, China, were studied. In total, 55 isolates (22.63%) were positive for PMQR genes, the most frequently detected gene wasqnrS(13.2%), followed byaac(6′)-Ib-cr(6.2%) andqnrB(3.7%). TheqnrAandqepAgenes were not detected. Furthermore, 92.73% (51/55) produced extended-spectrum β-lactamases (ESBLs) and 21.82% (12/55) were resistant to quinolones. DNA sequencing results showed that 14.55% (8/55) of isolates possessedgyrAmutations, while 1.82% (1/55) hadparCmutations in the quinolone resistance-determining region (QRDR). Nalidixic acid or ciprofloxacin resistance of the transconjugants increased from 2- to 32-fold.Enterobacterialrepetitive intergenic consensus sequence polymerase chain reaction typing indicated that most isolates were not clonally related. Our findings showed that the PMQR detection rate among pediatric clinical isolates ofE. coliandK. pneumoniaewas high in China. PMQR-positive strains were more common among ESBL-producing and ciprofloxacin-susceptible isolates. Conjugation experiments showed that these isolates could be transferred horizontally. The present study highlights the high prevalence of PMQR in Chinese pediatrics who are not treated with quinolones.