The co-selection of fluoroquinolone resistance genes in the gut flora of Vietnamese children.
The co-selection of fluoroquinolone resistance genes in the gut flora of Vietnamese children.
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DOI：
10.1371/journal.pone.0042919
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Baker S
中科院分区：
文献类型：
--
作者：
Vien le TM;Minh NN;Thuong TC;Khuong HD;Nga TV;Thompson C;Campbell JI;de Jong M;Farrar JJ;Schultsz C;van Doorn HR;Baker S
抗菌药物的消耗是促进表现出抗菌药物耐药性的细菌的发展和维持的主要因素之一。质粒介导的喹诺酮抗性（PMQR）基因，例如 qnr 家族，可以水平转移并有助于降低对氟喹诺酮类药物的敏感性。我们进行了一项观察性研究，调查抗菌治疗后 PMQR 的拷贝数。我们招募了 300 名居住在胡志明市的儿童，接受针对急性呼吸道感染 (ARIs) 的抗菌治疗。入组时采集直肠拭子，随后 7 天进行肠杆菌科细菌计数，并通过对宏基因组粪便 DNA 使用实时 PCR 来量化 qnrA、qnrB 和 qnrS。在入组时，我们发现参与者的年龄、性别或地点与 qnrA、qnrB 或 qnrS 患病率之间没有关联。然而，所有三个位点都显示出第 0 天和第 7 天之间检测呈阳性的样本数量成比例增加。此外，qnrB 显示配对样本之间的拷贝数显着增加（p<0.001；Wilcoxon 秩和），与非氟喹诺酮类联合抗菌治疗相关。据我们所知，这是第一项描述非氟喹诺酮类抗菌药物的使用与 qnr 基因相对流行率和数量增加之间关联的研究。我们的工作概述了选择和维持 PMQR 基因的潜在机制，并预测通过使用不相关且可能不必要的抗菌方案来共同选择这些耐药决定因素会产生强烈影响。
Antimicrobial consumption is one of the major contributing factors facilitating the development and maintenance of bacteria exhibiting antimicrobial resistance. Plasmid-mediated quinolone resistance (PMQR) genes, such as the qnr family, can be horizontally transferred and contribute to reduced susceptibility to fluoroquinolones. We performed an observational study, investigating the copy number of PMQR after antimicrobial therapy. We enrolled 300 children resident in Ho Chi Minh City receiving antimicrobial therapy for acute respiratory tract infections (ARIs). Rectal swabs were taken on enrollment and seven days subsequently, counts for Enterobacteriaceae were performed and qnrA, qnrB and qnrS were quantified by using real-time PCR on metagenomic stool DNA. On enrollment, we found no association between age, gender or location of the participants and the prevalence of qnrA, qnrB or qnrS. Yet, all three loci demonstrated a proportional increase in the number of samples testing positive between day 0 and day 7. Furthermore, qnrB demonstrated a significant increase in copy number between paired samples (p<0.001; Wilcoxon rank-sum), associated with non-fluoroquinolone combination antimicrobial therapy. To our knowledge, this is the first study describing an association between the use of non-fluoroquinolone antimicrobials and the increasing relative prevalence and quantity of qnr genes. Our work outlines a potential mechanism for the selection and maintenance of PMQR genes and predicts a strong effect of co-selection of these resistance determinants through the use of unrelated and potentially unnecessary antimicrobial regimes.
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