1887

Abstract

The aim of the study was to investigate the prevalence of plasmid-mediated quinolone resistance (PMQR) genes in an unselected collection of bloodstream isolates recovered over an 18-month period in a laboratory affiliated to a university hospital in Athens, Greece, and to assess their impact on the activity of ciprofloxacin and levofloxacin.

Eight PMQR genes were screened by PCR and sequencing. All PMQR-positive isolates were submitted to isoelectric focusing for β-lactamase detection, conjugation or transformation, time-kill assays, mutant prevention concentrationand inoculum effect evaluation. PCR and sequencing of and were performed for detection of chromosomal mutations.

Among 96 Gram-negative isolates, 7 (7.3 %) carried one or more PMQR genes. was the most prevalent (5.2 %), followed by (4.2 %) and their combination (2 %). Cloning was successful for three isolates. The presence of a single PMQR determinant without any target modification was not associated with quinolone resistance with one exception, carrying , which was resistant to norfloxacin and ciprofloxacin, but in this isolate, additional mechanisms of quinolone resistance cannot be excluded. All PMQR-positive isolates showed a significant inoculum effect. The mutant prevention concentrations of ciprofloxacin against the quinolone-susceptible clinical isolates ranged from 0.38 to 32 mg l and those of levofloxacin from 1 to 32 mg l.

PMQRs compromised the bactericidal activity of ciprofloxacin and levofloxacin when expressed in or and when more than one co-existed. PMQR determinants represent an unrecognized threat, capable to compromise the activity of quinolones if expressed in a favourable genetic environment and to favour selection of resistant mutants by widening the mutant selection window of these agents.

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2017-03-01
2020-11-30
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