دورية أكاديمية
أعرض في EDS

Characterization of Transferrable Mechanisms of Quinolone Resistance (TMQR) among Quinolone-resistant Escherichia coli and Klebsiella pneumoniae causing Urinary Tract Infection in Nepalese Children.

التفاصيل البيبلوغرافية
العنوان: Characterization of Transferrable Mechanisms of Quinolone Resistance (TMQR) among Quinolone-resistant Escherichia coli and Klebsiella pneumoniae causing Urinary Tract Infection in Nepalese Children.
المؤلفون: Shrestha RK; Siddhi Memorial Hospital, Bhaktapur, Nepal. shrestha.raz.np@gmail.com., Thapa A; Siddhi Memorial Hospital, Bhaktapur, Nepal., Shrestha D; Siddhi Memorial Hospital, Bhaktapur, Nepal., Pokhrel S; Siddhi Memorial Hospital, Bhaktapur, Nepal., Aryal A; Siddhi Memorial Hospital, Bhaktapur, Nepal., Adhikari R; Siddhi Memorial Hospital, Bhaktapur, Nepal., Shrestha N; Siddhi Memorial Hospital, Bhaktapur, Nepal., Dhoubhadel BG; School of Tropical Medicine and Global Health (TMGH), Nagasaki University, Nagasaki, Japan.; Department of Respiratory Infections, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan., Parry CM; School of Tropical Medicine and Global Health (TMGH), Nagasaki University, Nagasaki, Japan.; Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
المصدر: BMC pediatrics [BMC Pediatr] 2023 Sep 13; Vol. 23 (1), pp. 458. Date of Electronic Publication: 2023 Sep 13.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100967804 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2431 (Electronic) Linking ISSN: 14712431 NLM ISO Abbreviation: BMC Pediatr Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Quinolones*/pharmacology , Urinary Tract Infections*/drug therapy , Urinary Tract Infections*/epidemiology , Anti-Infective Agents*, Child ; Humans ; Escherichia coli/genetics ; Klebsiella pneumoniae/genetics ; Nepal/epidemiology ; Prospective Studies ; Fluoroquinolones/pharmacology ; beta-Lactamases/genetics
مستخلص: Background: Transferrable mechanisms of quinolone resistance (TMQR) can lead to fluoroquinolone non-susceptibility in addition to chromosomal mechanisms. Some evidence suggests that fluoroquinolone resistance is increasing among the pediatric population. We sought to determine the occurrence of TMQR genes among quinolone-resistant E. coli and K. pneumoniae causing urinary tract infections among Nepalese outpatient children (< 18 years) and identify molecular characteristics of TMQR-harboring isolates.
Methods: We performed antimicrobial susceptibility testing, phenotypic extended-spectrum β-lactamase (ESBL) and modified carbapenem inactivation method tests, and investigated the presence of six TMQR genes (qnrA, qnrB, qnrS, aac(6')-Ib-cr, oqxAB, qepA), three ESBL genes (bla CTX-M , bla TEM , bla SHV ), and five carbapenemase genes (bla NDM , bla OXA-48 , bla KPC , bla IMP , bla VIM ). The quinolone resistance-determining region (QRDR) of gyrA and parC were sequenced for 35 TMQR-positive isolates.
Results: A total of 74/147 (50.3%) isolates were TMQR positive by multiplex PCR [aac(6')-Ib-cr in 48 (32.7%), qnrB in 23 (15.7%), qnrS in 18 (12.3%), qnrA in 1 (0.7%), and oqxAB in 1 (0.7%) isolate]. The median ciprofloxacin minimum inhibitory concentration of TMQR-positive isolates (64 µg/mL) was two-fold higher than those without TMQR (32 µg/mL) (p = 0.004). Ser-83→Leu and Asp-87→Asn in GyrA and Ser-80→Ile in ParC were the most common QRDR mutations (23 of 35). In addition, there was a statistically significant association between TMQR and two β-lactamase genes; bla CTX-M (p = 0.037) and bla TEM (p = 0.000).
Conclusion: This study suggests a high prevalence of TMQR among the quinolone-resistant E. coli and K. pneumoniae isolates causing urinary tract infection in children in this area of Nepal and an association with the carriage of ESBL gene. This is a challenge for the management of urinary infections in children. Comprehensive prospective surveillance of antimicrobial resistance in these common pathogens will be necessary to devise strategies to mitigate the emergence of further resistance.
(© 2023. BioMed Central Ltd., part of Springer Nature.)
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فهرسة مساهمة: Keywords: Children; Nepal; Quinolone resistance; Transferrable mechanisms of quinolone resistance (TMQR); Urinary tract infection
المشرفين على المادة: 0 (Quinolones)
0 (Fluoroquinolones)
EC 3.5.2.6 (beta-Lactamases)
0 (Anti-Infective Agents)
تواريخ الأحداث: Date Created: 20230913 Date Completed: 20230915 Latest Revision: 20231123
رمز التحديث: 20231215
مُعرف محوري في PubMed: PMC10498618
DOI: 10.1186/s12887-023-04279-5
PMID: 37704964
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2431
DOI:10.1186/s12887-023-04279-5