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• W2169669684 abstract "• The co-existence of plasmid-mediated quinolone resistance (PMQR) determinants and mutations in the quinolone resistance-determining regions (QRDRs) of gyrA and parC among 215 fluoroquinolone (FQ)-resistant isolates was studied. • PMQR determinants were present in 49 isolates, among which aac(6 ′ )-Ib -cr and qnrB 1 predominated. • The majority of PMQR-harbouring isolates possessed three or four substitutions in the QRDRs. • FQ resistance is rather a complex interplay between PMQR determinants and mutations in the QRDRs. • The role of PMQR in the acquisition of high-level FQ resistance was strongly supported. Plasmid-mediated quinolone resistance (PMQR) determinants and the distribution of mutations in the quinolone resistance-determining regions (QRDRs) of gyrA and parC were investigated in 215 ciprofloxacin-resistant (MIC > 1 mg/L) clinical Enterobacteriaceae collected during a 6-month prospective study in a tertiary hospital in Warsaw, Poland. PMQR determinants were present in 49 isolates (22.8%), among which aac(6 ′ )-Ib -cr and qnrB 1 predominated (85.7% and 26.5%, respectively). Mutations in gyrA and parC QRDRs were detected among 89.8% of isolates (MIC ≥ 4 mg/L). Changes in Ser-83, Ala-84 and Asp-87 in GyrA and Ser-80 and Glu-84 in ParC were detected. Five isolates with ciprofloxacin MICs in the range 1.5–16 mg/L were found to have unaltered QRDRs, with PMQR as the only fluoroquinolone (FQ) resistance trait detected. The remaining 44 PMQR-positive isolates were found to carry altered QRDRs. Three substitutions (two in GyrA and one in ParC) were detected in 23 isolates, whilst 8 isolates carried four mutations (two in GyrA and two in ParC). One isolate of Klebsiella pneumoniae with two amino acid substitutions in the ParC QRDR in the presence of aac(6 ′ )-Ib -cr and qnrB 1 had a ciprofloxacin MIC of 16 mg/L. The results presented here show that FQ resistance in these clinical Enterobacteriaceae is a complex interplay between PMQR determinants and mutations in gyrA and parC rather than a single stepwise accumulation of mutations in the gyrase and topoisomerase subunits. In addition, these results show the role of PMQR determinants in promoting QRDR mutations and the acquisition of high-level FQ resistance in clinical settings." @default.
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• W2169669684 date "2015-03-01" @default.
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• W2169669684 title "Co-existence of plasmid-mediated quinolone resistance determinants and mutations in gyrA and parC among fluoroquinolone-resistant clinical Enterobacteriaceae isolated in a tertiary hospital in Warsaw, Poland" @default.
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• W2169669684 doi "https://doi.org/10.1016/j.ijantimicag.2014.09.019" @default.
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