Plasmid-mediated quinolone resistance in expanded spectrum beta lactamase producing enterobacteriaceae in Morocco

Authors

  • Mohammed Bouchakour Laboratoire de Bactériologie Moléculaire, Institut Pasteur du Maroc. Casablanca
  • Khalid Zerouali Laboratoire de Microbiologie, CHU Ibn Rochd, Casablanca
  • Jean David Perrier Gros Claude Laboratoire de Bactériologie Moléculaire, Institut Pasteur du Maroc.Casablanca
  • Hamid Amarouch Faculté des Sciences Ain Chock Casablanca.
  • Naima El Mdaghri Laboratoire de Microbiologie, CHU Ibn Rochd, Casablanca
  • Patrice Courvalin Unité des Agents Antibactériens, Institut Pasteur, 25, rue du docteur Roux, 75724 Paris Cedex 15.
  • Mohammed Timinouni Laboratoire de Bactériologie Moléculaire, Institut Pasteur du Maroc. Casablanca

DOI:

https://doi.org/10.3855/jidc.796

Keywords:

qnr, Prevalence, ESBL, Morocco

Abstract

Introduction: Although independently acquired, plasmid-mediated quinolone resistance appears to be linked with extended-spectrum or AmpC-type beta-lactamases. Since no data are available in African countries, the prevalence of qnr genes at the University Hospital Ibn Rochd, Casablanca, Morocco, was investigated.

Methodology: Between October 2006 and March 2007, the following 39 randomly selected non-duplicate Enterobacteriaceae producing an extended-spectrum beta-lactamase (ESBL), representing 20% of ESBL strains with respect to species and ward origin, were collected: Escherichia coli (n = 16); Klebsiella spp (n = 14); Enterobacter cloacae (n = 8); Proteus mirabilis (n = 1). Antibiotic susceptibility testing was performed according to CLSI guidelines. ESBL detection was performed by the double disc diffusion test. A multiplex PCR was conducted to detect qnrA, qnrB and qnrS genes that were confirmed by sequencing of the PCR product.

Results: The estimated overall prevalence of qnr reached 36% (n = 14; qnrA, 10.25%; qnrB, 23.07%; qnrS, 2.56%). Genes were identified in E. coli, Klebsiella and Enterobacter with a respective prevalence of 18.7%, 50% and 62.5%.  The qnr genes were detected in nine wards and qnrA1, qnrB1-B2-B4 and qnrS1 variants were identified. Three genes were identified among nalidixic acid susceptible strains (n = 6); three of those were also susceptible to ciprofloxacin. Among nalidixic acid and ciprofloxacin resistant strains, all strains had qnrB.

Conclusions: This study highlights the high prevalence of qnr genes among ESBL strains in the Ibn Rochd CHU, Casablanca. Moreover, qnr were present in quinolone-susceptible strains which could lead to in vivo selection of ciprofloxacin-resistant strains.

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Published

2010-08-06

How to Cite

1.
Bouchakour M, Zerouali K, Gros Claude JDP, Amarouch H, El Mdaghri N, Courvalin P, Timinouni M (2010) Plasmid-mediated quinolone resistance in expanded spectrum beta lactamase producing enterobacteriaceae in Morocco. J Infect Dev Ctries 4:779–803. doi: 10.3855/jidc.796

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