Transferable fluoroquinolone resistance in Enterobacteriaceae and Pseudomonas aeruginosa isolated from hemocultures.

BACKGROUND

The main mechanisms causing high-level resistance to fluoroquinolones (FQ) are encoded chromosomally; that includes mutations in genes coding DNA-gyrase, but overexpression of efflux pumps contributes to increased minimum inhibitory concentration (MIC) of FQ as well. However, genes responsible for FQ-resistance may be harboured in transferable/conjugative plasmids. For some time, there was an assumption that resistance to FQ cannot be transferable in conjugation due to their synthetic origin, until 1998, when plasmid-mediated resistance transmission in Klebsiella pneumoniae was proved. We aimed to detect the occurrence of transferable FQ-resistance among Gram- negative bacteria isolated from patients in Czech and Slovak hospitals.

METHODS

In this study, we tested 236 clinical isolates of Gram-negative bacteria for transferable resistance. Among relevant isolates we performed PCR detection of transferable fluoroquinolone genes (qnr).

RESULTS

We have observed transfer of determinants of cephalosporin-resistance, aminoglycoside resistance as well as FQ-resistance (in 10 cases; 4.24%) not only intra-species but inter-species too. The presence of qnr gene was detected in two isolates of forty tested (5%). We have also observed that determinants of cephalosporin-resistance and aminoglycoside-resistance were linked to those of FQ-resistance and were transferred en block in conjugation.

CONCLUSION

We have proved that resistance to fluoroquinolones can be transferred horizontally via conjugation among Gram-negative bacteria of different species and is associated with resistance to other antibiotics.