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质粒型氟喹诺酮类耐药基因在儿童和成人诊断为尿路感染的氟喹诺酮类耐药和/或产超广谱β-内酰胺酶株中的分布。

Plasmidic Fluoroquinolone Resistance Genes in Fluoroquinolone-Resistant and/or Extended Spectrum Beta-Lactamase-Producing Strains Isolated from Pediatric and Adult Patients Diagnosed with Urinary Tract Infection.

机构信息

Ankara University Faculty of Medicine, Ankara, Turkey.

Department of Medical Microbiology, Hacettepe University Faculty of Medicine, Ankara, Turkey.

出版信息

Microb Drug Resist. 2020 Nov;26(11):1334-1341. doi: 10.1089/mdr.2020.0007. Epub 2020 May 14.

DOI:10.1089/mdr.2020.0007
PMID:32407158
Abstract

is the leading etiological agent of community-acquired urinary tract infection (UTI). Fluoroquinolones have long been the choice of empirical treatment for UTIs. Plasmid-mediated fluoroquinolone-resistance (PMFR) is important not only for conferring resistance to fluoroquinolones but also because of the presence of PMFR genes on plasmids carrying genes encoding resistance to other antimicrobials. In this study, we aimed at investigating the frequency of PMFR genes in fluoroquinolone-resistant and/or expanded spectrum beta-lactamase (ESBL)-producing strains isolated from pediatric and adult patients diagnosed with UTI. strains isolated from urine cultures of 141 adult and 117 pediatric outpatients were evaluated. Antimicrobial susceptibilities were interpreted according to the EUCAST criteria. The presence of PMFR genes ( and Ib-cr) was investigated by multiplex PCR analysis. One hundred-three (73.05%) adult and 92 (78.63%) pediatric isolates were fluoroquinolone resistant and/or ESBL producers. One third (92/258) of all isolates carried at least one PMFR gene, the most prevalent one being (67.4%). None of the isolates carried and genes. PMFR determinants were found to be widespread among adult and pediatric isolates. Rational antimicrobial use is crucial for prevention of resistance in both adult and pediatric populations.

摘要

是引起社区获得性尿路感染(UTI)的主要病原体。氟喹诺酮类药物一直是治疗 UTI 的经验性治疗选择。质粒介导的氟喹诺酮耐药(PMFR)不仅对抗氟喹诺酮类药物的耐药性很重要,而且由于携带其他抗生素耐药基因的质粒上存在 PMFR 基因。在这项研究中,我们旨在调查氟喹诺酮耐药和/或产超广谱β-内酰胺酶(ESBL)的分离株中 PMFR 基因的频率,这些分离株来自诊断为 UTI 的儿科和成年患者。评估了 141 名成年和 117 名儿科门诊患者的尿液培养分离株。根据 EUCAST 标准解释抗菌药物敏感性。通过多重 PCR 分析研究 PMFR 基因( 和 Ib-cr)的存在。103 名(73.05%)成年和 92 名(78.63%)儿科分离株对氟喹诺酮类药物耐药和/或产 ESBL。所有分离株中有三分之一(92/258)携带至少一种 PMFR 基因,最常见的是 (67.4%)。没有分离株携带 和 基因。PMFR 决定因素在成年和儿科分离株中广泛存在。合理使用抗菌药物对于预防成年和儿科人群的耐药性至关重要。

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