Fluoroquinolone resistance determinants in carbapenem-resistant isolated from urine clinical samples in Thailand.

BACKGROUND

is the most common cause of urinary tract infections and has fluoroquinolone (FQ)-resistant strains, which are a worldwide concern.

OBJECTIVES

To characterize FQ-resistant determinants among 103 carbapenem-resistant (CREc) urinary isolates using WGS.

METHODS

Antimicrobial susceptibility, biofilm formation, and short-read sequencing were applied to these isolates. Complete genome sequencing of five CREcs was conducted using short- and long-read platforms.

RESULTS

ST410 (50.49%) was the predominant ST, followed by ST405 (12.62%) and ST361 (11.65%). Clermont phylogroup C (54.37%) was the most frequent. The genes (74.76%) and (71.84%) were the most identified. Most CREcs were resistant to ciprofloxacin (97.09%) and levofloxacin (94.17%), whereas their resistance rate to nitrofurantoin was 33.98%. Frequently, the gene (57.28%) was found and the coexistence of and was the most widely predominant. All isolates carried the mutants of S83L and D87N. In 12.62% of the isolates, the coexistence was detected of , , , and mutations. Furthermore, the five urinary CREc-complete genomes revealed that or were located on two plasmid Inc types, comprising IncFI (60%, 3/5) and IncFI/IncQ (40%, 2/5). In addition, both plasmid types carried other resistance genes, such as , , , and . Notably, the IncFI plasmid in one isolate carried three copies of the gene.

CONCLUSIONS

This study showed FQ-resistant determinants in urinary CREc isolates that could be a warning sign to adopt efficient strategies or new control policies to prevent further spread and to help in monitoring this microorganism.