title: Analysis of plasmid-mediated multidrug resistance in Escherichia coli and Klebsiella oxytoca isolates from clinical specimens in Japan.
abstract: This study investigated the relationship of plasmid-mediated quinolone resistance (PMQR) and aminoglycoside resistance among oxyimino-cephalosporin-resistant Escherichia coli (n=46) and Klebsiella oxytoca (n=28) clinical isolates in Japan. Seventy-three isolates appeared to produce an extended-spectrum beta-lactamase (ESBL) and one K. oxytoca isolate produced IMP-1 metallo-beta-lactamase (MBL). Polymerase chain reaction (PCR) and sequencing confirmed that eight CTX-M-9/SHV-12-producing isolates, one IMP-1-producing K. oxytoca isolate, and six ESBL-positive E. coli isolates respectively possessed PMQR genes qnrA1, qnrB6, and aac(6')-Ib-cr. All qnr-positive isolates also carried either aac(6')-Ib or aac(6')-IIc aminoglycoside acetyltransferase genes. Resistance determinants to beta-lactams, quinolones and aminoglycosides were co-transferred with a plasmid of ca. 140 kb. The qnrA1 gene was located downstream of insertion sequence ISCR1 in complex class 1 integrons. A novel qnrA1-carrying class 1 integron with the cassette arrangement aac(6')-IIc-aadA2 as well as a unique class 1 integron with bla(IMP-1)-aac(6')-IIc cassettes on the plasmid carrying qnrB6 were found in K. oxytoca isolates. We describe the identification of qnrB6 and aac(6')-Ib-cr and the close association of qnr with aac(6')-Ib and aac(6')-IIc for the first time in clinical isolates producing ESBL or MBL in Japan.
authors: Department of Microbiology and Immunology, Graduate School of Health Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan. takashi.ode.mt@gmail.com
authors: Takashi
authors: T
authors: Ode
authors: Ryoichi
authors: R
authors: Saito
authors: Wakako
authors: W
authors: Kumita
authors: Kenya
authors: K
authors: Sato
authors: Shu
authors: S
authors: Okugawa
authors: Kyoji
authors: K
authors: Moriya
authors: Kazuhiko
authors: K
authors: Koike
authors: Noboru
authors: N
authors: Okamura
mesh_terms: D000617:Aminoglycosides / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics; D003227:Conjugation, Genetic; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004926:Escherichia coli / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification; D004927:Escherichia coli Infections / Q000382:microbiology*; D006801:Humans; D032023:Integrons; D007564:Japan; D007710:Klebsiella Infections / Q000382:microbiology*; D041121:Klebsiella oxytoca / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000302:isolation & purification; D008826:Microbial Sensitivity Tests; D010957:Plasmids / Q000235:genetics*; D015363:Quinolones / Q000494:pharmacology; D017422:Sequence Analysis, DNA; D001618:beta-Lactamases / Q000096:biosynthesis / Q000235:genetics; D047090:beta-Lactams / Q000494:pharmacology
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015363:Quinolones; D047090:beta-Lactams; D001618:beta-Lactamases