title: High prevalence of plasmid-mediated quinolone resistance determinants in commensal members of the Enterobacteriaceae in Ho Chi Minh City, Vietnam.
abstract: Antimicrobial-resistant pathogenic members of the Enterobacteriaceae are a well-defined global problem. We hypothesized that one of the main reservoirs of dissemination of antimicrobial resistance genes in Vietnam is non-pathogenic intestinal flora, and sought to isolate antimicrobial-resistant organisms from hospitalized patients and non-hospitalized healthy individuals in Ho Chi Minh City. The results identified substantial faecal carriage of gentamicin-, ceftazidime- and nalidixic acid-resistant members of the Enterobacteriaceae in both hospitalized patients and non-hospitalized healthy individuals. A high prevalence of quinolone resistance determinants was identified, particularly the qnrS gene, in both community- and hospital-associated strains. Furthermore, the results demonstrated that a combination of quinolone resistance determinants can confer resistance to nalidixic acid and ciprofloxacin, even in the apparent absence of additional chromosomal resistance mutations in wild-type strains and laboratory strains with transferred plasmids. These data suggest that intestinal commensal organisms are a significant reservoir for the dissemination of plasmid-mediated quinolone resistance in Ho Chi Minh City.
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Le Thi
authors.initials: LT
authors.lastname: Minh Vien
authors.affiliation: Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK.|Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Stephen
authors.initials: S
authors.lastname: Baker
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Le Thi
authors.initials: LT
authors.lastname: Phuong Thao
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Le Thi
authors.initials: LT
authors.lastname: Phuong Tu
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Cao
authors.initials: C
authors.lastname: Thu Thuy
authors.affiliation: Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Tran Thi
authors.initials: TT
authors.lastname: Thu Nga
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.|Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Nguyen Van
authors.initials: NV
authors.lastname: Minh Hoang
authors.affiliation: Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK.|Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: James Iain
authors.initials: JI
authors.lastname: Campbell
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Lam
authors.initials: L
authors.lastname: Minh Yen
authors.affiliation: Hung Vuong Hospital, Ho Chi Minh City, Vietnam.
authors.forename: Nguyen
authors.initials: N
authors.lastname: Trong Hieu
authors.affiliation: Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Nguyen Van
authors.initials: NV
authors.lastname: Vinh Chau
authors.affiliation: Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK.|Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Jeremy
authors.initials: J
authors.lastname: Farrar
authors.affiliation: Center for Poverty-related Communicable Diseases (CPCD), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.|Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK.|Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
authors.forename: Constance
authors.initials: C
authors.lastname: Schultsz
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000235:genetics / Q000378:metabolism; D002353:Carrier State; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000235:genetics; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology*; D015964:Gene Expression Regulation, Bacterial / Q000502:physiology; D006801:Humans; D007223:Infant; D009154:Mutation; D010957:Plasmids / Q000235:genetics*; D015363:Quinolones / Q000494:pharmacology*; D014744:Vietnam / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015363:Quinolones
references.citation: Antimicrob Agents Chemother. 2007 Jul;51(7):2464-9
references.pmid: 17470656
references.citation: Acta Vet Scand Suppl. 2000;93:47-50; discussion 51-2
references.pmid: 10822857
references.citation: Curr Drug Targets. 2003 Feb;4(2):181-90
references.pmid: 12558069
references.citation: Nucleic Acids Res. 1991 Dec 25;19(24):6823-31
references.pmid: 1762913
references.citation: Antimicrob Agents Chemother. 2007 Jul;51(7):2650-1
references.pmid: 17452482
references.citation: Antimicrob Agents Chemother. 2008 Oct;52(10):3801-4
references.pmid: 18644958
references.citation: J Infect Dis. 2008 Feb 1;197(3):430-4
references.pmid: 18184093
references.citation: Antimicrob Agents Chemother. 2007 Aug;51(8):3001-3
references.pmid: 17526754
references.citation: Antimicrob Agents Chemother. 2005 Jan;49(1):118-25
references.pmid: 15616284
references.citation: J Antimicrob Chemother. 2008 Jul;62(1):133-6
references.pmid: 18385142
references.citation: Antimicrob Agents Chemother. 2008 Feb;52(2):798-9
references.pmid: 18086850
references.citation: J Antimicrob Chemother. 2003 Jul;52(1):36-42
references.pmid: 12775675
references.citation: Antimicrob Agents Chemother. 1996 Feb;40(2):491-3
references.pmid: 8834907
references.citation: J Antimicrob Chemother. 2008 May;61(5):1003-6
references.pmid: 18299311
references.citation: Acta Pharmacol Sin. 2008 Mar;29(3):320-4
references.pmid: 18298896
references.citation: Antimicrob Agents Chemother. 2007 Sep;51(9):3354-60
references.pmid: 17548499
references.citation: Curr Opin Microbiol. 2001 Oct;4(5):493-9
references.pmid: 11587923
references.citation: Emerg Infect Dis. 2008 Feb;14(2):231-7
references.pmid: 18258115
references.citation: Antimicrob Agents Chemother. 2009 Feb;53(2):519-24
references.pmid: 18936192
references.citation: Antimicrob Agents Chemother. 2006 Nov;50(11):3861-6
references.pmid: 16940067
references.citation: Clin Infect Dis. 2005 Jul 15;41 Suppl 2:S120-6
references.pmid: 15942878
references.citation: Antimicrob Agents Chemother. 2005 Jul;49(7):3050-2
references.pmid: 15980397
references.citation: Antimicrob Agents Chemother. 2007 Dec;51(12):4315-23
references.pmid: 17908946
references.citation: Antimicrob Agents Chemother. 2006 Nov;50(11):3953-5
references.pmid: 16954321
references.citation: Antimicrob Agents Chemother. 2005 Feb;49(2):801-3
references.pmid: 15673773
references.citation: Antimicrob Agents Chemother. 2007 Apr;51(4):1179-84
references.pmid: 17220407
references.citation: Int J Syst Evol Microbiol. 2001 May;51(Pt 3):915-924
references.pmid: 11411715
references.citation: Antimicrob Agents Chemother. 2007 Aug;51(8):2720-5
references.pmid: 17548490
references.citation: Antimicrob Agents Chemother. 2006 Aug;50(8):2872-4
references.pmid: 16870791
references.citation: Jpn J Infect Dis. 2008 Jan;61(1):13-7
references.pmid: 18219128
references.citation: J Bacteriol. 1981 Mar;145(3):1365-73
references.pmid: 7009583
references.citation: Lancet Infect Dis. 2006 Oct;6(10):629-40
references.pmid: 17008172
references.citation: Antimicrob Agents Chemother. 2008 Apr;52(4):1564-6
references.pmid: 18285488
references.citation: J Antimicrob Chemother. 2008 Sep;62(3):630-2
references.pmid: 18477707
references.citation: FEMS Microbiol Lett. 2008 Jun;283(1):112-6
references.pmid: 18422623
references.citation: Antimicrob Agents Chemother. 2006 Apr;50(4):1178-82
references.pmid: 16569827
references.citation: J Clin Pathol. 1997 Jul;50(7):573-9
references.pmid: 9306938
references.citation: Clin Infect Dis. 2006 Aug 1;43(3):297-304
references.pmid: 16804843
references.citation: J Antimicrob Chemother. 2007 Apr;59(4):751-4
references.pmid: 17307773