title: Emergence of Proteus mirabilis harboring blaKPC-2 and qnrD in a Chinese Hospital.
abstract: Nineteen carbapenem-nonsusceptible Proteus mirabilis isolates were recovered from intensive care units in the Second Affiliated Hospital of Zhejiang University during a 3-month period. The isolates showed a high level of resistance against ciprofloxacin, in addition to their resistance against the carbapenems. Pulsed-field gel electrophoresis (PFGE) analysis showed that these isolates belonged to three clonal strains. PCRs and DNA sequence analysis of the carbapenemase and other β-lactamase genes indicated that all the isolates harbored the bla(KPC-2) gene. Twelve of 19 isolates harbored the plasmid-mediated quinolone resistance (PMQR) genes, both the qnrD and aac(6')-Ib-cr genes. Eight representative isolates with high levels of quinolone resistance carried the similar mutation profiles of S83I in gyrA, E466D in gyrB, and S80I in parC. Reduced carbapenem susceptibility was transferred to Escherichia coli (EC600) in a conjugation experiment, while the quinolone resistance was not. DNA hybridization showed that qnrD was located on a plasmid of approximately 4.5 kb. In summary, large clonally related isolates of KPC-2-producing P. mirabilis emerged in a Chinese hospital, and qnrD was detected in KPC-producing P. mirabilis for the first time.
authors.affiliation: Second Affiliated Hospital of Zhejiang University, Zhejiang University, Hang Zhou, China.
authors.forename: Yan-yan
authors.initials: YY
authors.lastname: Hu
authors.forename: Jia-chang
authors.initials: JC
authors.lastname: Cai
authors.forename: Rong
authors.initials: R
authors.lastname: Zhang
authors.forename: Hong-wei
authors.initials: HW
authors.lastname: Zhou
authors.forename: Qian
authors.initials: Q
authors.lastname: Sun
authors.forename: Gong-xiang
authors.initials: GX
authors.lastname: Chen
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000235:genetics; D015780:Carbapenems / Q000008:administration & dosage / Q000627:therapeutic use; D002681:China; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D002999:Clone Cells; D003227:Conjugation, Genetic; D003428:Cross Infection / Q000188:drug therapy* / Q000382:microbiology; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects / Q000235:genetics*; D016521:Electrophoresis, Gel, Pulsed-Field; D004926:Escherichia coli / Q000235:genetics; D005798:Genes, Bacterial / Q000187:drug effects; D006801:Humans; D010957:Plasmids / Q000235:genetics; D016133:Polymerase Chain Reaction; D011512:Proteus Infections / Q000188:drug therapy* / Q000382:microbiology; D011513:Proteus mirabilis / Q000235:genetics* / Q000302:isolation & purification; D015363:Quinolones / Q000008:administration & dosage / Q000627:therapeutic use; D017422:Sequence Analysis, DNA; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D015780:Carbapenems; D015363:Quinolones; D002939:Ciprofloxacin; D001618:beta-Lactamases; C063912:carbapenemase