ArticleThe Journal of antimicrobial chemotherapy2013
Risk factors and clinical characteristics of patients with qnr-positive Klebsiella pneumoniae bacteraemia.
Article in The Journal of antimicrobial chemotherapy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 37 citations in OpenAlex.
- Occurrence of Plasmid-Mediated Quinolone Resistance and Carbapenemase-Encoding Genes inPathogens (Basel, Switzerland) · 2024Observational
- The secrets of environmental Pseudomonas aeruginosa in slaughterhouses: Antibiogram profile, virulence, and antibiotic resistance genes.Folia microbiologica · 2024Article
- Investigation of gyrA and parC mutations and the prevalence of plasmid-mediated quinolone resistance genes in Klebsiella pneumoniae clinical isolates.BMC microbiology · 2024Article
- Multidrug-resistant phenotypes of genetically diverse Escherichia coli isolates from healthy domestic cats.Scientific reports · 2024Article
- Antimicrobial Resistance Profiles and Co-Existence of Multiple Antimicrobial Resistance Genes inAntibiotics (Basel, Switzerland) · 2023Article
- Phenotypic and genotypic antimicrobial resistance inFrontiers in veterinary science · 2023Article
- Molecular Genetic Epidemiology of an Emerging Antimicrobial-ResistantAntibiotics (Basel, Switzerland) · 2022Article
- Antimicrobial Resistance and Prevalence of Extended Spectrum β-Lactamase-ProducingAntibiotics (Basel, Switzerland) · 2022Article
- Experimental and Molecular Docking Studies of Cyclic Diphenyl Phosphonates as DNA Gyrase Inhibitors for Fluoroquinolone-Resistant Pathogens.Antibiotics (Basel, Switzerland) · 2022Article
- Gut CommensalInfection and drug resistance · 2022Article
- Transferable Mechanisms of Quinolone Resistance from 1998 Onward.Clinical microbiology reviews · 2019Review
- Treatment of Infections Caused by Extended-Spectrum-Beta-Lactamase-, AmpC-, and Carbapenemase-Producing Enterobacteriaceae.Clinical microbiology reviews · 2018Review
- Prevalence and molecular characterization of extended-spectrum β-lactamase (ESBL) and plasmidic AmpC β-lactamase (pAmpC) producing Escherichia coli in dogs.The Journal of veterinary medical science · 2017Article
- The Frequency ofIranian journal of pathology · 2017Article
- Topoisomerase Inhibitors: Fluoroquinolone Mechanisms of Action and Resistance.Cold Spring Harbor perspectives in medicine · 2016Review
- Correlation between antimicrobial resistance and virulence in Klebsiella pneumoniae.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Review
- Article
- Plasmid-mediated quinolone resistance.Microbiology spectrum · 2014Review
- Molecular analysis of ciprofloxacin resistance mechanisms in Malaysian ESBL-producing Klebsiella pneumoniae isolates and development of mismatch amplification mutation assays (MAMA) for rapid detection of gyrA and parC mutations.BioMed research international · 2014Article
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Authors and funding
4 authors at 4 institutions in 2 countries.
Funding
Abstract
objectivesPlasmid-mediated quinolone resistance (PMQR) caused by qnr genes has been known for 15 years. Information about global distribution and prevalence of qnr genes is abundant, but clinical information concerning infections produced by these isolates and risk factors for their acquisition is limited.
methodsKlebsiella pneumoniae blood isolates (n = 227) from a 1 year prospective cohort of patients in Taiwan were studied. MICs of quinolones were determined for all isolates, and multiplex PCR for the presence of PMQR genes and DNA gyrase mutations was applied to all 24 isolates with ciprofloxacin MICs ≥ 0.12 mg/L and a control group of 72 isolates with MICs ≤ 0.06 mg/L.
resultsAll qnr isolates were in the group with ciprofloxacin MICs ≥ 0.12 mg/L, constituting 9.4% of tested isolates and 3.9% (qnrB 2.6% and qnrS 1.3%) of total isolates. aac(6')-Ib-cr and qepA were not found. Risk factors for qnr included nosocomial infection, bedridden status, surgery within 3 months, non-K1/K2 serotypes and prior antimicrobial use. Ciprofloxacin MIC ≥ 0.12 mg/L was associated with prior quinolone use; in contrast, prior cephalosporin use was more closely linked to the presence of qnr. Fourteen-day mortality was similar in patients infected with qnr-positive versus qnr-negative isolates, but there was a trend for increased in-hospital mortality in patients infected with qnr-positive isolates.
conclusionsIn K. pneumoniae blood isolates collected at a hospital in Taiwan, the overall prevalence of qnr genes was 3.9%. Prior quinolone use was linked to increased ciprofloxacin MIC, but not with the prevalence of qnr, which was most strongly linked to exposure to other antimicrobials, especially cephalosporins.
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