ArticleBMC microbiology2021
Distribution of fluoroquinolone resistance determinants in Carbapenem-resistant Klebsiella pneumoniae clinical isolates associated with bloodstream infections in China.
Article in BMC microbiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Risk factors for carbapenem-resistantFrontiers in public health · 2026Pooled it
- Molecular and phenotypic profiles of carbapenem- and third-generation cephalosporin-resistant Klebsiella pneumoniae isolates from the fecal microbiota of pediatric patients with COVID-19.BMC microbiology · 2026Article
- Article
- Klebsiella pneumoniae in the global AMR: resistance mechanisms and genomic adaptation.World journal of microbiology & biotechnology · 2026Review
- Pharmacokinetic/pharmacodynamic relationships and development of resistance of enrofloxacin and cefquinome in combination therapy against Klebsiella pneumoniae in chicks.BMC veterinary research · 2026Article
- Characterization and targeting of deleterious mutations in Carbapenemase-producing Klebsiella pneumoniae: insights from variant calling, Computer-aided drug design, and DFT analysis.Archives of microbiology · 2026Article
- Characterization of Carbapenem-Resistant Gram-Negative Bacilli Isolates in Multispecialty Private Hospitals in Lagos, Nigeria.Infectious disease reports · 2025Article
- Review
- Three simple and cost-effective assays for AAC(6')-Ib-cr enzyme activity.Frontiers in microbiology · 2025Article
- CombatingFrontiers in cellular and infection microbiology · 2025Review
- Exploring current hypervirulentFrontiers in microbiology · 2025Review
- Retrospective Case-Control Study of Risk Factors for Carbapenem-ResistantPathogens (Basel, Switzerland) · 2024Article
- Ciprofloxacin for the Treatment of Infections Caused by Carbapenemase-Producing Gram-Negative Bacteria.Antibiotics (Basel, Switzerland) · 2024Article
- Prevalence of plasmid-mediated quinolone resistance genes in extended-spectrum beta-lactamase producingHeliyon · 2024Article
- Navigating fluoroquinolone resistance in Gram-negative bacteria: a comprehensive evaluation.JAC-antimicrobial resistance · 2024Review
- Distribution and genetic characterization of fluoroquinolone resistance geneMicrobiology spectrum · 2024Article
- Anti-Klebsiella pneumoniae activity of secondary metabolism of Achromobacter from the intestine of Periplaneta americana.BMC microbiology · 2023Article
- pKpQIL-like plasmid contributes to the dissemination ofIranian journal of microbiology · 2023Article
- Fighting Antimicrobial Resistance in Neonatal Intensive Care Units: Rational Use of Antibiotics in Neonatal Sepsis.Antibiotics (Basel, Switzerland) · 2023Review
- Multidrug-resistant Klebsiella pneumoniae: a retrospective study in Manaus, Brazil.Archives of microbiology · 2022Article
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe rate of fluoroquinolone (FQ) resistance among carbapenem-resistant Klebsiella pneumoniae (CRKP) is high. The present study aimed to investigate the distribution of fluoroquinolone resistance determinants in clinical CRKP isolates associated with bloodstream infections (BSIs).
resultsA total of 149 BSI-associated clinical CRKP isolates collected from 11 Chinese teaching hospitals from 2015 to 2018 were investigated for the prevalence of fluoroquinolone resistance determinants, including plasmid-mediated quinolone resistance (PMQR) genes and spontaneous mutations in the quinolone resistance-determining regions (QRDRs) of the gyrA and parC genes. Among these 149 clinical CRKP isolates, 117 (78.5%) exhibited resistance to ciprofloxacin. The GyrA substitutions (Ser83 → IIe/Phe) and (Asp87 → Gly/Ala) were found among 112 (75.2%) of 149 isolates, while the substitution (Ser80 → IIe) of ParC was found in 111 (74.5%) of the 149 isolates. In total, 70.5% (105/149) of the CRKP isolates had at least two mutations within gyrA as well as a third mutation in parC. No mutations in the QRDRs were found in 31 ciprofloxacin susceptible CRKP isolates. Eighty-nine (56.9%) of 149 were found to carry PMQR genes including qnrS1 (43.0%), aac(6')-Ib-cr (16.1%), qnrB4 (6.0%), qnrB2 (2.7%), and qnrB1 (1.3%). Nine isolates contained two or more PMQR genes, with one carrying four [aac(6')-Ib-cr, qnr-S1, qnrB2, and qnrB4]. The co-existence rate of PMQR determinants and mutations in the QRDRs of gyrA and parC reached 68.5% (61/89). Seventy-four (83.1%, 74/89) PMQR-positive isolates harbored extended-spectrum beta-lactamase (ESBL)-encoding genes. Multilocus sequence typing (MLST) analysis demonstrated that the ST11 was the most prevalent STs in our study.
conclusionsMutations in the QRDRs of gyrA and parC were the key factors leading to the high prevalence of fluoroquinolone resistance among BSI-associated CRKP. The co-existence of PMQR genes and mutations in the QRDRs can increase the resistance level of CRKP to fluoroquinolones in clinical settings. ST11 CRKP isolates with identical QRDR substitution patterns were found throughout hospitals in China.
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