ArticleBMC infectious diseases2023
Fluoroquinolone resistance among fecal extended spectrum βeta lactamases positive Enterobacterales isolates from children in Dar es Salaam, Tanzania.
Article in BMC infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
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13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 16 citations in OpenAlex.
- An insight into the antibiotic resistance profiles of ESKAPE pathogens isolated from humans in Africa: a systematic review and meta-analysis.BMC infectious diseases · 2025Pooled it
- Extended Spectrum Beta-Lactamase-Producing Bacterial Clones in West Africa: A Systematic Review and Meta-Analysis from a One Health Perspective.Scientific reports · 2025Pooled it
- Molecular characterisation of extended-Spectrum-Beta-lactamase-producingOne health (Amsterdam, Netherlands) · 2026Article
- The Role of Neonatal Ward Environment as a Reservoir for the Dissemination of Multidrug-Resistant Klebsiella pneumoniae in Algeria.MicrobiologyOpen · 2026Article
- The Burden and Genomic Characterization ofmedRxiv : the preprint server for health sciences · 2026Article
- Whole-Genome Sequencing and Comparative Genomic Analysis ofVeterinary sciences · 2026Article
- Fluoroquinolone resistance without fluoroquinolone use; the genie is truly out of the bottle.Frontiers in microbiology · 2026Review
- Plasmid-mediated quinolone resistance among extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolated from hospitalized patients, hospital environment and wastewaters in Cameroon.Scientific reports · 2025Article
- First report of carbapenems encoding multidrug-resistant gram-negative bacteria from a pediatric hospital in Gaza Strip, Palestine.BMC microbiology · 2024Article
- Novel Fluoroquinolones with Possible Antibacterial Activity in Gram-Negative Resistant Pathogens: In Silico Drug Discovery.Molecules (Basel, Switzerland) · 2023Article
- Polyclonal Multidrug ESBL-ProducingAntibiotics (Basel, Switzerland) · 2023Article
- Commensal Fitness Advantage May Contribute to the Global Dissemination of Multidrug-Resistant Lineages of Bacteria-The Case of UropathogenicPathogens (Basel, Switzerland) · 2023Article
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8 authors at 4 institutions in 3 countries.
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Abstract
backgroundFluoroquinolones have been, and continue to be, routinely used for treatment of many bacterial infections. In recent years, most parts of the world have reported an increasing trend of fluoroquinolone resistant (FQR) Gram-negative bacteria.
methodsA cross-sectional study was conducted between March 2017 and July 2018 among children admitted due to fever to referral hospitals in Dar es Salaam, Tanzania. Rectal swabs were used to screen for carriage of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE). ESBL-PE isolates were tested for quinolone resistance by disk diffusion method. Randomly selected fluroquinolone resistant isolates were characterized by using whole genome sequencing.
resultsA total of 142 ESBL-PE archived isolates were tested for fluoroquinolone resistance. Overall phenotypic resistance to ciprofloxacin, levofloxacin and moxifloxacin was found in 68% (97/142). The highest resistance rate was seen among Citrobacter spp. (100%, 5/5), followed by Klebsiella. pneumoniae (76.1%; 35/46), Escherichia coli (65.6%; 42/64) and Enterobacter spp. (31.9%; 15/47). Whole genome sequencing (WGS) was performed on 42 fluoroquinolone resistant-ESBL producing isolates and revealed that 38/42; or 90.5%, of the isolates carried one or more plasmid mediated quinolone resistance (PMQR) genes. The most frequent PMQR genes were aac(6')-lb-cr (74%; 31/42), followed by qnrB1 (40%; 17/42), oqx, qnrB6 and qnS1. Chromosomal mutations in gyrA, parC and parE were detected among 19/42 isolates, and all were in E. coli. Most of the E. coli isolates (17/20) had high MIC values of > 32 µg/ml for fluoroquinolones. In these strains, multiple chromosomal mutations were detected, and all except three strains had additional PMQR genes. Sequence types, ST131 and ST617 predominated among E. coli isolates, while ST607 was more common out of 12 sequence types detected among the K. pneumoniae. Fluoroquinolone resistance genes were mostly associated with the IncF plasmids.
conclusionThe ESBL-PE isolates showed high rates of phenotypic resistance towards fluoroquinolones likely mediated by both chromosomal mutations and PMQR genes. Chromosomal mutations with or without the presence of PMQR were associated with high MIC values in these bacteria strains. We also found a diversity of PMQR genes, sequence types, virulence genes, and plasmid located antimicrobial resistance (AMR) genes towards other antimicrobial agents.
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