Frequency of Plasmid-Located Quinolone Resistance Genes in Clinical Isolates of Klebsiella pneumoniae in Northern Iran

Fluoroquinolones are a class of broad-spectrum antimicrobials typically used for the treatment of lower urinary tract infections. We aimed to determine the frequency of quinolone resistance genes in Klebsiella pneumoniae isolates from urinary tract infections in Guilan Province, Iran.

The resistance of 114 clinical isolates of K. pneumoniae to common fluoroquinolones and the minimum inhibitory concentration of ciprofloxacin were determined by disk diffusion and broth microdilution methods, respectively. Frequency of five plasmid-mediated quinolone resistance (PMQR) genes including qnrA, qnrB, qnrS, qepA, and aac (6')-Ib-cr was determined by PCR. 

Results:

 According to phenotypic assays, 60 isolates (52.6%) were resistant to at least one quinolone compound, 42 isolates (36.8%) were resistant to all tested quinolones, and 28 isolates (24.6%) showed a high level of ciprofloxacin resistance. In addition, aac(6')-Ib-cr was the most common PMQR gene (𝑛 = 44), followed by qnrS (𝑛 = 32), and qnrB (𝑛 = 21).

The possible dissemination of PMQR genes poses a serious threat to the management of infections by resistant Klebsiella pneumoniae.