A novel parC mutation potentiating fluoroquinolone resistance in Klebsiella pneumoniae and Escherichia coli clinical isolates.

Abstract

Resistance to fluoroquinolones is mainly due to point mutations that gave rise to amino acid substitutions in the quinolone resistance-determining regions of either gyrA or parC genes, which may be augmented by plasmid mediated resistance. Accordingly, the main aim of the study was to investigate the mutations in gyrA and parC genes as well as the qnrA and qnrB genes acquisition. 193 Klebsiella pneumoniae and Escherichia coli isolates were collected, identified and MICs for ciprofloxacin, levofloxacin and moxifloxacin were determined. Polymerase Chain Reaction to investigate qnrA, qnrB, gyrA and parC genes followed by DNA sequencing analysis to identify mutations in gyrA and parC genes. The most prominent mutation in gyrA gene was ser83leu, followed by asp87asn, and lys154arg. Regarding parC mutations, ser80ile was the most detected. Other mutations val141ala and glu84ala were also noted. In addition to a substitution mutation at codon 157 of leucine to tyrosin. To the best of our knowledge this mutation was not previously reported. qnrB was the most detected gene, as 64.7% Klebsiella pneumoniae and 57.1% Escherichia coli were positive. qnrA gene was detected in 11% Klebsiella pneumoniae and 4% of Escherichia coli isolates tested. This study suggests that the indiscriminate use of fluoroquinolones resulted in the increase of development of resistance either through mutations in the quinolone resistance-determining regions of either gyrA or parC genes augmented by plasmid mediated resistance. The irrational use of new fluoroquinolones such as moxifloxacin has created selective pressure for the appearance of new mutation.