Comparative Evaluation of qnrA, qnrB, and qnrS Genes in Enterobacteriaceae Ciprofloxacin-Resistant Cases, in Swine Units and a Hospital from Western Romania.

Alexandru O Doma,Roxana Popescu,Delia Muntean,Florin Muselin,János Dégi,Nikola Puvača,Isidora Radulov,Romeo T Cristina,Eugenia Dumitrescu,Marius V Boldea,Mihai Mitulețu

doi:10.3390/antibiotics9100698

Abstract

Excessive use of antimicrobials and inadequate infection control practices has turned antimicrobial resistance (AMR) into a global, public health peril. We studied the expression of qnrA, qnrB, and qnrS plasmid in ciprofloxacin (CIP)-resistant strains of Escherichia coli in swine and humans from Romania, using the Polymerase Chain Reaction (PCR) technique. Antibiotic Susceptibility Testing (AST) for human subjects (H) on 147 samples and 53 swine (S) was ascertained as well as the isolation of bacterial DNA (E. coli) as follows: bacteriolysis, DNA-binding, rinsing, elution, amplification, and nucleic acids’ migration and U.V. visualization stages. From 24 samples of E. coli resistant to CIP collected from H subjects and 15 from S, for PCR analysis, 15 H and 12 S were used, with DNA purity of 1.8. The statistically analyzed results using the Crosstabs function (IBM SPSS Statistics-Ver. 2.1.), revealed the qnrS (417 bp) gene in 13 human subjects (52.0%), as well as in all swine samples studied. The qnrB (526 bp) gene was exposed in 9 of the human patients (36.0%) and in all swine isolates, and the qnrA (516 bp) gene was observed only in 3 of the isolates obtained from human subjects (12.0%) and was not discovered in pigs (p > 0.05). The presence of plasmids qnrA, qnrB, and qnrS in the human samples and of qnrB and qnrS in swine, facilitates the survival of pathogens despite the CIP action. The long-term use of CIP could cause a boost in the prevalence of qnr resistance genes, and resistance in the pigs destined for slaughter, a perturbing fact for public health and the human consumer.

Highlights

Antimicrobial resistance (AMR) is the capacity of microorganisms to adjust to antimicrobials, antibiotics
The results obtained from Antibiotic Susceptibility Testing (AST) and the evolution of the resistance tendency showed the considerable presence of the multi-resistant strains in swine isolates where, from 53 samples analyzed, 15 isolates were presenting resistance to CIP and multi-resistance to other antibiotics, including other quinolone representatives like, enrofloxacin, in the majority of cases, and norfloxacin (Table 1)
This leads to the hypothesis regarding direct or indirect contact of these subjects with low concentrations of ciprofloxacin, which may increase resistance through the presence of plasmid qnrA—a mechanism that facilitates the survival of pathogenic E. coli [31,32]

Summary

Introduction

Antimicrobial resistance (AMR) is the capacity of microorganisms to adjust to antimicrobials, antibiotics. Excessive and improper uses of antimicrobial drugs and inadequate infection control practices have turned AMR into a severe global public health peril [1,2]. AMR is responsible for more than 25,000 human deaths/year in the EU, and 700,000 worldwide, and might lead to more deaths than cancer by 2050 [3,4]. In this respect, databases and surveillance systems, from both the human health and veterinary sector, are becoming increasingly ample in data, since resistance was reported for most antibiotic structures. In Romania, the main indicator for antimicrobial consumption in the veterinary sector is the Population Correction Unit (PCU), who revealed that the consumed amount of antibiotics was

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Conclusion