Abstract
Globally, and particularly in developing countries, the menace of anti-microbial resistance is an accelerating problem. In Nigeria, increase in bacterial resistance has been phenotypically established but due to high cost, few molecular studies have been reported. This study screened for presence of transferable resistance genes and mobile genetic elements (MGEs) such as integron among multi-drug resistant (MDR) P. mirabilis. A total of 108 P. mirabilis strains collected from five tertiary hospitals in SouthWest Nigeria were subjected to antibiotic susceptibility study using disc-diffusion method. Transferable resistance genes and MGEs were amplified using Polymerase chain reaction (PCR) analysis and amplicons sequenced. Varied resistance was observed against all the antibiotics tested. About 56% of the isolates were MDR including those from 0-12 years old children. PCR analysis revealed the presence of aac(6')-Ib (33.3%), plasmid mediated quinolone resistance (PMQR) genes [qnrA (36.7%), acc(6')-Ib-cr (5%)], TEM (48.3%), CTX-M (6.7%) and integrons class 1 (58.3%) and class 2 (26.7%). Sequencing analysis revealed blaTEM-1, blaCTX-M-15 associated with ISEcp1 and eight different arrays of gene cassettes: aadA1, aadA1-qacH, aadB-aadA2, aadA5, dfrA7, dfrA15, dfrA17, dfrA17-aadA5. Transferable resistance genes in association with MGEs are present in Nigerian P. mirabilis thus their potential in disseminating resistance.
Highlights
Anti-microbial drug resistance has become a global concern recognized by the World Health Organization[1]
Resistance to fluoroquinolones was initially thought to be majorly due to chromosomal mutation involving gyrA and topoisomerase genes until plasmid mediated quinolone resistance genes (PMQR) such as the qnr, qepA and aac(6’)-Ib-cr was later reported in 1998.19 Since PMQR genes have been described in several bacterial isolates members of the Enterobacteriaceae family worldwide.[13,15,20,21,22]
Clinical bacterial isolates A total of 108 non-duplicated clinical isolates of P. mirabilis were randomly collected during a 12 months period (January to December, 2011) from Microbiology units of five selected tertiary hospitals in SouthWest Nigeria, namely University Teaching Hospital (UCH) Ibadan (n = 43), Olabisi Onabanjo University Teaching Hospital (OOUTH) Sagamu (n = 10), Federal Medical Centre (FMC) Abeokuta (n = 13), Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife (n = 28) and Lagos state University Teaching Hospital (LUTH) Lagos (n = 14)
Summary
Anti-microbial drug resistance has become a global concern recognized by the World Health Organization[1]. Resistance to fluoroquinolones was initially thought to be majorly due to chromosomal mutation involving gyrA and topoisomerase genes until plasmid mediated quinolone resistance genes (PMQR) such as the qnr, qepA and aac(6’)-Ib-cr was later reported in 1998.19 Since PMQR genes have been described in several bacterial isolates members of the Enterobacteriaceae family worldwide.[13,15,20,21,22] The qnr genes are known to produce proteins (QNR proteins) that protect the quinolone targets from inhibition. Objectives: This study screened for presence of transferable resistance genes and mobile genetic elements (MGEs) such as integron among multi-drug resistant (MDR) P. mirabilis. Molecular screening of antibiotic-resistant determinants among multidrug-resistant clinical isolates of Proteus mirabilis from Southwest Nigeria.
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