Abstract
Introduction: Antibioticshave significant importance in medicinal drugs but unfortunately bacteria can adapt various resistance mechanisms against those due to their abuse. A frequent way through which nitrate-reducing uropathogens acquire resistance mechanism against fluoroquinolones group of antibiotics is by continuously occurring mutation either in gyrA or gyrB genes through altering enzyme DNA gyrase that help in DNA replication. Microorganisms causing Urinary Tract Infection (UTI) vary in their susceptibility to antimicrobials from place to place and from time to time. Aim: The current study was performed to find the prevalence of nitrate-reducing bacteria in district Kohat and Hangu, their antimicrobial sensitivity pattern to various fluoroquinolones group of antibiotics and detection of mutation in gyrA and gyrB genes in the resistant bacterial isolates. Nitrate-reducing bacteria i.e E.coli, Klebsiella and Proteus are considered to be the frequent cause of UTI that reduce nitrate to nitrite by releasing enzyme nitrate reductase. Methodology: A Total of 252 urine specimens of suspected UTI patients were collected from Districts Head Quarter Hospitals (DHQ) and Combined Military Hospital (CMH) hospitals of districts Kohat and Hangu, Pakistan. Specimens reactive to nitrate strip reduction test were inoculated on (Cysteine Lactose Electrolyte Deficient) CLED media, and incubated at 37°C for 24 hours. Ciprofloxacin, levofloxacin, norfloxacin, ofloxacin and moxifloxacin fluoroquinolones group of antibiotics were used for to check their sensitivity patterns. Result: One hundred and seventy-five (69.44%) urine specimens were positive for nitrate reduction test, including 135 (77.14%) E. coli, 33 (18.85%) Klebsiella and 7 (4.0%) Proteus, verified through biochemical tests. Conclusion: Among the nitrate-reducing bacteria, fifty-one (37.22%) out of 135 E. coli, 9 (27.27 %) out of 33 Klebsiella and 2 (28.57%) out of 7 Proteus were resistant to most of fluoroquinolones group of antibiotics with moxifloxacin being the least resistant while ofloxacin being the most resistant antibiotic Malformed DNA gyrase producing mutated gyrA and gyrB genes were further detected in nitrate-reducing bacteria showing resistant to fluoroquinolones.
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