Plasmid-mediated quinolone resistance: an update

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Abstract

In 1998, the first plasmid-mediated gene involved in quinolone resistance (currently named qnrA1) was reported. Extra qnr-like plasmid-mediated genes (qnrB, qnrS, qnrC, qnrD) and their chromosomal homologues have also been characterized. These genes code for a pentapeptide repeat protein that protects type II topoisomerases from quinolones. Since then, there have been reports of two other plasmid-mediated resistance mechanisms: the modification of quinolones with a piperazinyl substituent by the acetyltransferase, Aac(6′)-Ib-cr; and active efflux by QepA and OqxAB, pumps related to major facilitator superfamily (MFS) transporters. These genes have a wide geographic distribution (mainly in Enterobacteriaceae). Because of the difficulties of phenotypic detection of this type of resistance, its real prevalence is only partially known. One important point is that although these mechanisms cause only low-level resistance, they favor and complement the selection of other resistance mechanisms.

References (297)

  • GarauJ. et al.

    Emergence and dissemination of quinolone-resistant Escherichia coli in the community

    Antimicrob Agents Chemother

    (1999)
  • NeuhauserM.M. et al.

    Antibiotic resistance among Gram-negative bacilli in US intensive care units: implications for fluoroquinolone use

    JAMA

    (2003)
  • StrahilevitzJ. et al.

    Plasmid-mediated quinolone resistance: a multifaceted threat

    Clin Microbiol Rev

    (2009)
  • HooperD.C. et al.

    Mechanism of quinolone action and bacterial killing

  • HooperD.C.

    Bacterial topoisomerases, anti-topoisomerases, and anti-topoisomerase resistance

    Clin Infect Dis

    (1998)
  • ZhaoX. et al.

    DNA topoisomerase targets of the fluoroquinolones: a strategy for avoiding bacterial resistance

    Proc Natl Acad Sci USA

    (1997)
  • RobicsekA. et al.

    Fluoroquinolone-modifying enzyme: a new adaptation of a common aminoglycoside acetyltransferase

    Nat Med

    (2006)
  • PerichonB. et al.

    Transferable resistance to aminoglycosides by methylation of G1405 in 16S rRNA and to hydrophilic fluoroquinolones by QepA-mediated efflux in Escherichia coli

    Antimicrob Agents Chemother

    (2007)
  • YamaneK. et al.

    New plasmid-mediated fluoroquinolone efflux pump, QepA, found in an Escherichia coli clinical isolate

    Antimicrob Agents Chemother

    (2007)
  • YamaneK. et al.

    Plasmid-mediated qepA gene among Escherichia coli clinical isolates from Japan

    Antimicrob Agents Chemother

    (2008)
  • VanB.F. et al.

    Quinolones in 2005: an update

    Clin Microbiol Infect

    (2005)
  • LesherG.Y. et al.

    1,8-Naphthyridine derivatives. A new class of chemotherapeutic agents

    J Med Pharm Chem

    (1962)
  • BlondeauJ.M. et al.

    Moxifloxacin: a review of the microbiological, pharmacological, clinical and safety features

    Expert Opin Pharmacother

    (2001)
  • GoldsteinE.J.

    Review of the in vitro activity of gemifloxacin against Gram-positive and Gram-negative anaerobic pathogens

    J Antimicrob Chemother

    (2000)
  • WellerT.M. et al.

    The in vitro activity of BMS-284756, a new des-fluorinated quinolone

    J Antimicrob Chemother

    (2002)
  • DrlicaK. et al.

    DNA gyrase, topoisomerase IV, and the 4-quinolones

    Microbiol Mol Biol Rev

    (1997)
  • ChampouxJ.J.

    DNA topoisomerases: structure, function, and mechanism

    Annu Rev Biochem

    (2001)
  • SmithH.J. et al.

    Dual activity of fluoroquinolones against Streptococcus pneumoniae: the facts behind the claims

    J Antimicrob Chemother

    (2002)
  • YsernP. et al.

    Induction of SOS genes in Escherichia coli and mutagenesis in Salmonella typhimurium by fluoroquinolones

    Mutagenesis

    (1990)
  • Michel-BriandY. et al.

    Elimination of plasmids from Enterobacteriaceae by 4-quinolone derivatives

    J Antimicrob Chemother

    (1986)
  • MasecarB.L. et al.

    Analysis of acquired ciprofloxacin resistance in a clinical strain of Pseudomonas aeruginosa

    Antimicrob Agents Chemother

    (1990)
  • ShalitI. et al.

    Widespread quinolone resistance among methicillin-resistant Staphylococcus aureus isolates in a general hospital

    Antimicrob Agents Chemother

    (1989)
  • AoyamaH. et al.

    Clinical isolate of Citrobacter freundii highly resistant to new quinolones

    Antimicrob Agents Chemother

    (1988)
  • Martinez-MartinezL. et al.

    Ciprofloxacin resistance in Gram negative bacilli. Epidemiologic aspects

    Enferm Infecc Microbiol Clin

    (1993)
  • WatanabeM. et al.

    In vitro emergence of quinolone-resistant mutants of Escherichia coli Enterobacter cloacae, and Serratia marcescens

    Antimicrob Agents Chemother

    (1990)
  • DavidsonR. et al.

    Resistance to levofloxacin, failure of treatment of pneumococcal pneumonia

    N Engl J Med

    (2002)
  • WangH. et al.

    Genetic characterization of highly fluoroquinolone-resistant clinical Escherichia coli strains from China: role of acrR mutations

    Antimicrob Agents Chemother

    (2001)
  • YoshidaH. et al.

    Quinolone resistance-determining region in the DNA gyrase gyrA gene of Escherichia coli

    Antimicrob Agents Chemother

    (1990)
  • P. Heisig et al.

    Characterization of fluoroquinolone-resistant mutants of Escherichia coli selected in vitro

    Antimicrob Agents Chemother

    (1994)
  • NgE.Y. et al.

    Quinolone resistance mutations in topoisomerase IV: relationship to the flqA locus and genetic evidence that topoisomerase IV is the primary target and DNA gyrase is the secondary target of fluoroquinolones in Staphylococcus aureus

    Antimicrob Agents Chemother

    (1996)
  • ChapmanJ.S. et al.

    Routes of quinolone permeation in Escherichia coli

    Antimicrob Agents Chemother

    (1988)
  • Martinez-MartinezL. et al.

    Energy-dependent accumulation of norfloxacin and porin expression in clinical isolates of Klebsiella pneumoniae and relationship to extended-spectrum beta-lactamase production

    Antimicrob Agents Chemother

    (2002)
  • Hernandez-AllesS. et al.

    Development of resistance during antimicrobial therapy caused by insertion sequence interruption of porin genes

    Antimicrob Agents Chemother

    (1999)
  • OethingerM. et al.

    Ineffectiveness of topoisomerase mutations in mediating clinically significant fluoroquinolone resistance in Escherichia coli in the absence of the AcrAB efflux pump

    Antimicrob Agents Chemother

    (2000)
  • CohenS.P. et al.

    Cross-resistance to fluoroquinolones in multiple-antibiotic-resistant (Mar) Escherichia coli selected by tetracycline or chloramphenicol: decreased drug accumulation associated with membrane changes in addition to OmpF reduction

    Antimicrob Agents Chemother

    (1989)
  • PoirelL. et al.

    Vibrionaceae as a possible source of Qnr-like quinolone resistance determinants

    J Antimicrob Chemother

    (2005)
  • Rodriguez-MartinezJ.M. et al.

    Qnr-like pentapeptide repeat proteins in Gram-positive bacteria

    J Antimicrob Chemother

    (2008)
  • SanchezM.B. et al.

    Predictive analysis of transmissible quinolone resistance indicates Stenotrophomonas maltophilia as a potential source of a novel family of Qnr determinants

    BMC Microbiol

    (2008)
  • VelascoC. et al.

    Smaqnr, a new chromosome-encoded quinolone resistance determinant in Serratia marcescens

    J Antimicrob Chemother

    (2010)
  • TranJ.H. et al.

    Mechanism of plasmid-mediated quinolone resistance

    Proc Natl Acad Sci USA

    (2002)
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