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JAC Advance Access originally published online on February 21, 2008
Journal of Antimicrobial Chemotherapy 2008 61(5):999-1002; doi:10.1093/jac/dkn068
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

Surveillance for plasmid-mediated quinolone resistance determinants in Enterobacteriaceae within the Calgary Health Region, Canada: the emergence of aac(6')-Ib-cr

Johann D. D. Pitout1,2,3,*, Yi Wei1, Deirdre L. Church1,2,4 and Daniel B. Gregson1,2,4

1 Division of Microbiology, Calgary Laboratory Services, University of Calgary, #9, 3535 Research Road NW, Calgary, Alberta, Canada T2L 2K8 2 Department of Pathology and Laboratory Medicine, University of Calgary, #9, 3535 Research Road NW, Calgary, Alberta, Canada T2L 2K8 3 Department of Microbiology and Infectious Diseases, University of Calgary, #9, 3535 Research Road NW, Calgary, Alberta, Canada T2L 2K8 4 Department of Medicine, University of Calgary, #9, 3535 Research Road NW, Calgary, Alberta, Canada T2L 2K8

Received 19 December 2007; returned 22 January 2008; revised 25 January 2008; accepted 28 January 2008

* Corresponding author. Division of Microbiology, Calgary Laboratory Services, #9, 3535 Research Road NW, Calgary, Alberta, Canada T2L 2K8. Tel: +1-403-770-3309; Fax: +1-403-770-3347; E-mail: johann.pitout{at}cls.ab.ca

Objectives: A study was designed to determine the prevalence of plasmid-mediated quinolone resistance (PMQR) determinants among clinical isolates of Enterobacteriaceae from the Calgary Health Region (CHR).

Methods: During January and February 2004 and January and February 2007, 564 non-repeat isolates of Escherichia coli, Klebsiella spp., Proteus mirabilis and Morganella morganii resistant to ciprofloxacin and/or tobramycin were screened for PMQR determinants using a multiplex PCR for qnrA, qnrS and qnrB and aac(6')-Ib genes; aac(6')-Ib-cr was further identified by digestion with BstF5I.

Results: In 2004, 6/139 (4%) of the resistant E. coli were positive for aac(6')-Ib-cr. In 2007, 53/398 (13%) were positive for aac(6')-Ib-cr, 3/398 (0.8%) were positive for qnrS, and one isolate was positive for both. All the isolates were present in urines and the majority [40/63 (63%)] were submitted from community collection sites; 8 (13%) isolates co-produced AmpC β-lactamases and 34 (54%) co-produced CTX-M-15. aac(6')-Ib-cr was present in one Klebsiella pneumoniae and one P. mirabilis, whereas one isolate of K. pneumoniae was positive for both aac(6')-Ib-cr and qnrB.

Conclusions: Our results showed that isolates with aac(6')-Ib-cr, often associated with CTX-M-15, are emerging among fluoroquinolone-resistant E. coli in the CHR. Our study suggests that surveillance for PMQR determinants should be undertaken on a regular basis.

Keywords: PMQR , CTX-M-15 , Escherichia coli


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