Frequency of mutations in gyrA and parC genes among fluoroquinolone resistant Klebsiella pneumoniae isolated from urine specimens of hospitalized patients in Yazd, Iran
نویسندگان: Golnar Izadi, Mina Golban, Akram Astani, Hengameh Zandi ©
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Background and Aim
Klebsiella pneumoniae is an important cause of nosocomial infections, especially urinary tract infections. Considering the antimicrobial resistance due to the increasing use of fluoroquinolones and the importance of chromosomal genes in creating high level resistance to these drugs, the aim of this study was to evaluate the frequency of mutations in gyrA and parC chromosomal genes in Klebsiella pneumoniae isolated from urine specimens of hospitalized patients in Yazd city.
In this descriptive cross-sectional study, 100 K. pneumoniae were isolated from urine specimens and identified by biochemical tests. The fluoroquinolones susceptibility test was performed by disk diffusion method and the Minimum Inhibitory Concentration (MIC) was investigated by Etest method. The amplification of gyrA and parC genes was performed by PCR method using specific primers and after sequencing, the presence of possible mutations was investigated.
The results showed that the highest and lowest resistance were observed against nalidixic acid (28%) and levofloxacin (19%), respectively. Based on MIC tests, resistance to nalidixic acid and ciprofloxacin were 32% and 27%, respectively. The point mutations in gyrA and parC genes were observed in 17 resistant isolates.the most frequent mutations in gyrA were S83F,I and D87A,G and in parC were S80I,L. Increased antimicrobial resistance was observed in the gyrA and parC mutant isolates.
The results of the present study showed high resistance against fluoroquinolones, which is a warning sign for treatment. The prescription of fluoroquinolones should be controlled as much as possible to prevent the spread of mutant carrying clones.
Klebsiella pneumoniae; Fluoroquinolones; Antimicrobial Resistance; gyrA; parC
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