Distribution of Quinolone Plasmid Resistance Genes in ESBL and Carbapenemase Producing Escherichia coli Associated with Catheter Urinary Tract Infections

Ismaeil, Mohamed S.; Elewa, Ahmed M.; Abo El Kheir,, Nermin Y.; Zaki, Maysaa E.; Fahmy, Ehab M.; Montasser, Karim A.

doi:10.21608/ejmm.2025.371300.1533

Distribution of Quinolone Plasmid Resistance Genes in ESBL and Carbapenemase Producing Escherichia coli Associated with Catheter Urinary Tract Infections

Document Type : New and original researches in the field of Microbiology.

Authors

¹ Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt 35511

² Medical Microbiology and Immunology Department, Faculty of Medicine, Helwan University, Helwan 11731, Egypt

³ Clinical Pathology Department, Faculty of Medicine, Helwan University, Helwan 11731, Egypt

10.21608/ejmm.2025.371300.1533

Abstract

Background: Among hospitalized cases, urinary catheter-associated urinary tract infections (CAUTIs) are important problems. Objective: Finding plasmid-mediated quinolone resistance (PMQR) genes in Escherichia coli (E. coli) from CAUTI cases in intensive care units that exhibit high quinolone antibiotic resistance was the aim of this investigation. Additionally, the researchers aimed to speculate as to what connection these genes have with carbapenemase and Extended-spectrum beta-lactamase resistance (ESBL) resistances. Methodology: Adult cases with CAUTIs hospitalized to ICUs at Mansoura University Hospital in Egypt were included in the retrospective cross-sectional investigation. All isolated E. coli were added in the research, and the ciprofloxacin-resistant organisms were chosen for additional research using multiplex polymerase chain reaction (PCR) to detect the qnr A, qnr B, and qnr S genes. Additionally, we used phenotypic analysis to discover ESBL in these organisms. Results: 204 (24.5%) E. coli isolates from CAUI cases were found during the study period. Using the MIC technique, fifty of these isolates showed ciprofloxacin resistance. In 26 isolates (52%), the double disc technique detected ESBL, whereas in 23 isolates (46%), CDT detected carbapenemase. Multiplex PCR revealed that qnrA was the most common gene (84%), followed by qnrB (46%), and qnrS (34%). A strong correlation (P = 0.001) was found between an increase in ciprofloxacin MIC and the presence of numerous qnr genes.The qnrA (88.5%), qnrB (50%) and qnrS (26.9%) genes are present in high ESBL E. coli. Additionally, the qnrA gene (78.2%), qnrB gene (60.9%), and qnrS gene (26.7%) are present in many E. coli carbapenemase producers. Conclusions: The study examines the frequency of QR genes mediated by ciprofloxacin-resistant plasmids in E. coli derived from hospital-acquired CAUTI. The qnr genes were often linked to carbapenem resistance, ESBL, and other forms of antibiotic resistance.

Keywords