Detection of Chromosomal and Plasmid-Mediated Quinolone Resistance Among Escherichia coli Isolated from Urinary Tract Infection Cases; Zagazig University Hospitals, Egypt

Figures & data

Table 1 HinfI PCR-RFLP Patterns of gyrA

Mutation Site	Restriction Fragment Length
No mutations at either Ser-83 or Asp-87 (wild type)	109 bp and 40 bp
Mutations at both Ser-83 and Asp-87	164bp
Single mutation at Ser-83	124 bp and 40 bp
Single mutation at Asp-87	109 bp and 55 bp

Table 2 Primer Sets Used for Detection of PMQR Genes

PMQR Genes	Primer Sequence (5ʹ-3ʹ)	Product Size	Reference
qnrA	F: AGA GGA TTT CTC ACG CCA GG R: TGC CAG GCA CAG ATC TTG AC	580	Cattoir et al^Citation14
qnrB^a	F: GGM ATH GAA ATT CGC CAC TG R: TTT GCY GYY CGC CAG TCG AA	264	Cattoir et al^Citation14
qnrS	F: GCA AGT TCA TTG AAC AGG GT R: TCT AAA CCG TCG AGT TCG GCG	428	Cattoir et al^Citation14
aac(6ʹ)-Ib-cr^a	F: TTG GAA GCG GGG ACG GAM R: ACA CGG CTG GAC CAT A	260	Wareham et al^Citation16
qepA	F: GCA GGT CCA GCA GCG GGT AG R: CTT CCT GCC CGA GTA TCG TG	199	Le et al^Citation15

Notes: ^aM = A or C, H = A or C or T, Y = C or T.

Table 3 Antibiotic Susceptibility Pattern of FQ-Resistant E. coli Isolates (No 90)

Antibiotics	Antimicrobial Susceptibility Pattern
	Sensitive		Intermediate		Resistance
	No	%	No	%	No	%
Ciprofloxacin	–	–	–	–	90	100%
Levofloxacin	–	–	–	–	90	100%
Imipenem	73	81.1%	15	16.7%	2	2.2%
Meropenem	90	100	–	–	–	–
Amikacin	44	48.9%	7	7.8%	39	43.3%
Gentamicin	14	15.5%	8	8.9%	68	75.6%
Amoxicillin/Clavulanic acid	15	16.7%	–	–	75	83.3%
Aztreonam	12	13.3%	6	6.7%	72	80%
Cefoxitin	–	–	–	–	90	100%
Ceftazidime	–	–	–	–	90	100%
Cefepime	–	–	–	–	90	100%
Trimethoprim-Sulfamethoxazole	7	7.8%	-	-	83	92.2%
Nitrofurantoin	46	51.1%	5	5.6%	39	43.3%

Figure 1 Ciprofloxacin MIC of FQ-resistant E. coli isolates.

Table 4 Number of FQ-Resistant E. coli Isolates Harboring gyrA Gene Mutations and Their Corresponding Ciprofloxacin MIC (μg/mL)

MIC gyrA Mutation	4	8	16	32	>32	Total No (90)
Wild type (no mutation)	2	1	6	9	3	21 (23.3%)
Mutation (Ser-83 & Asp-87)	-	-	1	7	23	31 (34.4%)
Mutation (Ser-83)	-	-	1	4	19	24 (26.7%)
Mutation (Asp-87)	-	1	-	6	7	14 (15.6%)
Total No. of isolates with gyrA mutation	-	1	2	17	49	69 (76.7%)

Table 5 Number of FQ-Resistant E. coli Isolates with Resistance Determinants and Their Corresponding Ciprofloxacin MIC (μg/mL)

MIC Resistance Determinant	4	8	16	32	>32	Total No (90)
gyrA mutation only	–	1	2	3	10	16 (17.8%)
PMQR only	2	1	5	9	3	20 (22.2%)
gyrA and PMQR	–	–	–	14	39	53 (58.9%)
Absence of gyrA & PMQR	–	–	1	–	–	1 (1.1%)

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