Comparison of plasmid-mediated quinolone resistance and extended-spectrum β-lactamases in third-generation cephalosporin-resistant Enterobacteriaceae from four Irish hospitals

In this study, the frequency of extended-spectrum beta-lactamases (ESBL) and plasmid-mediated quinolone resistance (PMQR) mechanisms were investigated in 206 clinical isolates of third-generation cephalosporin (3GC)-resistant Enterobacteriaceae in four hospitals in the Republic of Ireland. bla(CTX-M-15) was the predominant ESBL gene. Of these 3GC resistant isolates, 54% were also resistant to ciprofloxacin. Investigation of the PMQR mechanisms revealed that the aac(6') lb-cr gene predominated in fluoroquinolone-resistant (FOR) strains of Escherichia coli and Klebsiella pneumoniae, while the qnrA gene predominated in the FOR strains of Enterobacter. The bla(CTX-M-15) gene was frequently identified with the aac(6')lb-cr gene but was not always on the same plasmid. The prevalence of the bla(CTX-M-15) gene appeared to be hospital-dependent. The epidemiology of both ESBL-producing and PMQR strains within the four hospitals indicated that their prevalence is not due to the spread of these resistance genes between isolates from different hospitals.