Molecular typing and profiling of topoisomerase mutations causing resistance to ciprofloxacin and levofloxacin inElizabethkingiaspecies

Author:

Jian Ming-Jr12,Cheng Yun-Hsiang12,Perng Cherng-Lih12,Shang Hung-Sheng12

Affiliation:

1. Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan

2. Division of Clinical Pathology, Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

Abstract

ObjectivesSeveralElizabethkingiaspecies often exhibit extensive antibiotic resistance, causing infections associated with severe morbidity and high mortality rates worldwide. In this study, we determined fluoroquinolone susceptibility profiles of clinicalElizabethkingiaspp. isolates and investigated the resistance mechanisms.MethodsIn 2017–2018, 131Elizabethkingiaspp. isolates were recovered from specimens collected at tertiary care centers in northern Taiwan. Initial species identification using the Vitek MS system and subsequent verification by 16S rRNA sequencing confirmed the presence ofElizabethkingia anophelis(n= 111),E. miricola(n= 11), andE. meningoseptica(n= 9). Fluoroquinolone susceptibility was determined using the microbroth dilution method, and fluoroquinolone resistance genes were analyzed by sequencing.ResultsAmongElizabethkingiaspp. isolates, 91% and 77% were resistant to ciprofloxacin and levofloxacin, respectively. The most prevalent alterations were two single mutations in GyrA, Ser83Ile, and Ser83Arg, detected in 76% of the isolates exhibiting fluoroquinolone MIC between 8 and 128 μg/ml. Another GyrA single mutation, Asp87Asn, was identified in two quinolone-resistantE. miricolastrains. None of the isolates had alterations in GyrB, ParC, or ParE. We developed a high-resolution melting assay for rapid identification of the prevalentgyrAgene mutations. The genetic relationship between the isolates was evaluated by random amplified polymorphic DNA PCR that yielded diverse pulsotypes, indicating the absence of any temporal or spatial overlap among the patients during hospitalization.ConclusionOur analysis of fluoroquinolone-resistantElizabethkingiaspp. isolates provides information for further research on the variations of the resistance mechanism and potential clinical guidance for infection management.

Funder

Tri-Service General Hospital, Taipei, Taiwan, ROC, Grant Numbers

Publisher

PeerJ

Subject

General Agricultural and Biological Sciences,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience

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