Detection of Plasmid Mediated Qnr Genes in Clinical Isolates of ESBL Producing Enterobacteriaceae from Tertiary Care Hospital in Rawalpindi, Pakistan @Zenodo

ESBL producing Enterobacteriacae harbouring multidrug-resistant plasmids is an emerging worldwide threat. One of the major concerns is the prevalence of plasmid-mediated quinolone resistance (PMQR) to Quinolones which has hindered the viability of these antibiotics. To date, very little data is available regarding the co-existence of ESBL and PMQR in Pakistan. This study aimed to detect PMQR genes in clinical isolates of ESBL producing Enterobacteriaceae in the city of Rawalpindi. A total of 60 clinical ESBL positive Enterobacteriaceae isolates were obtained from hospitalized patients at Holy family Hospital, Rawalpindi. It included strains of E. coli (n=24), K. pneumoniae (n=25), and Enterobacter spp (n=11). Antimicrobial susceptibility was determined by the standard disk diffusion method. Genes encoding quinolone resistance (qnrA, qnrB and qnrS) were detected using PCR. Out of 60 tested strains, 38 (63%) yielded PMQR determinants. QnrB was the most prevalent occurring alone and in combination with other qnr genes in about 89% (34/38) of the ESBL producing isolates. It was followed by qnrS (22/38 i.e 58%) and qnrA (12/38 i.e 32%). E.coli was the predominant qnrA (43%) and qnrS (69%) harbouring species