Plasmid-Mediated Quinolone Resistance Genes Detected in Ciprofoxacin Non-Susceptible Escherichia Coli and Klebsiella Isolated from Children under Five Years at Hospital Discharge, Kenya

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dc.contributor.authorKariuki, Kevin
dc.contributor.authorDiakhate, Mame Mareme
dc.contributor.authorMusembi, Susan
dc.contributor.authorBelanger, Stephanie N. Tornberg
dc.contributor.authorRwigi, Doreen
dc.contributor.authorMutuma, Timothy
dc.contributor.authorMutuku, Elizabeth
dc.contributor.authorTickell, Kirkby D
dc.contributor.authorSoge, Olusegun O
dc.contributor.authorSinga, Benson O
dc.contributor.authorWalson, Judd L
dc.contributor.authorPavlinac, Patricia B
dc.contributor.authorKariuki, Samuel
dc.date.accessioned2023-07-06T09:30:29Z
dc.date.available2023-07-06T09:30:29Z
dc.date.issued2023
dc.descriptionArticleen_US
dc.description.abstractBackground The increasing spread of fuoroquinolone resistant enteric bacteria is a global public health concern. Children recently discharged from the hospital are at high risk of carriage of antimicrobial resistance (AMR) due to frequent exposure to antimicrobials during inpatient stays. This study aimed to determine the prevalence, correlates of ciprofoxacin (CIP) non-susceptibility, and distribution of plasmid-mediated quinolone resistance (PMQR) genes in Escherichia coli (E. coli) and Klebsiella spp isolated from children under fve years being discharged from two Kenyan Hospitals. Methods E. coli and Klebsiella spp were isolated from fecal samples from children discharged from hospital and subjected to antimicrobial susceptibility testing (AST) by disc difusion and E-test. CIP non-susceptible isolates were screened for seven PMQR genes using multiplex polymerase chain reaction (PCR). Poisson regression was used to determine the association between the carriage of CIP non-susceptible isolates and patient characteristics. Results Of the 280 CIP non-susceptible isolates: 188 E. coli and 92 Klebsiella spp isolates identifed among 266 dis‑ charged children, 195 (68%) were CIP-non-susceptible with minimum inhibitory concentrations (MICs) of≥1 µg/mL. Among these 195 isolates, 130 (67%) had high-level CIP MIC= ≥32 µg/mL). Over 80% of the isolates had at least one PMQR gene identifed: aac(6’)lb-cr (60%), qnrB (24%), oqxAB (22%), qnrS (16%), and qepA (6%), however, qnrA was not identifed in any isolates tested. Co-carriage of qnrB with acc(6’)-lb-cr was the most predominant accounting for 20% of all the isolates. Ceftriaxone use during hospital admission and the presence of extended spectrum beta-lactamase (ESBL) production were signifcantly associated with the carriage of CIP non-susceptible E. coli and Klebsiella spp. Conclusion CIP non-susceptibility is common among E. coli and Klebsiella spp isolated from hospital discharged chil‑ dren in Kenya. Carriage and co-carriage of PMQR, including the newly identifed qepA gene, were frequently observed. These fndings suggest that children leaving the hospital may serve as an important reservoir for transmission of resistant E. coli and Klebsiella spp to the community. Enhanced surveillance for AMR determinants is critical to inform interventions to control antimicrobial-resistant bacteriaen_US
dc.description.sponsorshipThe National Institute of Health (R01HD079695 & R01AI150978) and the University of Washington Royalty Research Fund.en_US
dc.identifier.citationKariuki, K., Diakhate, M. M., Musembi, S., Tornberg-Belanger, S. N., Rwigi, D., Mutuma, T., ... & Kariuki, S. (2023). Plasmid-mediated quinolone resistance genes detected in Ciprofloxacin non-susceptible Escherichia coli and Klebsiella isolated from children under five years at hospital discharge, Kenya. BMC microbiology, 23(1), 129.en_US
dc.identifier.otherhttps://doi.org/10.1186/s12866-023-02849-2
dc.identifier.urihttp://ir-library.ku.ac.ke/handle/123456789/26103
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.subjectCiprofoxacinen_US
dc.subjectEscherichia colien_US
dc.subjectKlebsiella sppen_US
dc.subjectPost-hospital dischargeen_US
dc.subjectFluoroquinolonesen_US
dc.subjectAntimicrobial resistanceen_US
dc.titlePlasmid-Mediated Quinolone Resistance Genes Detected in Ciprofoxacin Non-Susceptible Escherichia Coli and Klebsiella Isolated from Children under Five Years at Hospital Discharge, Kenyaen_US
dc.typeArticleen_US
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