Prevalence of plasmid-mediated quinolone resistance (PMQR) genes in Klebsiella pneumoniae isolates from Iraqi patients.

Clinical Klebsiella pneumoniae isolates were tested for resistance to fluoroquinolones and beta-lactams, and the frequency of quinolone resistance genes (qnr genes) was determined. Out of 215 clinical samples, 85 were identified as K. pneumoniae isolates based on morphological and biochemical characteristics. These isolates came from various clinical samples, including urine 57 (67%), sputum 23 (27%), and oropharyngeal swap 5 (5.8%). It was found that these isolates were resistant 100% to the following antibiotics (Amoxicillin, Ceftazidime and Nalidixic acid) and (Ceftriaxone, Trimethoprim-sulfamethoxazole, Ciprofloxacin, and Norfloxacin). As percentage (89%,95%,90% and 93%) respectively. Also, these isolates demonstrated their sensitivity towards the two antibiotics (Meropenem and Imipenem) as percentages (70% and 78%) respectively. The results showed that every K. pneumoniae isolate that had developed resistance to fluoroquinolones also developed resistance to the lactams tested. Genomic sequencing has revealed that qnrS and qnrB are present in K. pneumoniae isolates. K. pneumoniae isolates lacked qnrA, however. DNA sequencing revealed no variants in the qnrB or qnrS genes. These genes can be found in the NCBI database under the accession numbers CP095426.1 and CP124706.1. K. pneumoniae's evolutionary tree was very different from that of the qnrB and qnrS strains. The emergence of MDR K. pneumoniae has caused significant public health concerns due to the diversity of qnr genes among K. pneumoniae clinical isolates. [ABSTRACT FROM AUTHOR]