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Original Article

J App Pharm Sci. 2022; 12(4): 185-198

Detection of qnr genes and gyrA mutation to Quinolone Phenotypic Resistance of UTI patho-gens in Bangladesh and the implications

Tanjum Ara Haque, Umme Laila Urmi, Abul Bashar Mir Md Khademul Islam, Bayasrin Ara, Shamsun Nahar, Abu Syed Md. Mosaddek, Halyna Lugova, Santosh Kumar, Dilshad Jahan, Nor Azlina A Rahman, Mainul Haque, Salequl Islam, Brian Godman.


Background: Plasmid-mediated quinolone resistance (PMQR) genes and mutations within the quinolone resistance-determining regions (QRDRs) bequeath to the advent of quinolone-resistant pathogenic microbes. This research was designed to assess the roles of three PMQR genes, qnrA, qnrB, and qnrS, and any mutation in the gyrA gene in the QRDR domain as a process of quinolone/fluoroquinolone resistance to urinary tract infection (UTI) bacteria in Bangladesh to guide future management of UTIs. Methods: Pathogens from UTIs were isolated and identi-fied, and their phenotype antibiotic susceptibilities were tested for lomefloxacin, ofloxacin, ciprofloxacin, and nalidixic acid. Polymerase chain reaction (PCR) detected the qnrA, qnrB, and qnrS genes. PCR and sequencing were performed to evaluate any mutation within the QRDRs of the gyrA gene. Results: Of 100 UTI bacteria, phenotypic resistance was observed in 95.0%, 89.0%, 83.0%, and 71.0% against lomefloxacin, nalidixic acid, ofloxacin, and ciprofloxacin, respectively. PMQR genes, qnrS, qnrA, and qnrB genes were found in 54.0%, 1.0%, and 4.0% of isolates, respec-tively. Sequencing the gyrA gene revealed single mutation (Ser-83 to Leu) and double mutations (Ser-83 to Leu and Asp-87 to Asn). PMQR genes showed a statistically non-significant association with phenotypic resistance. Conclusions: This study confirms the presence of QRDR mutations that were independent of PMQR quinolone resistance genes. Consequently, high resistance against quinolones among uropathogens is evident, and their future use needs to be moderat-ed.

Key words: Quinolone; fluoroquinolones; PMQR; qnr; QRDR; UTI; Bangladesh

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