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. 2023 Jan;26(1):93-98.
doi: 10.22038/IJBMS.2022.67095.14714.

Relationship of OqxAB efflux pump to antibiotic resistance, mainly fluoroquinolones in Klebsiella pneumoniae, isolated from hospitalized patients

Fereshteh Amereh  1 , Mohammad Reza Arabestani  1 , Leili Shokoohizadeh  1   2
Affiliations

Relationship of OqxAB efflux pump to antibiotic resistance, mainly fluoroquinolones in Klebsiella pneumoniae, isolated from hospitalized patients

Fereshteh Amereh et al. Iran J Basic Med Sci. 2023 Jan.

Abstract

Objectives: This research was designed to study the prevalence of OqxAB efflux pump genes and also to investigate the relationship between efflux pump and resistance to antibiotics, especially to fluoroquinolones, evaluate the expression levels of OqxAB genes, and molecular typing of Klebsiella pneumoniae isolated from hospitalized patients in Hamadan hospitals, west of Iran.

Materials and methods: In a cross-sectional study, 100 clinical strains of K. pneumoniae were isolated from hospitalized patients in three major teaching hospitals from January to June 2021. The antibiotic susceptibility of isolates was evaluated by the disk-diffusion agar method. The frequency of genes encoding oqxA and oqxB of efflux pump genes was investigated by PCR, and the expression of the oqxA efflux pump gene was investigated by the Real-time PCR method. The genetic relationship of K. pneumoniae isolates was analyzed by the Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR technique.

Results: According to our results, the multi-drug resistance phenotype (MDR) in 65% and high prevalence resistance to ciprofloxacin in 89% of K. pneumoniae isolates was detected. The higher prevalence of oqxA (95%) and oqxB (98%) was also detected. There was a significant relationship between ciprofloxacin resistance and the oqxB gene as well as between ceftriaxone and chloramphenicol resistance and the oqxA gene. The expression of the oqxA gene was higher in ciprofloxacin-resistant isolates.

Conclusion: The results of this study suggest a potential reservoir for the spread of OqxAB genes among hospital-acquired bacteria. Infection control strategies should be used prudently to reduce the spread of resistant strains of K. pneumoniae in hospitals.

Keywords: Antimicrobial; Ciprofloxacin; Efflux; K. pneumoniae; Pump; Resistance.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Antibiotic resistance (%) of Klebsiella pneumoniae isolated from Hamadan hospitals
Figure 2
Figure 2
Gel electrophoresis of PCR products of OqxAB encoding genes and ERIC-PCR typing in Klebsiella pneumoniae isolates from hospitalized patients in Hamadan hospitals
Figure 3
Figure 3
a: Specific amplification of the oqxA gene in Klebsiella pneumoniae isolates during Real-time PCR, b: melting curve of primers
Figure 4
Figure 4
Dendrogram of ERIC-PCR patterns of 100 Klebsiella pneumoniae isolates from Hamadan hospitals
See this image and copyright information in PMC

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