Plasmid-mediated qnrA1 in Klebsiella pneumoniae ST147 in Recife, Brazil

Objectives: Qnr-mediated quinolone resistance is increasingly detected worldwide, but few studies have been carried out so far in Brazil. The aim of this study was to test for qnr determinants in isolates of ciprofloxacin-resistant Klebsiella pneumoniae. Methods: Fifteen ciprofloxacin-resistant isolates from urine cultures of hospitalized patients at a university hospital in North-East Brazil were investigated. Specific PCRs were performed for bla(CTX-M) and bla(TEM), qnr, and class 1 integrons. Plasmid analyses and sequence type (ST) determination were performed, as described previously. Results: The KP 930 isolate showed qnrA1 and bla(TEM-1), together with dfrA12 and aadA2 in a class 1 integron. The qnr gene was located in a 133-kb plasmid. Multilocus sequence typing classified the isolate as ST147. Conclusions: We identified the combination of qnr with ST147 in Brazil; this is a clone that has disseminated widely and successfully in Latin America. The purpose of describing Qnr-mediated quinolone resistance in North-East Brazil is to draw attention to the spread of this mechanism in the country. (C) 2014 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license.