{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:24:03Z","timestamp":1777922643160,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2012,2,1]],"date-time":"2012-02-01T00:00:00Z","timestamp":1328054400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:p>\n                    Fluoroquinolone resistance in extended-spectrum \u03b2-lactamases (ESBL)\u2013producing isolates results in very few antimicrobial treatment options. In Taiwan's Surveillance of Antimicrobial Resistance (TSAR) III program, 124 (52.8%) cases of ESBL-producing\n                    <jats:italic toggle=\"yes\">Klebsiella pneumoniae<\/jats:italic>\n                    (ESBL-KP) were resistant to ciprofloxacin. The prevalence of plasmid-mediated quinolone resistance (PMQR) determinants and chromosomal quinolone resistance-determining regions (QRDR) of\n                    <jats:italic toggle=\"yes\">gyrA<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">parC<\/jats:italic>\n                    genes among ESBL-KP isolates was assessed via PCR sequencing. Chromosomal QRDR mutations were present in most of the 123 (96.8%) cases of ciprofloxacin-resistant ESBL-KP isolates. Sixty-six (53.2%) isolates had at least one PMQR gene.\n                    <jats:italic toggle=\"yes\">qnrB2<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">qnrB4<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">qnrS1<\/jats:italic>\n                    were detected in 26, 19, and 13 isolates, respectively, whereas\n                    <jats:italic toggle=\"yes\">qnrA<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">qnrC,<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">qnrD<\/jats:italic>\n                    were not detected. ESBL genes were transferable via conjugation with either\n                    <jats:italic toggle=\"yes\">aac(6\u2032)Ib-cr<\/jats:italic>\n                    or\n                    <jats:italic toggle=\"yes\">qnrB<\/jats:italic>\n                    in 63.6% of the isolates carrying PMQR genes.\n                    <jats:italic toggle=\"yes\">QnrB<\/jats:italic>\n                    was associated with either CTX-M-15 or SHV-12, and\n                    <jats:italic toggle=\"yes\">aac(6\u2032)Ib-cr<\/jats:italic>\n                    was linked to CTX-M-3 or CTX-M-14 in plasmids.\n                    <jats:italic toggle=\"yes\">qnrS<\/jats:italic>\n                    did not co-transfer with ESBL genes. Clonal spread of PMQR genes harboring ESBL-KP isolates was observed in three hospitals.\n                    <jats:italic toggle=\"yes\">QnrA<\/jats:italic>\n                    , which is common in Asia, was unexpectedly absent in ESBL-KP in Taiwan. Aside from transmission via clonal spread for ciprofloxacin-resistant ESBL-KP, concomitant transference of PMQR genes with either\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>CTX-M<\/jats:sub>\n                    or\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>SHV<\/jats:sub>\n                    via plasmid was common.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2011.0060","type":"journal-article","created":{"date-parts":[[2011,10,24]],"date-time":"2011-10-24T11:08:09Z","timestamp":1319454489000},"page":"52-58","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Molecular Epidemiology of Ciprofloxacin-Resistant Extended-Spectrum \u03b2-Lactamase\u2013Producing\n                    <i>Klebsiella pneumoniae<\/i>\n                    in Taiwan"],"prefix":"10.1177","volume":"18","author":[{"given":"Chi-Jan","family":"Lin","sequence":"first","affiliation":[{"name":"National Health Research Institutes","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Kristopher","family":"Siu","sequence":"additional","affiliation":[{"name":"National Health Research Institutes","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Ma","sequence":"additional","affiliation":[{"name":"National Health Research Institutes","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya-Ting","family":"Chang","sequence":"additional","affiliation":[{"name":"Kaohsiung Medical University Hospital","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Po-Liang","family":"Lu","sequence":"additional","affiliation":[{"name":"Kaohsiung Medical University Hospital","place":["Taiwan"]},{"name":"Kaohsiung Medical University","place":["Taiwan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,2]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"crossref","first-page":"4171","DOI":"10.1128\/AAC.01480-06","article-title":"Emergence of the quinolone resistance-mediating gene aac(6\u2032)-Ib-cr in extended-spectrum-beta-lactamase-producing Klebsiella isolates collected in Slovenia between 2000 and 2005","volume":"51","author":"Ambrozic Avgustin J.","year":"2007","unstructured":"Ambrozic Avgustin J., , Keber R., , Zerjavic K., , Orazem T., , Grabnar M. 2007. Emergence of the quinolone resistance-mediating gene aac(6\u2032)-Ib-cr in extended-spectrum-beta-lactamase-producing Klebsiella isolates collected in Slovenia between 2000 and 2005. Antimicrob. Agents Chemother., 51:4171\u20134173.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"2051","DOI":"10.1128\/AAC.43.8.2051","article-title":"Comparative in vitro activities of ciprofloxacin, clinafloxacin, gatifloxacin, levofloxacin, moxifloxacin, and trovafloxacin against Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, and Enterobacter aerogenes clinical isolates with alterations in GyrA and ParC proteins","volume":"43","author":"Brisse S.","year":"1999","unstructured":"Brisse S., , Milatovic D., , Fluit A.C., , Verhoef J., , Martin N., , Scheuring S., , Kohrer K., , Schmitz F.J. 1999. Comparative in vitro activities of ciprofloxacin, clinafloxacin, gatifloxacin, levofloxacin, moxifloxacin, and trovafloxacin against Klebsiella pneumoniae, Klebsiella oxytoca, Enterobacter cloacae, and Enterobacter aerogenes clinical isolates with alterations in GyrA and ParC proteins. Antimicrob. Agents Chemother., 43:2051\u20132055.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00997-08"},{"key":"e_1_3_3_5_2","volume-title":"Approved standard","author":"Clinical and Laboratory Standards Institute","year":"2006","unstructured":"Clinical and Laboratory Standards Institute. 2006. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically. 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