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Children recently discharged from the hospital are at high risk of carriage of antimicrobial resistance (AMR) due to frequent exposure to antimicrobials during inpatient stays. This study aimed to determine the prevalence, correlates of ciprofloxacin (CIP) non-susceptibility, and distribution of plasmid-mediated quinolone resistance (PMQR) genes in\n                      <jats:italic>Escherichia coli (E. coli)<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp isolated from children under five years being discharged from two Kenyan Hospitals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp were isolated from fecal samples from children discharged from hospital and subjected to antimicrobial susceptibility testing (AST) by disc diffusion and E-test. CIP non-susceptible isolates were screened for seven PMQR genes using multiplex polymerase chain reaction (PCR). Poisson regression was used to determine the association between the carriage of CIP non-susceptible isolates and patient characteristics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 280 CIP non-susceptible isolates: 188\n                      <jats:italic>E. coli<\/jats:italic>\n                      and 92\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp isolates identified among 266 discharged children, 195 (68%) were CIP-non-susceptible with minimum inhibitory concentrations (MICs) of\u2009\u2265\u20091\u00a0\u00b5g\/mL. Among these 195 isolates, 130 (67%) had high-level CIP MIC\u2009=\u2009\u2009\u2265\u200932\u00a0\u00b5g\/mL). Over 80% of the isolates had at least one PMQR gene identified:\n                      <jats:italic>aac(6\u2019)lb-cr (60%), qnrB (24%)<\/jats:italic>\n                      ,\n                      <jats:italic>oqxAB (22%), qnrS (16%),<\/jats:italic>\n                      and\n                      <jats:italic>qepA (6%),<\/jats:italic>\n                      however,\n                      <jats:italic>qnrA<\/jats:italic>\n                      was not identified in any isolates tested. Co-carriage of\n                      <jats:italic>qnrB<\/jats:italic>\n                      with\n                      <jats:italic>acc(6\u2019)-lb-cr<\/jats:italic>\n                      was the most predominant accounting for 20% of all the isolates. Ceftriaxone use during hospital admission and the presence of extended spectrum beta-lactamase (ESBL) production were significantly associated with the carriage of CIP non-susceptible\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      CIP non-susceptibility is common among\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp isolated from hospital discharged children in Kenya. Carriage and co-carriage of PMQR, including the newly identified\n                      <jats:italic>qepA<\/jats:italic>\n                      gene, were frequently observed. These findings suggest that children leaving the hospital may serve as an important reservoir for transmission of resistant\n                      <jats:italic>E. coli<\/jats:italic>\n                      and\n                      <jats:italic>Klebsiella<\/jats:italic>\n                      spp to the community. Enhanced surveillance for AMR determinants is critical to inform interventions to control antimicrobial-resistant bacteria.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12866-023-02849-2","type":"journal-article","created":{"date-parts":[[2023,5,12]],"date-time":"2023-05-12T23:24:11Z","timestamp":1683933851000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Plasmid-mediated quinolone resistance genes detected in Ciprofloxacin non-susceptible Escherichia coli and Klebsiella isolated from children under five years at hospital discharge, Kenya"],"prefix":"10.1186","volume":"23","author":[{"given":"Kevin","family":"Kariuki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mame Mareme","family":"Diakhate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Musembi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie N.","family":"Tornberg-Belanger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doreen","family":"Rwigi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Mutuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Mutuku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirkby D.","family":"Tickell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olusegun O.","family":"Soge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benson O.","family":"Singa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judd L.","family":"Walson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia B.","family":"Pavlinac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Kariuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,5,13]]},"reference":[{"key":"2849_CR1","doi-asserted-by":"publisher","unstructured":"Centers for Disease Control. 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Epub ahead of print 6 August 2020. https:\/\/doi.org\/10.1186\/S13756-020-00786-7.","DOI":"10.1186\/S13756-020-00786-7"}],"container-title":["BMC Microbiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-023-02849-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12866-023-02849-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12866-023-02849-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T11:12:30Z","timestamp":1700219550000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmicrobiol.biomedcentral.com\/articles\/10.1186\/s12866-023-02849-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,13]]},"references-count":50,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["2849"],"URL":"https:\/\/doi.org\/10.1186\/s12866-023-02849-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2413866\/v1","asserted-by":"object"}]},"ISSN":["1471-2180"],"issn-type":[{"value":"1471-2180","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,13]]},"assertion":[{"value":"25 December 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 May 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was approved by the Scientific and Ethics Review Unit (SERU) of Kenya Medical Research Institute (KEMRI) (SSC No. 4127). The parent study was approved by Kenya Medical Research Institute (SERU 3086). All methods were performed in accordance with the relevant guidelines and regulations for clinical and laboratory research ethics. Informed written consent was provided by the caregivers or the child\u2019s legal guardian in their preferred language for the child to participate in this study. If a caregiver was not literate, information was read in the language of their choice and consent was obtained using a witnessed thumbprint.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"129"}}