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Emergence and spread of antibiotic resistant strains to fluoroquinolones have led to treatment failures and increased mortality in\n                      <jats:italic>Salmonella<\/jats:italic>\n                      infection. However, there is dearth of information regarding mechanisms of resistance to fluoroquinolones in Ghana. This study therefore sought to identify chromosomal mutations and plasmid-mediated resistance as possible mechanisms of fluoroquinolone resistance from clinical isolates in Ghana.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This was a retrospective study of archived isolates biobanked at Kumasi Centre for Collaborative Research in Tropical Medicine, Ghana. Isolates were obtained from blood, stool and oropharynx samples at two hospitals, between May, 2016 and January, 2018.\n                      <jats:italic>Salmonella<\/jats:italic>\n                      identification was done using standard microbiological protocols and antibiotic susceptibility testing performed by Kirby-Bauer disc diffusion method. Isolates with intermediate susceptibility and\/or resistance to nalidixic acid and\/or ciprofloxacin were selected and examined for chromosomal mutations by Sanger sequencing and plasmid-mediated resistance by PCR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 133 biobanked isolates cultured, 68 (51.1%) and 16 (12%) were identified as\n                      <jats:italic>Salmonella<\/jats:italic>\n                      Typhi and non-typhoidal\n                      <jats:italic>Salmonella<\/jats:italic>\n                      (NTS), respectively. Sequence analysis of\n                      <jats:italic>gyrA<\/jats:italic>\n                      gene revealed the presence of 5 different nonsynonymous mutations, with the most frequent mutation (Ile203Ser) occurring in 12 out of 13 isolates tested. Gyrase B (\n                      <jats:italic>gyrB<\/jats:italic>\n                      ) gene had 1 nonsynonymous mutation in 3 out of 13 isolates, substituting phenylalanine with leucine at codon 601 (Phe601Leu). No mutation was observed in\n                      <jats:italic>parC<\/jats:italic>\n                      and\n                      <jats:italic>parE<\/jats:italic>\n                      genes. Two NTS isolates were found to harbour\n                      <jats:italic>qnrS<\/jats:italic>\n                      plasmid-mediated resistant gene of molecular size 550\u2009bp with high ciprofloxacin MIC of 0.5\u2009\u03bcg\/ml.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      This study reports for the first time in Ghana plasmid-mediated fluoroquinolone resistant gene\n                      <jats:italic>qnrS<\/jats:italic>\n                      in\n                      <jats:italic>Salmonella<\/jats:italic>\n                      clinical isolates. Nonsynonymous mutations of\n                      <jats:italic>gyrA<\/jats:italic>\n                      and\n                      <jats:italic>gyrB<\/jats:italic>\n                      genes likely to confer\n                      <jats:italic>Salmonella<\/jats:italic>\n                      reduced susceptibility to ciprofloxacin were also reported.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-019-4522-1","type":"journal-article","created":{"date-parts":[[2019,10,28]],"date-time":"2019-10-28T11:05:26Z","timestamp":1572260726000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Chromosomal and plasmid-mediated fluoroquinolone resistance in human Salmonella enterica infection in Ghana"],"prefix":"10.1186","volume":"19","author":[{"given":"Godfred","family":"Acheampong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Owusu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Owusu-Ofori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Osei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nimako","family":"Sarpong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augustina","family":"Sylverken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Jui","family":"Kung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Ting","family":"Cho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Horng","family":"Kuo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se Eun","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Marks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaw","family":"Adu-Sarkodie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4232-4292","authenticated-orcid":false,"given":"Ellis","family":"Owusu-Dabo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,28]]},"reference":[{"issue":"10","key":"4522_CR1","doi-asserted-by":"publisher","first-page":"e570","DOI":"10.1016\/S2214-109X(14)70301-8","volume":"2","author":"V Mogasale","year":"2014","unstructured":"Mogasale V, Maskery B, Ochiai RL, Lee JS, Mogasale VV, Ramani E, Kim YE, Park JK, Wierzba TF. 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Written informed consent was obtained from all participants of the study by means of signature and\/or thumbprinting. Children older than 7\u2009yrs. but younger than 18\u2009yrs. gave their assent together with parental\/guardian consent (written) before they were enrolled into the study. The main study protocol was reviewed and approved by the Committee for Human Research Publications and Ethics (CHRPE) at the School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors (including Florian Marks, who is an editorial board member for BMC Infectious Diseases) declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"898"}}