{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:53:45Z","timestamp":1792292025532,"version":"4.4.0"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T00:00:00Z","timestamp":1574294400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T00:00:00Z","timestamp":1574294400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Fluoroquinolones are commonly recommended as treatment for urinary tract infections (UTIs). The development of resistance to these agents, particularly in gram-negative microorganisms complicates treatment of infections caused by these organisms. This study aimed to investigate antimicrobial resistance of different\n                      <jats:italic>Enterobacteriaceae<\/jats:italic>\n                      species isolated from hospital- acquired and community-acquired UTIs against fluoroquinolones and correlate its levels with the existing genetic mechanisms of resistance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 440\n                      <jats:italic>Enterobacteriaceae<\/jats:italic>\n                      isolates recovered from UTIs were tested for antimicrobial susceptibility. Plasmid-mediated quinolone resistance (PMQR) genes and mutations in the quinolone resistance-determining regions (QRDRs) of\n                      <jats:italic>gyrA<\/jats:italic>\n                      and\n                      <jats:italic>parC<\/jats:italic>\n                      genes were examined in quinolone-resistant strains.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      About (32.5%) of isolates were resistant to quinolones and (20.5%) were resistant to fluoroquinolones. All isolates with high and intermediate resistance phenotypes harbored one or more PMQR genes. Q\n                      <jats:italic>nrB<\/jats:italic>\n                      was the most frequent gene (62.9%) of resistant isolates. Co-carriage of 2 PMQR genes was detected in isolates (46.9%) with high resistance to ciprofloxacin (CIP) (MICs &gt;\u2009128\u2009\u03bcg\/mL), while co-carriage of 3 PMQR genes was detected in (6.3%) of resistant isolates (MICs &gt;\u2009512\u2009\u03bcg\/mL). Carriage of one gene only was detected in intermediate resistance isolates (MICs of CIP\u2009=\u20091.5\u20132\u2009\u03bcg\/mL). Neither\n                      <jats:italic>qnrA<\/jats:italic>\n                      nor\n                      <jats:italic>qnrC<\/jats:italic>\n                      genes were detected. The mutation at code 83 of\n                      <jats:italic>gyrA<\/jats:italic>\n                      was the most frequent followed by Ser80-Ile in p\n                      <jats:italic>arC<\/jats:italic>\n                      gene, while Asp-87 Asn mutation of\n                      <jats:italic>gyr<\/jats:italic>\n                      A gene was the least, where it was detected only in high resistant\n                      <jats:italic>E. coli<\/jats:italic>\n                      isolates (MIC \u2265128\u2009\u03bcg\/mL). A double mutation in\n                      <jats:italic>gyrA<\/jats:italic>\n                      (Lys154Arg and Ser171Ala) was observed in high FQs resistant isolates (MIC of CIP &lt;\u2009128\u2009\u03bcg\/mL).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      FQs resistance is caused by interact between PMQR genes and mutations in both\n                      <jats:italic>gyrA<\/jats:italic>\n                      and\n                      <jats:italic>parC<\/jats:italic>\n                      genes while a mutation in one gene only can explain quinolone resistance. Accumulation of PMQR genes and QRDR mutations confers high resistance to FQs.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12879-019-4606-y","type":"journal-article","created":{"date-parts":[[2019,11,21]],"date-time":"2019-11-21T05:03:56Z","timestamp":1574312636000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":54,"title":["Impact of co-existence of PMQR genes and QRDR mutations on fluoroquinolones resistance in Enterobacteriaceae strains isolated from community and hospital acquired UTIs"],"prefix":"10.1186","volume":"19","author":[{"given":"Dalia Nabil","family":"Kotb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wafaa Khairy","family":"Mahdy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud Shokry","family":"Mahmoud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4481-8608","authenticated-orcid":false,"given":"Rasha M. 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As the study used anonymous clinical data, the patients were not required to give informed consent for the study (code: 45 A at 2\/5\/2016).","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 declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"979"}}