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Prevalence of CTX-M enzyme and qnrA, qnrB, qnrC, qnrS, aac-(6)-Ib genes among ESBL (Extended spectrum beta lactamase)-positive isolates in patients undergoing transrectal needle prostate biopsy in Turkey.

Elif Tükenmez Tigen, Zafer Tandoğdu, Gülşen Altınkanat, Arzu Doğru, Buket Erturk Sengel, Korten Volkan.

Abstract
Fecal carriage is one of the most important reasons for extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) causing infections. We aimed to demonstrate epidemiological features for subtype of ESBL-PE-encoding TEM, SHV and CTX-M as well as for qnrA, qnrB, qnrC, qnrS, aac-(6)-Ib genes through polymerase chain reaction (PCR) in patients undergoing transrectal needle prostate biopsy (TRNBP). Between October 2008 and February 2010, we collected 400 fecal swabs from patients prior to TRNBP in four separate centers. After detecting ESBL- PE isolates in the material, we further analyzed TEM, SHV and CTX-M enzymes, as well as three types of qnr genes of qnrA, qnrB, qnrC and aac-(6)-Ib by PCR. We detected 80 ESBL-PE isolates in 400 fecal samples. Of the 80 isolates; blaSHV, blaTEM and blaCTX-M were observed in 12, 46 and 79 isolates, respectively. All three genes were present in eight isolates. Resistance to Quinolone was identified in 67 (83.7%) isolates, resistance to aminoglycoside in 52 (65%) isolates, and resistance to both antibiotics in 46 (57.5%) isolates. Subsequently, we determined qnrB, qnrS and aac-(6)-Ib genes in 7 (8.8%), 11 (14%) and 60 (76%) isolates, respectively. qnrA and qnrC were not detected in any of the isolates. CTX-M-producing ESBL-PE is the most common pathogen responsible for fecal carriage in the community. Plasmid mediated quinolone resistance genes (qnr, aac-(6)-Ib) are the reason behind the dissemination of ESBLs.

Key words: Beta-lactamase CTX-M, Enterobacteriaceae , Qnr protein, prostate



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