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Annals of Clinical & Laboratory Science 39:55-59 (2009)
© 2009 Association of Clinical Scientists

Accumulation of Plasmid-Mediated Fluoroquinolone Resistance Genes, qepA and qnrS1, in Enterobacter aerogenes Co-producing RmtB and Class A β-lactamase LAP-1

Yeon-Joon Park1, Jin Kyung Yu1, Sang-Il Kim2, Kyungwon Lee3 and Yoshichika Arakawa4
1 Departments of Laboratory Medicine and 2 Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul; 3 Department of Laboratory Medicine, College of Medicine, Yonsei University, Seoul, Korea; 4 Department of Bacterial Pathogenesis and Infection Control, National Institute of Infectious Diseases, Tokyo, Japan

Address correspondence to Professor Yeon-Joon Park, Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea; tel 82 2 590 1604; fax 82 2 590 2547; e-mail yjpk{at}catholic.ac.kr.

A new plasmid-mediated fluoroquinolone efflux pump gene, qepA, is known to be associated with the rmtB gene, which confers high-level resistance to aminoglycosides. We investigated the qepA gene in 573 AmpC-producing Enterobacteriaceae including one Citrobacter freundii known to harbor rmtB. Of them, two clonally unrelated E. aerogenes harbored qepA. Both isolates co-harbored rmtB, qnrS1, qepA, and blaLAP-1 on an IncFI type plasmid. The qepA was flanked by two copies of IS26 containing ISCR3C, tnpA, tnpR, blaTEM, and rmtB. The qnrS1 and blaLAP-1 were located upstream of qepA. All the resistance determinants (qepA, qnrS1, rmtB, and blaLAP-1) were co-transferred to E. coli J53 by filter mating from both isolates. Although the prevalence of qepA is currently low, considering the presence of ISCR3C and the possibility of co-selection and co-transferability of plasmids, more active surveillance for these multi-drug resistant bacteria and prudent use of antimicrobials are needed.

Keywords: qepA, qnrS1, rmtB, blaLAP-1, ISCR3C, gene co-transferance




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