Journal
EXPERT REVIEW OF ANTI-INFECTIVE THERAPY
Volume 6, Issue 5, Pages 685-711Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1586/14787210.6.5.685
Keywords
acetyl transferase; antibiotic resistance; efflux; enterobacteria; pentapeptide-repeat protein; plasmid; qnr; quinolone
Funding
- Ministerio de Sanidad y Consumo
- Instituto de Salud Carlos III, Spain [PI050690, PI060580]
- Consejeria de Innovacion Ciencia y Empresa
- Junta de Andalucia, Spain [P07-CTS-02908]
- Spanish Network for Research in Infectious Diseases, Spain [REIPI RD06/0008]
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The first plasmid-mediated gene involved in quinolone resistance (qnrA1) was reported in 1998. It codes for a pentapeptide-repeat protein that protects type II topoisomerases from quinolones. Additional related plasmid-mediated genes (qnrB, qnrS and qnrC) and chromosomal homologs of them have also been discovered. Two other plasmid-mediated resistance mechanisms were later reported: modification of quinolones with a piperazinyl substituent by the acetyltransferase Aac(6')-1b-cr and active efflux by QepA, a pump related to the major facilitator superfamily transporters. These genes have a wide geographical distribution (essentially in enterobacteria), although their real prevalence is only partially known because of the difficulty of phenotypic detection of this type of resistance. Although these mechanism cause low-level resistance, they favor and complement the selection of additional mechanisms of resistance.
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