Plasmid-mediated quinolone resistance (PMQR) among Enterobacteriales in Latin America: a systematic review

Area of Science:

• Microbiology
• Antimicrobial Resistance
• Public Health

Background:

• Plasmid-mediated quinolone resistance (PMQR) genes are altering quinolone resistance patterns, particularly in Enterobacteriales.
• High fluoroquinolone prescription rates in Latin America may drive PMQR gene dissemination.
• A comprehensive review of PMQR impact in Latin America was lacking.

Purpose of the Study:

• To summarize current knowledge on the circulation of PMQR genes among Enterobacteriales in Latin America.
• To identify prevalent PMQR genes and bacterial hosts in the region.
• To provide data for developing control measures against quinolone resistance.

Main Methods:

• Systematic review of published studies on PMQR genes in Latin America.
• Included 61 articles reporting on Enterobacteriales from human and animal samples.
• Analyzed the frequency and distribution of identified PMQR genes and bacterial species.

Main Results:

• PMQR genes were detected in Enterobacteriales from human (77%) and animal (29.5%) samples across Latin America.
• Brazil (37.7%), Mexico (18%), and Uruguay (11.5%) were key countries.
• Nine PMQR genes were identified, with aac(6')-Ib-cr (60.6%) and qnrB (42.6%) being most common.
• Escherichia coli (65.6%) was the most frequent host, followed by Klebsiella pneumoniae (39.3%).

Conclusions:

• This review consolidates data on PMQR gene prevalence in Latin American Enterobacteriales.
• Specific genes like aac(6')-Ib-cr and qnrB, and species like E. coli, are significant.
• Findings are crucial for designing targeted interventions to control quinolone resistance spread.