Escherichia coli is the leading etiological agent of community-acquired urinary tract infection (UTI). Fluoroquinolones have long been the choice of empirical treatment for UTIs. Plasmid-mediated fluoroquinolone-resistance (PMFR) is important not only for conferring resistance to fluoroquinolones but also because of the presence of PMFR genes on plasmids carrying genes encoding resistance to other antimicrobials. In this study, we aimed at investigating the frequency of PMFR genes in fluoroquinolone-resistant and/or expanded spectrum beta-lactamase (ESBL)-producing E. coli strains isolated from pediatric and adult patients diagnosed with UTI. E. coli strains isolated from urine cultures of 141 adult and 117 pediatric outpatients were evaluated. Antimicrobial susceptibilities were interpreted according to the EUCAST criteria. The presence of PMFR genes (qnrA, qnrB, qnrC, qnrS, qepA, aac(6′)-Ib, and aac(6′)-Ib-cr) was investigated by multiplex PCR analysis. One hundred-three (73.05%) adult and 92 (78.63%) pediatric isolates were fluoroquinolone resistant and/or ESBL producers. One third (92/258) of all isolates carried at least one PMFR gene, the most prevalent one being qnrS (67.4%). None of the isolates carried qnrC and qepA genes. PMFR determinants were found to be widespread among adult and pediatric isolates. Rational antimicrobial use is crucial for prevention of resistance in both adult and pediatric populations.

中文翻译：

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从诊断为尿路感染的儿童和成人患者中分离出的抗氟喹诺酮和/或产超广谱β-内酰胺酶的大肠杆菌菌株中的质粒氟喹诺酮抗性基因。

大肠杆菌是社区获得性尿路感染 (UTI) 的主要病原体。长期以来，氟喹诺酮类药物一直是 UTI 经验性治疗的选择。质粒介导的氟喹诺酮耐药性 (PMFR) 不仅对于赋予对氟喹诺酮类药物的耐药性很重要，而且还因为质粒上存在 PMFR 基因，该质粒携带编码对其他抗菌药物的耐药性的基因。在这项研究中，我们旨在调查从诊断为 UTI 的儿童和成人患者中分离出的耐氟喹诺酮类和/或产广谱 β-内酰胺酶 (ESBL) 的大肠杆菌菌株中 PMFR 基因的频率。大肠杆菌评估了从 141 名成人和 117 名儿科门诊患者的尿培养物中分离的菌株。根据 EUCAST 标准解释抗菌药物敏感性。PMFR 基因（qnrA、qnrB、qnrC、qnrS、qepA、aac(6')-Ib和aac(6')- Ib-cr）的存在通过多重 PCR 分析进行研究。103 个 (73.05%) 成人和 92 个 (78.63%) 儿童分离株对氟喹诺酮类和/或 ESBL 产生耐药性。所有分离株中的三分之一 (92/258) 携带至少一种 PMFR 基因，最普遍的一种是qnrS (67.4%)。没有分离株携带qnrC和qepA基因。PMFR 决定因素被发现在成人和儿童分离株中广泛存在。合理使用抗菌药物对于预防成人和儿童人群的耐药性至关重要。