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J Med Microbiol 58 (2009), 1585-1592; DOI: 10.1099/jmm.0.010033-0
© 2009 Society for General Microbiology
ISSN 0022-2615

High prevalence of plasmid-mediated quinolone resistance determinants in commensal members of the Enterobacteriaceae in Ho Chi Minh City, Vietnam

Le Thi Minh Vien1, Stephen Baker1,2, Le Thi Phuong Thao1, Le Thi Phuong Tu1, Cao Thu Thuy1, Tran Thi Thu Nga1, Nguyen Van Minh Hoang1,3, James Iain Campbell1,2, Lam Minh Yen3, Nguyen Trong Hieu4, Nguyen Van Vinh Chau3, Jeremy Farrar1,2 and Constance Schultsz1,2,5

1 Oxford University Clinical Research Unit, Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam

2 Nuffield Department of Clinical Medicine, John Radcliffe Hospital, University of Oxford, Oxford, UK

3 Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam

4 Hung Vuong Hospital, Ho Chi Minh City, Vietnam

5 Center for Poverty-related Communicable Diseases (CPCD), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

Correspondence
Constance Schultsz
schultsz{at}gmail.com

Received February 4, 2009
Accepted August 14, 2009

Antimicrobial-resistant pathogenic members of the Enterobacteriaceae are a well-defined global problem. We hypothesized that one of the main reservoirs of dissemination of antimicrobial resistance genes in Vietnam is non-pathogenic intestinal flora, and sought to isolate antimicrobial-resistant organisms from hospitalized patients and non-hospitalized healthy individuals in Ho Chi Minh City. The results identified substantial faecal carriage of gentamicin-, ceftazidime- and nalidixic acid-resistant members of the Enterobacteriaceae in both hospitalized patients and non-hospitalized healthy individuals. A high prevalence of quinolone resistance determinants was identified, particularly the qnrS gene, in both community- and hospital-associated strains. Furthermore, the results demonstrated that a combination of quinolone resistance determinants can confer resistance to nalidixic acid and ciprofloxacin, even in the apparent absence of additional chromosomal resistance mutations in wild-type strains and laboratory strains with transferred plasmids. These data suggest that intestinal commensal organisms are a significant reservoir for the dissemination of plasmid-mediated quinolone resistance in Ho Chi Minh City.






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