Plasmid Mediated Quinolone Resistance in Enterobacteriaceae: A Review

Antimicrobial resistance (AMR) is a global problem which is hindering treatment of bacterial infections. Evaluation of the prevalence of PMQR genes is important in terms of selection of antibiotics for treatment options. The aim of this work is to review prior data on PMQR with a view of evaluating the prevalence of PMQR genes in Enterobacteriaceae and to identify the knowledge gap if any. This systematic review was conducted in line with the Preferred Reporting Items of Systematic Reviews and Meta-analyses (PRISMA) guideline. Pubmed and Ajol online databases were primarily searched for relevant articles. The eligible articles were evaluated using a set of eligibility criteria. Ninety five (95) full text article were selected for screening using the eligibility criteria. Twenty four (24) articles with majority emanating from Iran and China and only one article reporting study carried out in Nigeria where selected for qualitative synthesis for this review. The PMQR genes include qnr, aac (6’) Ib-cr and qepA gene. 46% of the articles focused on only one type of PMQR gene but not any of the two or three together while 54% screened for more than one type of the PMQR genes. Most frequently isolated PMQR gene is Qnr gene (96%) followed by Aac (6’)Ib-cr gene (46%) and QepA gene (13%). High occurrence of QepA gene (18.7%) was reported in the only study in Nigeria.The review showed a high prevalence of PMQR genes especially in Nigeria. With the limited studies evaluating the burden of PMQR there is also the need for the establishment of antibiotics surveillance policies especially in Nigeria.