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The aim of this study was to characterize fluoroquinolone (FQ)-resistant  Escherichia coli  isolates from bacteremia in Taiwan in 2001–2015. During the study period, 248 (21.2%) of 1171 isolates were identified as levofloxacin-resistant. The results of phylogenetic group analysis showed that 38.7% of the FQ-resistant isolates belonged to phylogenetic group B2, 23.4% to group B1, 22.6% to groupA, 14.9% to group D, and 0.4% belonged to group F. FQ-resistant isolates were highly susceptible to cefepime (91.5%), imipenem (96.0%), meropenem (98.8%), amikacin (98.0%), and fosfomycin (99.6%), as determined by the agar dilution method. β-lactamases, including  bla  TEM  (66.1%),  bla  CMY-2  (16.5%),  bla  CTX-M  (5.2%),  bla  DHA-1  (1.6%), and  bla  SHV-12  (1.6%), were found in FQ-resistant isolates. The results of PCR and direct sequencing showed that 37 isolates (14.9%) harbored plasmid-mediated quinolone resistance (PMQR) genes.  qnrB2 ,  qnrB4 ,  qnrS1 , coexistence of  qnrB4  and  qnrS1 ,  oqxAB , and  aac ( 6 ′)- Ib-cr  were found in 1, 4, 4, 1, 15, and 14 isolates, respectively. PMQR genes were successfully transfered for 11 (29.7%) of the 37 PMQR-harboring isolates by conjugation to  E. coli  C600. These findings indicate that  qnr  genes remained rare in  E. coli  but demonstrate the potential spread of  oqxAB  and  aac ( 6 ′)- Ib-c  in Taiwan.

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Plasmid-mediated quinolone resistance determinants in quinolone-resistant Escherichia coli isolated from patients with bacteremia in a university hospital in Taiwan, 2001–2015