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The high frequency of fluoroquinolone resistance inEscherichia coli is a feature of clinical bacteriology in China, where the molecular epidemiology and genetic characteristics of this resistance in county hospitals remain unclear. A total of 590 nonduplicateE. coli isolates from 30 county hospitals located across seven Chinese regions were examined for plasmid-mediated quinolone resistance (PMQR) genes and mutations in quinolone resistance-determining regions (QRDRs). Multilocus sequence typing (MLST) and phylogenetic analysis of fluoroquinolone-resistant isolates were used to determine their genetic relatedness. The ciprofloxacin resistance rate of community-onsetE. coli was 51.2%, and at least one PMQR gene was carried by 220 (37.3%) isolates. These includedqnr (3.7%),aac(6 ′)-Ib-cr (19.7%),qepA (14.4%), andoqxAB (3.8%). Two noveloqxB mutants were identified and namedoqxB20 andoqxB29 . From 60 sequence types (STs) isolated, 5 novel STs (ST4499 to ST4503) were identified. ST1193 (7.9%) was the second most abundant ST among fluoroquinolone-resistant isolates (ST131 was the most common, with 14.6%), and this is the first report of it in China. This is also the first report of ST2115 and ST3014 isolates from human samples. Ciprofloxacin-resistantE. coli isolates fell mainly into phylogroups B2 and D. The rates of fluoroquinolone resistance and the prevalence of PMQR genes in community-onsetE. coli isolates from Chinese county hospitals were high. The wide-ranging molecular epidemiology ofE. coli isolates from scattered locations across China indicates that fluoroquinolone resistance evolved from different sources.

journal of clinical microbiology

Molecular Epidemiology and Genetic Diversity of Fluoroquinolone-Resistant Escherichia coli Isolates from Patients with Community-Onset Infections in 30 Chinese County Hospitals