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The aim of this study was to show the emergence of the  qnrD  gene among fluoroquinolone-resistant  Morganella morganii  isolate. The occurrence of mutations in DNA gyrase ( gyrA  and  gyrB ) and topoisomerase IV ( parC , parE ) genes was also investigated in this strain.    Methodology  95 clinical Enterobacteria were screened for harbouring the  qnrD  gene. The clinical isolate of  M. morganii  was recovered from urine from a patient hospitalized in the urology unit at Fattouma Bourguiba Hospital, Tunisia. Antibiotic susceptibility was tested with the agar disk diffusion method. Quinolone susceptibility was studied with microbroth dilution technique. The investigations of plasmid mediated quinolone resistance (PMQR) and topoisomerases mutations were performed by polymerase chain reaction and nucleotide sequencing.    Results  This isolate showed high level of resistance to quinolones. The MIC with microbroth dilution technique was 512 μg/ml for norfloxacin, 256 μg/ml for ofloxacin and ciprofloxacin and 64μg/ml for levofloxacin.  This strain was found to harbour the quinolone resistance determinant  qnrD.  In addition, this strain harboured two new  gyrB  mutations (S463A, S464Y) and one  parC  mutation (S80I).    Conclusions  This is the first report in Tunisia of  qnrD  determinant and tow new  gyrB  muations in  M. morganii . The nosocomial infection due to this  proteeae  invites further study of its epidemiologic evolution.

Type II and type IV topoisomerase mutations in clinical isolates of Morganella morganii harbouring the qnrD gene