Three simple and cost-effective assays for AAC(6′)-Ib-cr enzyme activity

The enzyme AAC(6′)-Ib-cr belongs to plasmid-mediated quinolone resistance (PMQR), first reported in 2006 and now widely disseminating. Here, we developed three phenotypic methods to detect AAC(6′)-Ib-cr enzyme-producing Enterobacteriaceae (APE), two of which are proposed innovatively in this researc...

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Main Authors: Shizhou Liang, Wenpin Cai, Ruiben Mao, Mengquan Chen, Xianning Dai, Xiaoli Jin, Wanzhong Kong
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Microbiology
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Online Access:https://www.frontiersin.org/articles/10.3389/fmicb.2025.1513425/full
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author Shizhou Liang
Wenpin Cai
Wenpin Cai
Ruiben Mao
Mengquan Chen
Xianning Dai
Xiaoli Jin
Wanzhong Kong
author_facet Shizhou Liang
Wenpin Cai
Wenpin Cai
Ruiben Mao
Mengquan Chen
Xianning Dai
Xiaoli Jin
Wanzhong Kong
author_sort Shizhou Liang
collection DOAJ
description The enzyme AAC(6′)-Ib-cr belongs to plasmid-mediated quinolone resistance (PMQR), first reported in 2006 and now widely disseminating. Here, we developed three phenotypic methods to detect AAC(6′)-Ib-cr enzyme-producing Enterobacteriaceae (APE), two of which are proposed innovatively in this research. These tests are based on the following principles: (i) Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF MS) can measure the mass shift of 42 Da resulting from ciprofloxacin acetylation by the AAC(6′)-Ib-cr enzyme. (ii) Co-incubation of ciprofloxacin disks with APE results in inactivation of the drug activity, making it unable to inhibit the growth of the indicator organism. We named this test the quinolone inactivation method (QIM). (iii) Based on the principles of the modified Hodge test, we designed the quinolone Hodge test (QHT). Through exploration of optimal conditions for three methods, we found that MALDI-TOF MS provides the most intuitive results after 1 h of incubation. The interpretability of the QIM and QHT results was significantly improved when the indicator organism E. coli ATCC25922 was replaced with a quinolone-slightly-resistant isolate. However, Proteus mirabilis was excluded from both QIM and QHT due to its swarming motility. Next, a validation study was conducted using a prospectively collected set of 187 clinical strains, demonstrating 100% specificity (MSM: 141/141; QIM, QHT: 135/135) and 100% sensitivity (MSM: 46/46; QIM, QHT: 33/33) compared to the genotype. In a word, this study presented three simple, efficient, and cost-effective methods for detecting APE, suitable for clinical microbiology laboratories under various conditions for the prevention and control of hospital infections.
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spelling doaj-art-0786b8b4fd3f463ab60ffd17e6fb79f12025-08-20T02:18:28ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2025-04-011610.3389/fmicb.2025.15134251513425Three simple and cost-effective assays for AAC(6′)-Ib-cr enzyme activityShizhou Liang0Wenpin Cai1Wenpin Cai2Ruiben Mao3Mengquan Chen4Xianning Dai5Xiaoli Jin6Wanzhong Kong7Department of Clinical Laboratory, Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, Zhejiang, ChinaDepartment of Clinical Laboratory, Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, Zhejiang, ChinaDepartment of TCM Science and Research Center, Wenzhou, Zhejiang, ChinaDepartment of Clinical Laboratory, Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, Zhejiang, ChinaDepartment of Clinical Laboratory, Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, Zhejiang, ChinaDepartment of Clinical Laboratory, Wenzhou People’s Hospital, Wenzhou Women and Children’s Hospital, Wenzhou, Zhejiang, ChinaDepartment of Clinical Laboratory, Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, Zhejiang, ChinaDepartment of Clinical Laboratory, Wenzhou TCM Hospital of Zhejiang Chinese Medical University, Wenzhou, Zhejiang, ChinaThe enzyme AAC(6′)-Ib-cr belongs to plasmid-mediated quinolone resistance (PMQR), first reported in 2006 and now widely disseminating. Here, we developed three phenotypic methods to detect AAC(6′)-Ib-cr enzyme-producing Enterobacteriaceae (APE), two of which are proposed innovatively in this research. These tests are based on the following principles: (i) Matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF MS) can measure the mass shift of 42 Da resulting from ciprofloxacin acetylation by the AAC(6′)-Ib-cr enzyme. (ii) Co-incubation of ciprofloxacin disks with APE results in inactivation of the drug activity, making it unable to inhibit the growth of the indicator organism. We named this test the quinolone inactivation method (QIM). (iii) Based on the principles of the modified Hodge test, we designed the quinolone Hodge test (QHT). Through exploration of optimal conditions for three methods, we found that MALDI-TOF MS provides the most intuitive results after 1 h of incubation. The interpretability of the QIM and QHT results was significantly improved when the indicator organism E. coli ATCC25922 was replaced with a quinolone-slightly-resistant isolate. However, Proteus mirabilis was excluded from both QIM and QHT due to its swarming motility. Next, a validation study was conducted using a prospectively collected set of 187 clinical strains, demonstrating 100% specificity (MSM: 141/141; QIM, QHT: 135/135) and 100% sensitivity (MSM: 46/46; QIM, QHT: 33/33) compared to the genotype. In a word, this study presented three simple, efficient, and cost-effective methods for detecting APE, suitable for clinical microbiology laboratories under various conditions for the prevention and control of hospital infections.https://www.frontiersin.org/articles/10.3389/fmicb.2025.1513425/fullAAC(6′)-Ib-crPMQRquinoloneantimicrobial resistanceEnterobacteriaceae
spellingShingle Shizhou Liang
Wenpin Cai
Wenpin Cai
Ruiben Mao
Mengquan Chen
Xianning Dai
Xiaoli Jin
Wanzhong Kong
Three simple and cost-effective assays for AAC(6′)-Ib-cr enzyme activity
Frontiers in Microbiology
AAC(6′)-Ib-cr
PMQR
quinolone
antimicrobial resistance
Enterobacteriaceae
title Three simple and cost-effective assays for AAC(6′)-Ib-cr enzyme activity
title_full Three simple and cost-effective assays for AAC(6′)-Ib-cr enzyme activity
title_fullStr Three simple and cost-effective assays for AAC(6′)-Ib-cr enzyme activity
title_full_unstemmed Three simple and cost-effective assays for AAC(6′)-Ib-cr enzyme activity
title_short Three simple and cost-effective assays for AAC(6′)-Ib-cr enzyme activity
title_sort three simple and cost effective assays for aac 6 ib cr enzyme activity
topic AAC(6′)-Ib-cr
PMQR
quinolone
antimicrobial resistance
Enterobacteriaceae
url https://www.frontiersin.org/articles/10.3389/fmicb.2025.1513425/full
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