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Epidemiology of qnrVC alleles and emergence out of the Vibrionaceae family.

The quinolones are antibiotics effective in the treatment of several current nosocomial infections. Bacteria carrying qnr genes present with decreased susceptibility to fluoroquinolones. In addition to this low-level resistance, qnr genes are associated with reduced bactericidal activity of ciprofloxacin in vitro and in vivo, which represents a therapeutic threat (Allou et al., 2009). Moreover, in association with mutations in gyrA/parC and with efflux pump regulatory systems, a full fluoroquinolone resistance phenotype can easily emerge, resulting in treatment failure (Rodrı́guezMartı́nez et al., 2011). Recently, due to increasing reports of qnrVC alleles in different genetic contexts, these genes were classified within a new transferable qnr family (Pons et al., 2013). Here, using in silico analysis, we show that qnrVC has already emerged worldwide out of the Vibrionaceae family in bacterial species of public health relevance, and in association with mobile genetic elements.