Prevalence of the Integrons and ESBL Genes in Multidrug-Resistant Strains of Escherichia coli Isolated from Urinary Tract Infections, Ardabil, Iran

Barzegar, Soheyla; Arzanlou, Mohsen; Teimourpour, Amir; Esmaelizad, Majid; Yousefipour, Mehdi; MohammadShahi, Jafar; Teimourpour, Roghayeh

doi:10.30699/ijmm.16.1.56

year 16, Issue 1 (January - February 2022) Iran J Med Microbiol 2022, 16(1): 56-65 | Back to browse issues page

‎ 10.30699/ijmm.16.1.56

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Barzegar S, Arzanlou M, Teimourpour A, Esmaelizad M, Yousefipour M, MohammadShahi J et al . Prevalence of the Integrons and ESBL Genes in Multidrug-Resistant Strains of Escherichia coli Isolated from Urinary Tract Infections, Ardabil, Iran. Iran J Med Microbiol 2022; 16 (1) :56-65
URL: http://ijmm.ir/article-1-1472-en.html

Prevalence of the Integrons and ESBL Genes in Multidrug-Resistant Strains of Escherichia coli Isolated from Urinary Tract Infections, Ardabil, Iran

Soheyla Barzegar¹

, Mohsen Arzanlou¹

, Amir Teimourpour²

, Majid Esmaelizad³

, Mehdi Yousefipour⁴

, Jafar MohammadShahi⁵

, Roghayeh Teimourpour

⁶

1- Department of Microbiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil Iran
2- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
3- Central Labaratory, Razi Vaccine and Serum Research Institute, Karaj, Iran
4- Department of Infectious and Tropical Diseases, Tehran University of Medical Sciences, Tehran, Iran
5- Departments of Infectious Diseases, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
6- Department of Microbiology, School of Medicine, Ardabil University of Medical Sciences, Ardabil Iran , r.teymourpour@gmail.com

Abstract: (3264 Views)

Background and Objective: Integrons play an essential role in disseminating drug resistance genes among bacteria. The aim of this study was to determine the prevalence of integrons, and Extended-Spectrum β-Lactamase (ESBL) genes in Escherichia coli (E. coli) isolates collected from patients with urinary tract infection (UTI) referred to teaching hospitals in Ardabil, Iran.
Materials and Methods: In this descriptive, cross-sectional study (2017-2018), 163 isolates of E.coli were collected from patients with UTI. The drug susceptibility pattern of these isolates to 12 common antibiotics was investigated using the disk diffusion method based on CLSI guidelines. The prevalence of class 1, 2 ,3 integrons and ESBL genes was verified by the PCR method. Finally, the genetic variation of isolates was analyzed using the ERIC-PCR method.
Results: Of 163 isolates, 138 (84.7%) isolates were multidrug-resistance (MDR) strains. The lowest and highest antibiotic resistance was reported to nitrofurantoin and ampicillin, with a resistance rate of 1.2% and 89.6%, respectively. The incidence of class 1 and 2 integrons was obtained in 39.9% and 14.1% of the isolates, respectively. Class 3 integron was not found in any of the isolates. Based on the ERIC-PCR fingerprinting method, 4 ERIC types were detected.
Conclusion: Our study showed that E. coli isolates taken from patients mainly were MDR strain and resistant to many of the common antibiotics used to treat urinary tract infections. Using the correct dose of medication and multidrug therapy would be effective in reducing the incidence of antibiotic resistance.

Keywords: Escherichia coli, Integron, Multi-drug resistance, UTI

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Type of Study: Original Research Article | Subject: Antibiotic Resistance
Received: 2021/09/4 | Accepted: 2021/12/28 | ePublished: 2022/01/20

References

1. Robins-Browne RM, Holt KE, Ingle DJ, Hocking DM, Yang J, Tauschek M. Are Escherichia coli Pathotypes Still Relevant in the Era of Whole-Genome Sequencing? Front Cell Infect Microbiol. 2016;6:141. [DOI:10.3389/fcimb.2016.00141] [PMID] [PMCID]

2. Bono MJ, Reygaert WC. Urinary tract infection. StatPearls [Internet]: StatPearls Publishing; 2018.

3. Gillings MR. Integrons: past, present, and future. Microbiol Mol Biol Rev. 2014;78(2):257-77. [DOI:10.1128/MMBR.00056-13] [PMID] [PMCID]

4. Partridge SR, Tsafnat G, Coiera E, Iredell JR. Gene cassettes and cassette arrays in mobile resistance integrons. FEMS Microbiol Rev. 2009;33(4):757-84. [DOI:10.1111/j.1574-6976.2009.00175.x] [PMID]

5. Khoramrooz SS, Sharifi A, Yazdanpanah M, Malek Hosseini SA, Emaneini M, Gharibpour F, et al. High Frequency of Class 1 Integrons in Escherichia coli Isolated From Patients With Urinary Tract Infections in Yasuj, Iran. Iran Red Crescent Med J. 2016;18(1):e26399. [DOI:10.5812/ircmj.26399] [PMID] [PMCID]

6. Mahon CR, Lehman DC, Manuselis G. Textbook of diagnostic microbiology-e-book: Elsevier Health Sciences; 2014.

7. Yousefi A, Torkan S. Uropathogenic Escherichia coli in the Urine Samples of Iranian Dogs: Antimicrobial Resistance Pattern and Distribution of Antibiotic Resistance Genes. Biomed Res Int. 2017;2017:4180490. [DOI:10.1155/2017/4180490] [PMID] [PMCID]

8. Performance Standards for Antimicrobial Susceptibility Testing Wayne, PA, USA: Clinical and Laboratory Standards Institute. 2017.

9. Davies J, Davies D. Origins and evolution of antibiotic resistance. Microbiol Mol Biol Rev. 2010;74(3):417-33. [DOI:10.1128/MMBR.00016-10] [PMID] [PMCID]

10. Sambrook J, Fritsch EF, Maniatis T. Molecular cloning: a laboratory manual: Cold spring harbor laboratory press; 1989.

11. Kargar M, Mohammadalipour Z, Doosti A, Lorzadeh S, Japoni-Nejad A. High prevalence of class 1 to 3 integrons among multidrug-resistant diarrheagenic Escherichia coli in southwest of Iran. Osong Public Health Res Persp. 2014;5(4):193-8. [DOI:10.1016/j.phrp.2014.06.003] [PMID] [PMCID]

12. Wayne P. Clinical and laboratory standards institute. Performance standards for antimicrobial susceptibility testing. 2011.

13. El-Hady SA, Adel LA. Occurrence and detection of AmpC β-lactamases among Enterobacteriaceae isolates from patients at Ain Shams University Hospital. Egypt J Med Hum Gen. 2015;16(3):239-44. [DOI:10.1016/j.ejmhg.2015.03.001]

14. Ranjbar R, Ghazi FM. Antibiotic sensitivity patterns and molecular typing of Shigella sonnei strains using ERIC-PCR. Iran J Public Health. 2013;42(10):1151.

15. Mandal J, Sangeetha V, Nivedithadivya, Das A, Parija SC. Characterization of extended-spectrum beta-lactamase-producing clinical isolates of Shigella flexneri. J Health Popul Nutr. 2013;31(3):405-8. [DOI:10.3329/jhpn.v31i3.16834] [PMID] [PMCID]

16. Stamm WE, Norrby SR. Urinary tract infections: disease panorama and challenges. J Infect Dis. 2001;183 Suppl 1(Supplement_1):S1-4. [DOI:10.1086/318850] [PMID]

17. Bimanand L, Pakzad I, Sayehmiri K, Yasemi M, Sayehmiri F, Peyman H, et al. Prevalence of Urinary Tract Infection and Associated Microorganisms in Iran; A meta-Analysis Study. Res J Pharm Biol Chem Sci. 2017;8(1):1255-62.

18. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13(5):269-84. [DOI:10.1038/nrmicro3432] [PMID] [PMCID]

19. UTI C-a. CA-UTI. Curr Opinion Infect Dis. 2010;23:76-82.

20. Chenoweth CE, Gould CV, Saint S. Diagnosis, management, and prevention of catheter-associated urinary tract infections. Infect Dis Clin North Am. 2014;28(1):105-19. [DOI:10.1016/j.idc.2013.09.002] [PMID]

21. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG, et al. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance. Clin Microbiol Infect. 2012;18(3):268-81. [DOI:10.1111/j.1469-0691.2011.03570.x] [PMID]

22. Hadifar S, Moghoofei M, Nematollahi S, Ramazanzadeh R, Sedighi M, Salehi-Abargouei A, et al. Epidemiology of multi drug resistant uropathogenic Escherichia coli in Iran: a systematic review and meta-analysis. Jpn J Infect Dis. 2016:JJID. 2015.652.

23. Bryce A, Hay AD, Lane IF, Thornton HV, Wootton M, Costelloe C. Global prevalence of antibiotic resistance in paediatric urinary tract infections caused by Escherichia coli and association with routine use of antibiotics in primary care: systematic review and meta-analysis. bmj. 2016;352:i939. [DOI:10.1136/bmj.i939] [PMID] [PMCID]

24. Allocati N, Masulli M, Alexeyev MF, Di Ilio C. Escherichia coli in Europe: an overview. Int J Environ Res Public Health. 2013;10(12):6235-54. [DOI:10.3390/ijerph10126235] [PMID] [PMCID]

25. Rezaee MA, Sheikhalizadeh V, Hasani A. Detection of integrons among multi-drug resistant (MDR) Escherichia coli strains isolated from clinical specimens in northern west of Iran. Braz J Microbiol. 2011;42(4):1308-13. [DOI:10.1590/S1517-83822011000400010] [PMID] [PMCID]

26. Masoumian N, Haghi F. Analysis of integrons and associated gene cassettes in clinical isolates of Escherichia coli. J Zanjan Univ Med Sci. 2015;23(99):74-82.

27. Shams F, Hasani A, Rezaee MA, Nahaie MR, Hasani A, Haghi MHSB, et al. Carriage of class 1 and 2 integrons in quinolone, extended-spectrum-β-lactamase-producing and multi drug resistant E. coli and K. pneumoniae: High burden of antibiotic resistance. Adv Pharm Bull. 2015;5(3):335. [DOI:10.15171/apb.2015.047] [PMID] [PMCID]

28. Alizade H. Escherichia coli in Iran: An Overview of Antibiotic Resistance: A Review Article. Iran J Public Health. 2018;47(1):1-12.

29. Pormohammad A, Pouriran R, Azimi H, Goudarzi M. Prevalence of integron classes in Gram-negative clinical isolated bacteria in Iran: a systematic review and meta-analysis. Iran J Basic Med Sci. 2019;22(2):118-27.

30. Paterson DL, Bonomo RA. Extended-spectrum beta-lactamases: a clinical update. Clin Microbiol Rev. 2005;18(4):657-86. [DOI:10.1128/CMR.18.4.657-686.2005] [PMID] [PMCID]

31. Moghanni M, Ghazvini K, Farsiani H, Namaei MH, Derakhshan M, Yousefi M, et al. High prevalence of sequence type 131 isolates producing CTX-M-15 among extended-spectrum β-lactamase-producing Escherichia coli strains in northeast Iran. J Glob Antimicrob Resist. 2018;15:74-8. [DOI:10.1016/j.jgar.2018.05.016] [PMID]

32. Ghaderi RS, Yaghoubi A, Amirfakhrian R, Hashemy SI, Ghazvini K. The prevalence of genes encoding ESBL among clinical isolates of Escherichia coli in Iran: A systematic review and meta-analysis. Gene Rep. 2020;18:100562. [DOI:10.1016/j.genrep.2019.100562]

33. Pana ZD, Zaoutis T. Treatment of extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBLs) infections: what have we learned until now? F1000Res. 2018;7. [DOI:10.12688/f1000research.14822.1] [PMID] [PMCID]

34. Dalla-Costa LM, Irino K, Rodrigues J, Rivera IN, Trabulsi LR. Characterisation of diarrhoeagenic Escherichia coli clones by ribotyping and ERIC-PCR. J Med Microbiol. 1998;47(3):227-34. [DOI:10.1099/00222615-47-3-227] [PMID]

35. Ying C, Li Y, Wang Y, Zheng B, Yang C. Investigation of the molecular epidemiology of Acinetobacter baumannii isolated from patients and environmental contamination. J Antibiot (Tokyo). 2015;68(9):562-7. [DOI:10.1038/ja.2015.30] [PMID]

36. Torres LE, Melian K, Moreno A, Alonso J, Sabatier CA, Hernandez M, et al. Prevalence of vacA, cagA and babA2 genes in Cuban Helicobacter pylori isolates. World J Gastroenterol. 2009;15(2):204-10. [DOI:10.3748/wjg.15.204] [PMID] [PMCID]