Investigation of antibiotic resistance patterns of Escherichia coli isolates isolated from cases of urinary tract infections in children in Isfahan city in 2018
Subject Areas : microbiologyfatemeh Khodaverdipour 1 , parisa karimi 2 , نازیلا ارباب سلیمانی 3 *
1 - 1- Research Center of Nutrition and Organic Products (R.C.N.O.P), Islamic Azad University, Shahrekord Branch,Shahrekord ,Iran.
2 - 1- Master's degree in microbiology, Faculty of Basic Sciences, Islamic Azad University, Shahrekord Branch, Shahrekord, Iran.
3 - 3- Department of Microbiology, Faculty of Basic Sciences, Islamic Azad University, Damghan Branch, Damghan,Iran.
Keywords: Urinary tract infection, antibiotic resistance, Escherichia coli.,
Abstract :
Urinary tract infections (UTIs) are one of the most common bacterial infections in children, the most common cause of which is Escherichia coli. Considering the growth of antibiotic resistance in pathogen strains, investigation and identification of resistance and virulence genes of Escherichia coli is of particular importance. This study was conducted with the aim of determining the molecular characteristics and patterns of virulence and antibiotic resistance genes in Escherichia coli isolates isolated from children with urinary tract infections in Isfahan city. In this research, among 100 urine samples collected from children with urinary tract infection and after bacterial culture and confirmation of Escherichia coli species using microbial culture and PCR methods, virulence genes including fimH, hlyA, cnf1 and other virulence and resistance genes were examined. Antibiotic was done by multiple PCR method. From a total of 56 Escherichia coli isolates, the fimH gene was detected in 100% of the isolates, which indicates its key role in the infection process. The toxin-producing genes hlyA and cnf1 were observed in 85.7% of the samples, respectively. In addition, the studies showed that the distribution of virulence genes and the pattern of antibiotic resistance are significantly related to the severity of infection and the clinical condition of children with urinary tract infection. In particular, isolates carrying the hlyA and cnf1 toxin-producing genes caused more severe and prolonged infections that required more therapeutic care. Also, the antibiotic resistance results showed that these isolates are highly resistant to beta-lactam drugs and some other common antibiotics.
1. Griebling TL.2005. Urologic diseases in America project: trends in resource use for urinary tract infections in women. Urology J.173(4):1281-7.
2. Ejrnæs K.2011. Bacterial characteristics of importance for recurrent urinary tract infections caused by Escherichia coli. Dan Med Bull. 58(4):B4187.
3. Bader MS, Hawboldt J, Brooks A.2010. Management of complicated urinary tract infections in the era of antimicrobial resistance. Postgraduate medicine.122(6):7-15
4. Mittal S, Sharma M, Chaudhary U.2010. Study of virulence factors of uropathogenic Escherichia coli and its antibiotic susceptibility pattern. Indian Journal of Pathology and Microbiology. 57(1):61.
5. Marhova M, Kostadinova S, Stoitsova S.2009. Antimicrobial resistance profiles of urinary Escherichia coli isolates. Biotechnology & Biotechnological Equipment. 23(sup1):616-20.
6. Wagenlehner FM, Naber KG, Weidner W.2008. Rational antibiotic therapy of urinary tract infections. Med Monatsschr Pharm. 31(10):385-390.
7. Sanchez U M, Bello T H, Dominguez Y M, Mella M S, Zemelman Z R, Gonzalez RG.2006. Transference of extendedspectrum beta-lactamases from nosocomial strains of Klebsiella pneumoniae to other species of Enterobacteriaceae. Rev Med Chil. 134(4):415-420.
8. Hickerson AD, Carson CC. The treatment of urinary tract infections and use of ciprofloxacin extended release. Expert opinion on investigational drugs. 2006 May 1;15(5):519-32.
9. Johnson JR, Russo TA.2005. Molecular epidemiology of extraintestinal pathogenic (uropathogenic) Escherichia coli. International journal of medical microbiology. 295(6-7):383-404
10. Haghgoo SM, Varshochi M, Sabour S, Askari E, et al. 2014.The Prevalence and Antibiotic Susceptibility Pattern of Isolated Microorganisms from Hospitalized Patients with Heart Diseases. J Isfahan Med Sch . 260-68. [Persian]
11. Zhanel GG, Karlowsky JA, Harding GKM. 2010. A Canadian national surveillance study of urinary tract isolates from outpatients: comparison of the activities of trimethoprim sulfamethoxazole, ampicillin, mecillinam, nitrofurantoin, and ciprofloxacin. Antimicrob Agents Chemother 2000; 44(4): 1089-92.
12. Croxen MA, Finlay BB. 2010. Molecular mechanisms of Escherichia coli pathogenicity. Nature Reviews Microbiology. (8): 26-38.
13. Akhi MT, Toloue Ostadgavahi A, Ghotaslou R, Asgharzadeh M, Pirzadeh T. 2015. Virulence Gene Assessment and Antibiotic Resistance Pattern of O157 Enterohemorrhagic Escherichia coli in Tabriz, Iran. Jundishapur Journal of Microbiology.8(11): e25317.
14. Pan H, Zhang J, Kuang D, Yang X, Ju W, Huang Z, et al.2015. Molecular analysis and antimicrobial susceptibility of enterotoxigenic Escherichia coli from diarrheal patients. Diagnostic microbiology and infectious disease.81(2):126-31.
15. Brandon AN, Hill DR.1983. Selected list of Books and Journals for the small medical library. Bulletin of the Medical Library Association. 71(2):147.
16. Nazemi A, Naderi M, Jafarpour M, Mirinargesi M, Sharifi S.2014. The Detection of Fimbrial Pathogenic Genes in E. coli Strains Isolated from Patients with Urinary Tract Infection. Med Lab J.4(2): 31.
17. Arabi SH,Tohidi F, Naderi S, Nazemi A, Jafarpour M, Naghshbandi R.2012. The common fimbaria genotypeing inuropathogenic Escherichia coli:Annals Biologi Res.3(10): 4951-54.
18. Karimian A, Momtaz H, Madani M.2012. Detection of uropathogenic Escherichia coli virulence factors in patients with urinary tract infections in Iran. Afr J Microbiol Res.6(39): 6811-6.
19. Bahalo S, Tajbakhsh E, Tajbakhsh S, Momeni M, Tajbakhsh F.2013. Detection of some virulence factors of Escherichia coli isolated from urinary tract infection isolated of children in Shahrekord Iran by multiplex PCR. Middle East J Sci Res.14(1): 29-32.
20. Jalali HR, Pourbakhsh A, Fallah F, Eslami G.2015. Genotyping of Virulence Factors of Uropathogenic Escherichia coli by PCR. Novel Biomed. 3(4): 177-81.
21. Hojati Z, Zamanzad B, Hashemzadeh M, Molaie R, Gholipour A. 2015. The FimH gene in uropathogenic Escherichia coli strains isolated from patients with urinary tract infection. Jundishapur J Microbiol.8(2): e17520
22. Momtaz H, Karimian A, Madani M, Safarpoor Dehkordi F, Ranjbar R, Sarshar M, et al.2013. Uropathogenic Escherichia coli in Iran: serogroup distributions, virulence factors and antimicrobial resistance properties. Ann Clin Microbiol Antimicrob.12: 8.
23. Derakhshandeh A, Firouzi R, Motamedifar M, Motamedi Boroojeni A, Bahadori M, Arabshahi S, et al.2015. Distribution of virulence genes and multiple drug-resistant patterns amongst different phylogenetic groups of uropathogenic Escherichia coli isolated from patients with urinary tract infection. Lett Appl Microbiol.60(2): 148-54.
24. Asadi S, Kargar M, Solhjoo K, Najafi A, Ghorbani-Dalini S.2014. The association of virulence determinants of uropathogenic Escherichia coli with antibiotic resistance. Jundishapur J Microbiol. 7(5): e9936.
25. Johnson JR, Stell AL.2000. Extended virulence genotypes of Escherichia coli strains from patients with urosepsis in relation to phylogeny and host compromise. J Infect Dis.181(1): 261-72.
26. Robino L, Scavone P, Araujo L, Algorta G, Zunino P, Pirez MC, et al.2014. Intracellular bacteria in the pathogenesis of Escherichia coli urinary tract infection in children. Clin Infect Dis.59(11): e158-64.
27. Tiba MR, Yano T, Leite Dda S.2008. Genotypic characterization of virulence factors in Escherichia coli strains from patients with cystitis. Rev Inst Med Trop Sao Paulo.50(5): 255-60.
28. Tramuta C, Nucera D, Robino P, Salvarani S, Nebbia P.2011. Virulence factors and genetic variability of uropathogenic Escherichia coli isolated from dogs and cats in Italy. J Vet Sci. 12(1): 49-55.