Prevalence of class 1 and 2 integrons in uropathogenic Escherishia coli isolates from diabetic patients in Kermanshah, Iran
محورهای موضوعی : میکروبیولوژی
رسول پژوهش
1
,
فاطمه خداوردی پور
2
,
حسین آقاجانی دزکی
3
1 - گروه میکروبیولوژی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران
2 - گروه میکروبیولوژی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران
3 - گروه میکروبیولوژی، واحد شهرکرد، دانشگاه آزاد اسلامی، شهرکرد، ایران
کلید واژه: Escherishia coli, Integrons, Multi Drug Resistance, Urinary Tract Infection,
چکیده مقاله :
Escherichia coli is one of the most predominant pathogens causing 80-90% of community acquired UTIs and 30-50% of nosocomial acquired UTIs. Multi drug resistance isolates encoded by linked resistance genes occurs on integrons.
In this cross sectional study, a total number of 90 E. coli isolates were obtained from urine samples of diabetic patients in Kermanshah, Iran, during a six-month period (October to March, 2015). Urine samples were tested by standard bacteriological methods and antibiotic susceptibility tests were done for all isolates by Kirby Bauer agar disk diffusion. Detection of class 1 and class 2 integrons were performed by PCR in MDR isolates.
The most common resistant phenotypes were found to be Cefalothin (88.88%), Nalidixic acid (83.33%), Co-trimoxazole (70%), Ciprofloxacin (58.88%), tetracycline (56.66%), Norfloxacin (55.55%), Ceftazidim (40%), Gentamycine(32.23%), Choloramphenicol (26.66%), Nitrofurantion (21.11%), Amikacin (17.77%) and Imipenem (2.22%). In this study, a total of 90 isolates in 76 samples were reported MDR. Class I integron was found in16 isolates (21.05%) and class 2 integron was found in 8 isolates (10.52%). No strain was found to contain both class 1 and 2 integrons. In this study,
There was a significant relationship between the presence of the intI1 gene and resistance to Norfloxacin and Cephalotin. This indicated that the antibiotic resistance genes were located within the integron.
Escherichia coli is one of the most predominant pathogens causing 80-90% of community acquired UTIs and 30-50% of nosocomial acquired UTIs. Multi drug resistance isolates encoded by linked resistance genes occurs on integrons.
In this cross sectional study, a total number of 90 E. coli isolates were obtained from urine samples of diabetic patients in Kermanshah, Iran, during a six-month period (October to March, 2015). Urine samples were tested by standard bacteriological methods and antibiotic susceptibility tests were done for all isolates by Kirby Bauer agar disk diffusion. Detection of class 1 and class 2 integrons were performed by PCR in MDR isolates.
The most common resistant phenotypes were found to be Cefalothin (88.88%), Nalidixic acid (83.33%), Co-trimoxazole (70%), Ciprofloxacin (58.88%), tetracycline (56.66%), Norfloxacin (55.55%), Ceftazidim (40%), Gentamycine(32.23%), Choloramphenicol (26.66%), Nitrofurantion (21.11%), Amikacin (17.77%) and Imipenem (2.22%). In this study, a total of 90 isolates in 76 samples were reported MDR. Class I integron was found in16 isolates (21.05%) and class 2 integron was found in 8 isolates (10.52%). No strain was found to contain both class 1 and 2 integrons. In this study,
There was a significant relationship between the presence of the intI1 gene and resistance to Norfloxacin and Cephalotin. This indicated that the antibiotic resistance genes were located within the integron
1- Aarati N, Rao M, Barlow L.A, Boring J.R, Tenover FC, McGowan JE. Class 1 integrons in resistant Escherichia coli and Klebsiellaspp., US Hospitals. Emerg. Infect Dis. 2006; 12 (6):1011-1014.
2- Ahangarzadeh Rezaee M, Sheikhalizadeh V, Hasani A. Detection of Integrons among Multi-drug resistant (MDR) Escherichia coli strains isolated from clinical specimens in Northren West of Iran. Braz. J Microbiol. 2011; 42: 1308-1313.
3- Ahangarzadeh Rezaee M, Langarizadeh N, Aghazadeh M. First report of class 1 and class 2 integrons in multidrug-resistant Klebsiella pneumoniae isolates from Northwest Iran. Jpn. J Infect Dis. 2012; 65: 256-259.
4- Arakawa YM, Murakami K, Suzuki H, Ito R, Wacharotayankun S, Ohsuka N, Ohta M. A novel integrons like element carrying the metallobetalactamase gene bla IMP. Antimicrob Agents Chemothe. 1995; 39: 1612-1615.
5- Bonnet R. Growing group of extended-spectrum a-lactamases: The CTX-M enzymes. Antimicrob Agents Chemother. 2004; 48:1-14.
6- Boucher Y, Labbate M, Koenig JE, Stokes HW. Integrons: mobilizable platforms that promote genetic diversity in bacteria. Trends Microbiol. 2007; 15: 301-309.
7- Clinical and Laboratory Standards Institute, Performance standards for antimicrobial susceptibility testing, CLSI document M100-S15, Clinical and Laboratory Standards Institute, Wayne, Pa, USA, 15th International supplement. 2005.
8- Collis CM, Kim MJ, Partridge SR, Stokes HW, Hall RM. Characterization of the class 3 integron and the site-specific recombination system it determines. J Bacteriol. 2002; 184: 3017-3026.
9- Daoud Z, Afif C. Escherichia coli Isolated from Urinary Tract Infections of Lebanese Patients between 2000 and 2009: Epidemiology and Profiles of Resistance. Chemother Res Practice. 2011; 1-6.
10- Dromigny JA, Nabeth P, Juergens-Behr A, Perrier-Gros-Claude JD. Risk factors for antibiotic-resistant Escherichia coli isolated from community-acquired urinary tract infections in Dakar, Senegal. J Antimicrob Chemother. 2005; 56: 236-239.
11- Falakian Z, Nikokar I, Nafisi M, Karimi A, Validi M. Frequency of Class 1 Integrons among Escherichia coli Isolates of Patients with Urinary Tract Infection. Iran. J Clin Infect Dis. 2011; 6 (4): 157-160.
12- Franklin GA, Moore KB, Snyder JW, Polk JC, Cheadle WG. Emergence of resistant microbes in critical care units in transient, despite an unrestricted formulary and multiple antibiotic trials. Surge Infect. 2002; 3(2): 135-144.
13- Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Dis Mon. 2003; 49(2):53–70.
14- Gündoğdu A, Long YB, Vollmerhausen TL, Katouli M. Antimicrobial resistance and distribution of sul genes and integron-associated intI genes among uropathogenic Escherichia coli in Queensland, Australia. J. Med. Microbiol., 2011; 60: 1633–1642.
15- Hak SunYu, Lee JC, Young Kang H, Ro DW, Young Chung J, Sook Jeong Y, Tae SH, Choi CH, Lee EY. Changes in gene cassettes of class 1 integrons among Escherichia coli isolates from urine specimens collected in Korea during the last two decades. J Clin Microbiol. 2004; 41(12): 5429-5433.
16- Hall RM, Collis CM, Kim MJ, Partridge SR, Recchia GD, Stokes HW. Mobile gene cassettes and integrons in evolution. Ann NY. Acad Sci. 1999; 870: 68-80.
17- Hall RM, Stokes HW. Integrons: novel DNA elements which capture genes by site-specific recombination. Genetica. 1993; 90:115-32.
18- Hamada TA, Mahmood AR, Ahmed IA. Antibiotic resistance in pathogenic bacteria isolated from UTIs in Tikrit province. Tikrit Med J. 2008; 14(1):203-10.
19- Hansson K, Sundstrom L, Pelletier A, Roy PH. IntI2 integron integrase in Tn7. J. Bacteriol. 2002; 184: 1712-21.
20- Ho P, King-Sun Y, Kin-Hung C, Janice YC, Tak-Lun Q, Kwok-yung Y. Antimicrobial resistance among uropathogens that cause acute uncomplicated cystitis in women in Hong Kong: a prospective multicenter study in 2006 to 2008. Diag. Microbiol Inf Dis. 2010:66: 87-93. [In Persian]
21- Islami G, Seyed Javadi S, Gudarzi H, Falah F, Gudarzi F. Prevalence of integron in multidrug resistant Escherichia coli and Klebsiella isolated from children with urinary tract infection . 2010; 34 (1): 61-65.
22- Khadri HC, Surekha S, Lakshmi S, Narasimha, G. Multi drug resistance and b-lactamase production by Klebsiella pneumoniae. Afr J Biotechnol. 2006; 12 (6):1791–93.
23- Ko WC, Paterson DL, Sagnimeni AJ, Hansen DS, Gottberg AV, Mohapatra S, Casellas JM, Goossens H, Mulazimoglu L, Trenholme G, Klugman KP, McCormack JG, Yu VL. Community-Acquired Klebsiella pneumonia bacteremia: Global differences in clinical patterns. Emerg Infect Dis. 2002; 8 (2): 160-5.
24- Langari Zadeh N, Ahangarzade Rezaei M, Hassani A. Comparsion with the prevalence of multi-drug resistant Klebsiella pneumonia in children and adults with UTI referring to Tabriz health centers. J Biologic Sci Univ Zanjan. 2011; 4(1): 1-9. [In Persian]
25- Leverstein-van H, Paauw MA, Box A, Blok ATA, Verhoef HE. MM Fluit J. Presence of integron-associated resistance in the community is widespread and contributes to multi-drug resistance in the hospital. J Clin Microbiol. 2002; 40 (8): 3038-3040.
26- Liebert, CA, Hall RM, Summers AO. Transposon Tn21, flagship of the floating genome. Microbiol Mol Biol Rev. 1999; 63: 507-522.
27- Livermore, D.M. Lactamases in laboratory and clinical resistance. Clin. Microbiol. Rev., 1995; 8: 557-584.
28- Martinez-Freijo P, Fluit AC, Schmitz FJ, Verhoef J, Jones ME. Many classes I integrons comprise distinct stable structures occurring in different species of Enterobacteriaceae isolated from widespread geographic regions in Europe. Antimicrob Agents. Chemother. 1999; 43 (3): 686-89.
29- Momtaz H, Karimian A, Madani M, Safarpoor Dehkordi F, Ranjbar R, Sarshar M, Souod N. Uropathogenic Escherichia coli in Iran: Serogroup distributions, virulence factors and antimicrobial resistance properties. ACMA. 2013; 12: 8.
30- Muhammad I, Uzma M, Yasmin B, Mehmood Q, Habib B. Prevalence of Antimicrobial Resistance and Integrons in Escherichia coli from Punjab, Pakistan. Braz J .Microbiol. 2011; 42: 462-466.
31- Ragnar Norrby S. Integrons: Adding Another Threat to the Use of Antibiotic Therapy. Clin Infect Dis. 2005; 41 (1): 10-11.
32- Rao AN, Barlow M, Ann Clark L, Boring JR, Tenover FC, McGowan JE. Class 1 Integrons in Resistant Escherichia coli and Klebsiellaspp., US Hospitals. Emerging. Infect Dis. 2006; 12 (6): 1011-16.
33- Salem MM, Muharram M, Ibrahim M. Alhosiny Distribution of Classes 1 and 2 Integrons among Multi Drug Resistant E. coli Isolated from Hospitalized Patients with Urinary Tract Infection in Cairo, Egypt. Aust J Basic Applied Sci. 2010; 4(3): 398-407.
34- Saraylu, J, Mehrabadi JF, ImaniFooladi AA, Sabbaghi A, MollaAghamirzaei H, Hasankhani M. Prevalence and evaluation of toxin genes among uropathogenic Escherichia coli clinical isolates by duplex PCR. J Med Bacteriol. 2012; 1 (1): 17-22.
35- Schroll, C., Barken, K.B., Krogfel, K.A., Struve, C. Role of type 1 and type 3 fimbriae in Klebsiella pneumonia biofilm formation. BMC Microbiol. 2010; 10(79): 1-10.
36- Soltan Dalal MM, Miretemadi A, Sharif Yazdi MK, Rastegar Lari AA. Determine the antibiotic resistance of Klebsiella species isolated from patients hospitalized in Imam Khomeini Hospital. J Tehran Univ Med. Sci. 2011; 8 (4): 275-281.
37- Taslima TL, Sabita RR, Donald JG. Multiple antibiotic resistance mediated by plasmids and integrons in uropathogenic Escherichia coli and Klebsiella pneumoniae. Bangl. J Microbiol. 2007; 24: 19–23.
38- Van Essen-Zandbergen A, Smith, H., Veldman, K., Mevius D. Occurrence and characteristics of class 1, 2 and 3 integrons in Escherichia coli, Salmonella and Campylobacter spp. in the Netherlands. J Antimicrob Chemother. 2007; 59 (4): 746-750
