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da Silva CR, Cabral VPDF, Rodrigues DS, Ferreira TL, Barbosa AD, de Andrade Neto JB, Barbosa SA, Moreira LEA, da Costa ÉRM, de Queiroz MVF, de Lima EA, Pinheiro DRS, Nobre Júnior HV, Valente Sá LGDA. Antibiofilm activity of promethazine against ESBL-producing strains of Escherichia coli in urinary catheters. Microb Pathog 2024; 193:106769. [PMID: 38955237 DOI: 10.1016/j.micpath.2024.106769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/17/2024] [Accepted: 06/29/2024] [Indexed: 07/04/2024]
Abstract
The bacterium Escherichia coli is one of the main causes of urinary tract infections. The formation of bacterial biofilms, especially associated with the use of urinary catheters, contributes to the establishment of recurrent infections and the development of resistance to treatment. Strains of E. coli that produce extended-spectrum beta-lactamases (ESBL) have a greater ability to form biofilms. In addition, there is a lack of drugs available in the market with antibiofilm activity. Promethazine (PMZ) is an antihistamine known to have antimicrobial activity against different pathogens, including in the form of biofilms, but there are still few studies of its activity against ESBL E. coli biofilms. The aim of this study was to evaluate the antimicrobial activity of PMZ against ESBL E. coli biofilms, as well as to assess the application of this drug as a biofilm prevention agent in urinary catheters. To this end, the minimum inhibitory concentration and minimum bactericidal concentration of PMZ in ESBL E. coli strains were determined using the broth microdilution assay and tolerance level measurement. The activity of PMZ against the cell viability of the in vitro biofilm formation of ESBL E. coli was analyzed by the MTT colorimetric assay and its ability to prevent biofilm formation when impregnated in a urinary catheter was investigated by counting colony-forming units (CFU) and confirmed by scanning electron microscopy (SEM). PMZ showed bactericidal activity and significantly reduced (p < 0.05) the viability of the biofilm being formed by ESBL E. coli at concentrations of 256 and 512 μg/ml, as well as preventing the formation of biofilm on urinary catheters at concentrations starting at 512 μg/ml by reducing the number of CFUs, as also observed by SEM. Thus, PMZ is a promising candidate to prevent the formation of ESBL E. coli biofilms on abiotic surfaces.
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Affiliation(s)
- Cecília Rocha da Silva
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Vitória Pessoa de Farias Cabral
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Daniel Sampaio Rodrigues
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Thais Lima Ferreira
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Amanda Dias Barbosa
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - João Batista de Andrade Neto
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil; Christus University Center, Fortaleza, Ceará, Brazil
| | - Sarah Alves Barbosa
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Lara Elloyse Almeida Moreira
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Érica Rayanne Mota da Costa
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Elaine Aires de Lima
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | - Hélio Vitoriano Nobre Júnior
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Livia Gurgel do Amaral Valente Sá
- Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Laboratory of Bioprospection in Antimicrobial Molecules (LABIMAN), Federal University of Ceará, Fortaleza, Ceará, Brazil; Drug Research and Development Center, Federal University of Ceará, Fortaleza, Ceará, Brazil; Christus University Center, Fortaleza, Ceará, Brazil.
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Sohrabi M, Fathi J, Mohebi S, Hashemizadeh Z, Kholdi S, Hadadi M, Keshavarz K, Darvishvand Z. High prevalence of plasmid-mediated quinolone resistance in escherichia coli strains producing extended-spectrum beta-lactamases isolated from faeces and urine of pregnant women with acute cystitis. Mol Biol Rep 2024; 51:566. [PMID: 38656625 DOI: 10.1007/s11033-024-09491-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 03/27/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Escherichia coli is the most common etiological agent of urinary tract infections (UTIs). Meanwhile, plasmid-mediated quinolone resistance (PMQR) is reported in E. coli isolates producing extended-spectrum β-lactamases (ESBLs). Furthermore, the reservoirs and mechanisms of acquisition of uropathogenic Escherichia coli (UPEC) strains are poorly understood. On the other hand, UTIs are common in pregnant women and the treatment challenge is alarming. METHODS AND RESULTS In the present study, 54 pregnant women with acute cystitis were included. A total of 108 E. coli isolates, 54 isolates from UTI and 54 isolates from faeces of pregnant women (same host) were collected. In the antimicrobial susceptibility test, the highest rate of antibiotic resistance was to nalidixic acid (77%, 83/108) and the lowest rate was to imipenem (9%, 10/108). Among the isolates, 44% (48/108) were ESBLs producers. A high frequency of PMQR genes was observed in the isolates. The frequency of PMQR genes qnrS, qnrB, aac(6')-Ib-cr, and qnrA was 58% (63/108), 21% (23/108), 9% (10/108), and 4% (4/108), respectively. Meanwhile, PMQR genes were not detected in 24% (20/85) of isolates resistant to nalidixic acid and/or fluoroquinolone, indicating that other mechanisms, i.e. chromosomal mutations, are involved in resistance to quinolones, which were not detected in the present study. In ESBL-producing isolates, the frequency of PMQR genes was higher than that of non-ESBL-producing isolates (81% vs. 53%). Meanwhile, UTI and faeces isolates mainly belonged to phylogenetic group B2 (36/54, 67% and 25/54, 46%, respectively) compared to other phylogenetic groups. In addition, virulence factors and multidrug-resistant (MDR) were mainly associated with phylogenetic group B2. However, predominant clones in faeces were not found in UTIs. Rep-PCR revealed the presence of 85 clones in patients. Among the clones, 40 clones were detected only in faeces (faeces-only), 35 clones only in UTI (UTI-only) and 10 clones in both faeces and UTI (faeces-UTI). We found that out of 10 faeces-UTI clones, 5 clones were present in the host's faeces flora. CONCLUSION This study revealed a high rate of resistance to the quinolone nalidixic acid and a widespread distribution of PMQR genes in MDR E. coli strains producing ESBLs. The strains represented virulence factors and phylogenetic group B2 are closely associated with abundance in UTI and faeces. However, the predominant clones in faeces were not found in UTIs and it is possible that rep-PCR is not sufficiently discriminating clones.
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Affiliation(s)
- Maryam Sohrabi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Javad Fathi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samane Mohebi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Hashemizadeh
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
- Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Soudeh Kholdi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtab Hadadi
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kowsar Keshavarz
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Darvishvand
- Department of Bacteriology and Virology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Helmy AA, Abdel Ghafar MT, Okda HI, Abo-Elenein AM. Study of antibiotic resistance and virulence genes in Escherichia coli isolated from urinary tract infection patients in Tanta University Hospitals. J Investig Med 2023; 71:664-673. [PMID: 37148186 DOI: 10.1177/10815589231172497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This study aimed to investigate the prevalence of antibiotic resistance genes CTX-M and Qnr, as well as the virulence genes HlyA, Pap, CNF1, and Afa, in uropathogenic Escherichia coli (UPEC) isolates from the Egyptian population. In this cross-sectional study, a total of 50 E. coli isolates were collected from urine samples from patients with urinary tract infections (UTIs) admitted to Tanta University Hospital from December 2020 to November 2021. The isolates were cultured, identified, and tested for antibiotic susceptibility by the disc diffusion method. The CTX-M, Qnr (QnrA, B, and S), Pap, CNF1, HlyA, and Afa genes were detected by polymerase chain reaction in UPEC isolates. The Pap, CNF1, HlyA, and Afa genes were found to be positive in 18%, 12%, 10%, and 2% of the isolates, respectively. In addition, CTX-M and QnrS were found to be positive in 44% and 8% of the isolates, while QnrA and B were not detected. Furthermore, positive Pap, CNF1, and HlyA genes were significantly associated with both upper and lower UTIs, increased frequency, urgency, and dysuria, and complicated UTIs, as well as pyuria over 100 white blood cells per high-power field. In conclusion, the prevalence of virulence and antibiotic resistance genes varies by population. At our hospital, the Pap gene is the most prevalent virulence gene and was strongly associated with complicated UTIs, while the CTX-M and QnrS genes were the most prevalent and related to antibiotic resistance. Our findings, however, should be interpreted with caution due to the small sample size.
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Affiliation(s)
- Aya A Helmy
- Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Hanaa I Okda
- Internal Medicine and Nephrology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Amany M Abo-Elenein
- Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
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Hamwi AM, Salem-Sokhn E. High frequency and molecular characterization of ESBL-producing Enterobacteriaceae isolated from wound infections in North Lebanon. Expert Rev Anti Infect Ther 2023; 21:901-909. [PMID: 37409395 DOI: 10.1080/14787210.2023.2234082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/19/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Extended-spectrum beta-lactamases producing Enterobacteriaceae (ESBL-PE) represent a major problem in wound infections. Here, we investigated the prevalence and molecular characterization of ESBL-PE associated with wound infections in North Lebanon. RESEARCH DESIGN AND METHODS A total of 103 non-duplicated E. coli and K. pneumoniae strains isolated from 103 patients with wound infections, were collected from seven hospitals in North Lebanon. ESBL-producing isolates were detected using a double-disk synergy test. In addition, multiplex polymerase chain reaction (PCR) was used for the molecular detection of ESBLs genes. RESULTS E. coli was the predominant bacteria (77.6%), followed by K. pneumoniae (22.3%). The overall prevalence of ESBL-PE was 49%, with a significantly higher rate among females and elderly patients. K. pneumoniae was the common MDR and ESBL-producer bacteria (86.95% and 52.17%) compared to E. coli (77.5% and 47.5%). Most of the isolated ESBL producers harbored multiple resistant genes (88%), where blaCTX-M was the most predominant gene (92%), followed by blaTEM (86%), blaSHV (64%), and blaOXA genes (28%). CONCLUSIONS This is the first data on the ESBL-PE prevalence associated with wound infections in Lebanon, showing the emergence of multidrug-resistant ESBL-PE, the dominance of multiple gene producers, and the widespread dissemination of blaCTX-M and blaTEM genes.
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Affiliation(s)
- Afnan M Hamwi
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Elie Salem-Sokhn
- Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
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Mengistu DA, Alemu A, Abdukadir AA, Mohammed Husen A, Ahmed F, Mohammed B. Incidence of Urinary Tract Infection Among Patients: Systematic Review and Meta-Analysis. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231168746. [PMID: 37096884 PMCID: PMC10134187 DOI: 10.1177/00469580231168746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Abstract
Healthcare-associated infection is one of the most common and severe threats to patients' health and remains a significant challenge for healthcare providers. Among healthcare-associated infections, urinary tract infection (UTI) is one of the most common infections. This study aimed to determine the global incidence of UTI among patients. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was used to perform this systematic review and meta-analysis. The articles were searched from April 4 to August 5, 2022, from electronic databases (Scopus, PubMed, Web of Science, Google Scholar, DOAJ, and MedNar) using Boolean logic operators, MeSH terms, and keywords. The quality of the study was assessed using the JBI Critical Assessment tool. One thousand nine ninety three articles were retrieved from the electronic databases, of which 38 articles conducted on 981 221 patients were included in the current study. The study found the global pooled incidence of UTI accounted for 1.6%. Based on the subgroup analysis by survey period and WHO region, the highest incidence of UTI was reported in the African Region [3.6%] and among studies conducted between 1996 and 2001 [3.7%]. This study revealed the overall pooled incidence of UTI was 1.6%. The highest incidence of UTI (3.6%) was reported in the African region. This indicates that there is a need to implement safety measures.
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Affiliation(s)
| | - Addisu Alemu
- Haramaya University College of Health and Medical Science, Harar, Ethiopia
| | | | | | - Fila Ahmed
- Haramaya University College of Health and Medical Science, Harar, Ethiopia
| | - Baredin Mohammed
- Haramaya University College of Health and Medical Science, Harar, Ethiopia
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Qasemi A, Rahimi F, Katouli M. Clonal groups of extended-spectrum β-lactamase and biofilm producing uropathogenic Escherichia coli in Iran. Pathog Glob Health 2022; 116:485-497. [PMID: 34904540 PMCID: PMC9639551 DOI: 10.1080/20477724.2021.2011578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Pathogenicity of a bacterium is affected by the social characteristics of the population and environmental factors. The ability of biofilm formation among β-lactamase-producing uropathogenic Escherichia coli (UPEC) could facilitate the exchange of antibiotic-resistance genes, which resulted in widespread dissemination of antibacterial drug resistance. We investigated the prevalence of biofilm and β-lactamase producing UPECs among patients with urinary tract infection (UTI) in two cities with different demographics and climates in Iran. A total of 265 E. coli was isolated from patients with UTIs from two referral hospitals (n = 191) and two outpatient clinics (n = 74) in Isfahan and Zahedan, Iran. Production of curli and cellulose, and, biofilm formation was investigated using Congo red agar and microtiter plate methods, respectively. Biofilm producing (BFP) isolates (n = 107) were further characterized using rep-PCR, antimicrobial susceptibility testing and extended-spectrum β-lactamase (ESBL)/AmpC phenotypic production. Isolates were also screened for the presence of carbapenemase, ESBL and AmpC genes using multiplex PCR. High diversity was found among BFP strains in both cities, with 58% strains producing ESBL and 21% producing AmpC. ESBL (98%), AmpC (50%) and carbapenemase genes (40%) were identified in BFP strains with ESBL-positive phenotype, respectively. The prevalence of BFP strains, antibiotic resistance and β-lactamase genes in Zahedan, a low socioeconomic city with a warm climate, was significantly higher than that of Isfahan. High prevalence of biofilm and β-lactamase producing UPEC strains among strains from Zahedan suggests that socioeconomic status and environmental factors might have a role in pathogenicity of the strains.
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Affiliation(s)
- Ali Qasemi
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran
| | - Fateh Rahimi
- Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran,CONTACT Fateh Rahimi ; Department of Cell and Molecular Biology & Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Hezarjarib St., Isfahan, Iran
| | - Mohammad Katouli
- Genecology Research Center and School of Science, Technology and Education,University of the Sunshine Coast, Queensland, Australia
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Studies on Virulence and Extended-Spectrum β-Lactamase-Producing Uropathogenic Escherichia coli Isolates and Therapeutic Effect of Fosfomycin in Acute Pyelonephritis Mice. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8334153. [PMID: 35141335 PMCID: PMC8818418 DOI: 10.1155/2022/8334153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/26/2021] [Accepted: 01/11/2022] [Indexed: 02/08/2023]
Abstract
The understanding about virulence factors (VFs) and the drug resistance of uropathogenic Escherichia coli (UPEC) helps us understand the pathogenesis of urinary tract infections (UTIs) and make better decisions for clinical treatment. This study examined the correlation between the extended-spectrum β-lactamases (ESBLs) phenotype and VFs in UPEC strains. In addition, we validated the therapeutic potential of fosfomycin in acute pyelonephritis mice. From May 2017 to November 2018, 22 nonduplicate E coli. strains were isolated from UTI patients. PCR was utilized to detect the distribution of virulence genes. We also analyzed the ESBL phenotype in E coli. We further evaluated the therapeutic effect of intravenous fosfomycin treatment in the acute pyelonephritis (APN) model. All 22 UPEC strains expressed the type 1 fimbriae (FimH) gene and more than 50% (12/22) of strains produced ESBLs. The detection rates of the iron acquisition-associated genes ChuT and IutA were 77.3% (n = 17) and 50% (n = 11) and those of P fimbria papA and papC genes were 45% (n = 10) and 50% (n = 11), respectively. Though the VFs were closely related with pathologenicity, the relationship between VFs and ESBLs still needs further investigation. Furthermore, intravenous fosfomycin 800 mg/kg significantly reduced the bacterial load and the inflammatory infiltration in the bladder and kidney, maintaining the structural integrity of the kidney. Intravenous fosfomycin administration can be used for the treatment of acute pyelonephritis caused by highly pathogenic and drug-resistant UPEC strains.
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Sadeghi M, Sedigh Ebrahim-Saraie H, Mojtahedi A. Prevalence of ESBL and AmpC genes in E. coli isolates from urinary tract infections in the north of Iran. New Microbes New Infect 2022; 45:100947. [PMID: 34984104 PMCID: PMC8693013 DOI: 10.1016/j.nmni.2021.100947] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 10/02/2021] [Accepted: 11/03/2021] [Indexed: 12/26/2022] Open
Abstract
Beta-lactam resistance in Gram-negative bacteria, especially Escherichia coli, is a main clinical problem. It is often caused by the production of β-lactamases, particularly extended-spectrum β-lactamases (ESBLs) or AmpC enzymes. This study was undertaken to characterize ESBL and AmpC producers among Escherichia coli isolates from urine samples. During six months, 263 E. coli isolates were detected by standard biochemical tests. The isolates were screened for ESBL production by the double-disk synergy test using Ceftazidime (30 μg) and Cefotaxime (30 μg) disks and confirmed by combined disk diffusion test using Clavulanic acid. AmpC production was confirmed by an AmpC disk test based on filter paper disks impregnated with EDTA. The presence of genes encoding TEM, SHV, CTX-M, CIT, FOX, MOX, ACC, and EBC were detected by PCR. 263 E. coli isolates were selected for the combined disk (Ceftazidime, Cefotaxime, and Clavulanic acid) assay in the disk agar diffusion test. In the combined disk assay, among 263 isolates, 121 (46%) isolates were detected as ESBLs, and none of the isolates were AmpC producers. PCR performed on all ESBL producers and blaSHV, blaTEM, and blaCTX-M were detected in 42 (34.7%), 44 (36.4%), and 47 (38.8%) cases, respectively. Also, from 48 Isolates with zone diameters of less than or equal to 18 mm to Cefoxitin, 7 (14.6%), 4 (8.3%), and 9 (18.8%) cases contained MOX, EBC, and CIT genes, respectively. DHA, FOX, and ACC genes were not detected in any sample. Since pathogens evolve in the hospital setting, updating local data, such as this research, offers scientific evidence to improve the outcome of nosocomial infections.
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Affiliation(s)
- M. Sadeghi
- Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - H. Sedigh Ebrahim-Saraie
- Razi Clinical Research Development Unit, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - A. Mojtahedi
- Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
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Valadbeigi H, HatamiLak M, Maleki A, Kouhsari E, Sadeghifard N. Molecular characteristics, antimicrobial resistance profiles, and antibiotic resistance determinants in uropathogenic fluoroquinolone resistant-Escherichia coli isolates. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2019.100584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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FarajzadehSheikh A, Veisi H, Shahin M, Getso M, Farahani A. Frequency of quinolone resistance genes among extended-spectrum β-lactamase (ESBL)-producing Escherichia coli strains isolated from urinary tract infections. Trop Med Health 2019; 47:19. [PMID: 30872947 PMCID: PMC6399935 DOI: 10.1186/s41182-019-0147-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 02/20/2019] [Indexed: 11/21/2022] Open
Abstract
Background As an opportunistic pathogen, Escherichia coli (E. coli) is widely recognized as the main cause of nosocomial infections as well as some disorders especially those associated with urinary tract infections (UTIs). This study, therefore, sets out to determine the extent of antibiotic resistance to quinolones and to measure the frequency of qnr genes (A, B, and S) within extended-spectrum beta-lactamase (ESBL) and non-ESBL-producing strains of E. coli isolated from UTI-diagnosed patients as well as to investigate their antimicrobial susceptibility patterns for some selected antibiotics in southwest Iran. Methods Two hundred E. coli strains were isolated from UTI-diagnosed patients, hospitalized in nine different wards of Ahvaz Golestan Hospital between November 2015 and March 2016. The isolates were confirmed through well-practiced phenotypical methods. Moreover, the antimicrobial susceptibility test was successfully performed using a disk diffusion method. ESBL production among the isolates was screened by double disk synergism test (DDST), and the qnr genes were identified using a multiplex PCR. Results Out of the 200 samples collected, 167 isolates were confirmed to be E. coli strains. Maximum and minimum resistance were reported against nalidixic acid and chloramphenicol with 65.3% and 17.4%, respectively. Most of the isolates were resistant to all three types of quinolones studied in this research. Using multiplex PCR, the qnr genes were found in 100 (59.88%) strains (qnrA = 10, qnrB = 21, qnrS = 41, qnrB-S = 21, qnrB-A = 1, qnrA-S = 3, qnrA-B-S = 3), 58% of which was found among ESBL-producing isolates. Conclusions Resistance to quinolones antibiotics was highest among ESBL-producing isolates harboring, especially qnrS among other determinants of the qnr gene. There is a need for sensitive antibiotic stewardship especially in hospitals of Ahvaz, Khuzestan province. Further research is needed to ascertain the gravity of quinolones resistance in Iran and to quickly act against its spread among other nosocomial pathogens.
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Affiliation(s)
- Ahmad FarajzadehSheikh
- 1Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,2Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hojat Veisi
- 2Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,3Department of Microbiology, Arvand international Division, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojtaba Shahin
- 1Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,2Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Muhammad Getso
- 4Department of Medical Microbiology and Parasitology, College of Health Sciences, Bayero University, PMB, Kano, 3011 Nigeria
| | - Abbas Farahani
- 5Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Karam MRA, Habibi M, Bouzari S. Relationships between Virulence Factors and Antimicrobial Resistance among Escherichia coli Isolated from Urinary Tract Infections and Commensal Isolates in Tehran, Iran. Osong Public Health Res Perspect 2018; 9:217-224. [PMID: 30402376 PMCID: PMC6202021 DOI: 10.24171/j.phrp.2018.9.5.02] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Objectives Uropathogenic Escherichia coli (UPEC) are the major cause of urinary tract infections (UTIs). Here, we determined whether sensitivity to antibiotics was related to the prevalence of iron scavenging genes, or to biofilm and hemolysis formation. Methods A total of 110 UPEC and 30 E coli isolates were collected from the urine of UTI patients and feces of healthy individuals without UTI, respectively. The presence of iron receptor genes and phenotypic properties were evaluated by polymerase chain reaction and phenotypic methods, respectively. Susceptibility to routine antibiotics was evaluated using the disc diffusion method. Results The prevalence of iron scavenging genes ranged from 21.8% (ireA) to 84.5% (chuA) in the UPEC. Resistance to ceftazidime and cefotaxime was significantly correlated with the presence of fyuA and iutA iron genes. Biofilm production was significantly associated with the prevalence of fyuA and hma iron genes. A higher degree of antibiotic resistance was exhibited by isolates that produced biofilms than by their non-biofilm producing counterparts. Conclusion Our study clearly indicates that biofilm production is associated with antibiotic resistance, and that iron receptors and hemolysin production also contribute to reduced antibiotic sensitivity. These results further our understanding of the role that these virulence factors play during UPEC pathogenesis, which in turn may be valuable for the development of novel treatment strategies against UTIs.
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Affiliation(s)
| | - Mehri Habibi
- Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
| | - Saeid Bouzari
- Department of Molecular Biology, Pasteur Institute of Iran, Tehran, Iran
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12
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Sweileh WM, Al-Jabi SW, Zyoud SH, Sawalha AF, Abu-Taha AS. Global research output in antimicrobial resistance among uropathogens: A bibliometric analysis (2002-2016). J Glob Antimicrob Resist 2018; 13:104-114. [PMID: 29224787 DOI: 10.1016/j.jgar.2017.11.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 11/25/2017] [Accepted: 11/28/2017] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Antimicrobial resistance (AMR) among uropathogens contributes to treatment failure. Research in AMR among uropathogens is important to establish treatment options. This study assessed global research trends in AMR among uropathogens. METHODS SciVerse Scopus was used to retrieve relevant documents for the period 2002-2016. Only journal articles were included in the analysis. Analysis of author keywords was carried out using VOSviewer. RESULTS A total of 1087 journal articles were retrieved with an h-index of 50. The number of publications increased noticeably in the past decade. Analysis of subject areas of retrieved documents showed that 275 (25.3%) articles were in molecular biology/genetics/microbiology/immunology, 197 (18.1%) were in pharmacological/therapeutic approaches for treatment of urinary tract infections and 615 (56.6%) were in epidemiology/public health. Terms such as multidrug-resistant and extended-spectrum β-lactamases (ESBLs) appeared more frequently in documents published in the period 2012-2016. The mean number of authors per article was 5.3. Most active authors in this field were from Japan. The USA ranked first with 148 documents (13.6%), followed by India (97; 8.9%) and Iran (84; 7.7%). The top productive institution was Tehran University of Medical Sciences (21 publications), followed by Kobe University in Japan (20 publications). The Journal of Antimicrobial Chemotherapy ranked first with 33 publications. CONCLUSION Research in AMR among uropathogens showed a noticeable increase in the past decade. Reports of increasing incidence of resistance among uropathogens were published from different parts of the world. Empirical therapy should be based on updated research in AMR.
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Affiliation(s)
- Waleed M Sweileh
- Department of Physiology, Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ansam F Sawalha
- Department of Physiology, Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.
| | - Adham S Abu-Taha
- Department of Physiology, Pharmacology and Toxicology, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Shahbazi S, Asadi Karam MR, Habibi M, Talebi A, Bouzari S. Distribution of extended-spectrum β-lactam, quinolone and carbapenem resistance genes, and genetic diversity among uropathogenic Escherichia coli isolates in Tehran, Iran. J Glob Antimicrob Resist 2018; 14:118-125. [PMID: 29581075 DOI: 10.1016/j.jgar.2018.03.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 03/16/2018] [Accepted: 03/16/2018] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Antimicrobial resistance among uropathogenic Escherichia coli (UPEC) is increasing. The aim of this study was to evaluate antimicrobial resistance in UPEC isolates and its correlation with virulence factors. METHODS A total of 120 E. coli isolates were collected from patients with urinary tract infection in Tehran, Iran. Biofilm formation and antimicrobial susceptibility were determined by phenotypic tests. The combination disk diffusion test and modified Hodge test (MHT) were performed for phenotypic detection of extended-spectrum β-lactamases (ESBLs) and carbapenemases, respectively. PCR was used for the detection of virulence genes, ESBL-encoding genes, and quinolone (qnr) and carbapenem resistance genes. Pulsed-field gel electrophoresis (PFGE) was performed to explore the genetic relatedness among isolates. RESULTS Most isolates exhibited biofilm formation, and different frequencies of virulence genes were observed. There was a high rate of resistance, especially multidrug resistance, to most of the antimicrobial agents tested. Phenotypically, 67.5% of the isolates produced an ESBL and were resistant to different antimicrobial classes. In total, 83.3% of the isolates harboured ESBL genes, especially blaTEM and blaCTX-M, and 32.5% were positive for the quinolone resistance genes qnrS and qnrB. All isolates were negative for carbapenemases by the MHT and PCR. These results indicate the association between the presence of various virulence genes and antimicrobial susceptibility. PFGE analysis showed that there was great clonal diversity among the selected isolates, with 17 isolates divided into five clusters. CONCLUSIONS These results indicate that the high antimicrobial resistance among UPEC isolates is alarming and requires urgent attention.
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Affiliation(s)
- Shahla Shahbazi
- Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran 13164, Iran
| | | | - Mehri Habibi
- Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran 13164, Iran.
| | - Atefeh Talebi
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Bouzari
- Department of Molecular Biology, Pasteur Institute of Iran, Pasteur Ave., Tehran 13164, Iran.
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Determination of Antibiotic Resistance and Pulsed-Field Gel Electrophoresis Profiles for the Extended-Spectrum β-Lactamase Producing Escherichia coli. Jundishapur J Microbiol 2018. [DOI: 10.5812/jjm.57878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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ALIZADE H. Escherichia coli in Iran: An Overview of Antibiotic Resistance: A Review Article. IRANIAN JOURNAL OF PUBLIC HEALTH 2018; 47:1-12. [PMID: 29318111 PMCID: PMC5756583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Escherichia coli is the most prominent cause of infectious diseases that span from the gastrointestinal tract to extra-intestinal sites such as urinary tract infection, septicaemia, and neonatal meningitis. The emergence and spread of antibiotic resistance in E. coli is an increasing public health concern across the world. Rising resistance in E. coli isolates is also observed in Iran. This review summarizes the status of antibiotic resistance of E. coli isolates in Iran from 2007 to 2016. METHODS The data of the prevalence of E. coli antibiotic resistance were collected from databases such as Web of Science, PubMed, Scopus, Embase, Cochrane Library, Google Scholar and Scientific Information Database. RESULTS Antibiotic resistance in E. coli is on the rise. CONCLUSION Prevalence of antibiotic resistance of E. coli varies from region to region in Iran.
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Leylabadlo HE, Pourlak T, Bialvaei AZ, Aghazadeh M, Asgharzadeh M, Kafil HS. EXTENDED-SPECTRUM BETA-LACTAMASE PRODUCING GRAM NEGATIVE BACTERIA IN IRAN: A REVIEW. Afr J Infect Dis 2017; 11:39-53. [PMID: 28670639 PMCID: PMC5476812 DOI: 10.21010/ajid.v11i2.6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background: The emergence and spread of extended spectrum β-lactamase (ESBL)-producing Gram- negative bacteria (GNB), particularly in Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa, have increased all over the world. ESBLs are characterized by their ability to hydrolyze β-lactams, early cephalosporins, oxyimino-thiazolyl cephalosporins, and monobactams, but not cephamycins or carbapenems. The rate of nosocomial infections caused by ESBL-producing GNB in Asia Pacific has increased and several studies have identified their prevalence in the region. The aim of this study is to review the prevalence of ESBL-producing GNB in the West Asia and the Middle East with a particular focus on Iran. Materials and Methods: The available evidence from various studies (Microbia and clinical studies, retrieved from the PubMed, and Scopus databases) regarding the ESBL producing Gram negative bacteria in Iran were evaluated. Results: In almost all parts of the country, high resistance has been observed, especially in the central part of Iran. Up to 89.8% Escherichia coli, 72.1% Klebsiella pneumonia, 84.2% Acinetobacter baumannii, and 83.8% Pseudomonas aeruginosa isolates are ESBL positive. Conclusion: The present study showed the increasing prevalence of ESBLs in different regions of Iran, which could be useful to strategic policy towards reducing reduce their prevalence.
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Affiliation(s)
| | - Tala Pourlak
- Infectious Disease and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abed Zahedi Bialvaei
- Infectious Disease and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Aghazadeh
- Infectious Disease and Tropical Medicine Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asgharzadeh
- Biotechnology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Samadi Kafil
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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17
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The role of parC, parE, and qnrB Genes in Ciprofloxacin-Resistant Escherichia coli Isolates from Urinary Tract Infections. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2017. [DOI: 10.5812/pedinfect.41504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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18
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Ochoa SA, Cruz-Córdova A, Luna-Pineda VM, Reyes-Grajeda JP, Cázares-Domínguez V, Escalona G, Sepúlveda-González ME, López-Montiel F, Arellano-Galindo J, López-Martínez B, Parra-Ortega I, Giono-Cerezo S, Hernández-Castro R, de la Rosa-Zamboni D, Xicohtencatl-Cortes J. Multidrug- and Extensively Drug-Resistant Uropathogenic Escherichia coli Clinical Strains: Phylogenetic Groups Widely Associated with Integrons Maintain High Genetic Diversity. Front Microbiol 2016; 7:2042. [PMID: 28066364 PMCID: PMC5174082 DOI: 10.3389/fmicb.2016.02042] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 12/05/2016] [Indexed: 12/21/2022] Open
Abstract
In recent years, an increase of uropathogenic Escherichia coli (UPEC) strains with Multidrug-resistant (MDR) and Extensively Drug-resistant (XDR) profiles that complicate therapy for urinary tract infections (UTIs) has been observed and has directly impacted costs and extended hospital stays. The aim of this study was to determine MDR- and XDR-UPEC clinical strains, their virulence genes, their phylogenetic groups and to ascertain their relationship with integrons and genetic diversity. From a collection of 500 UPEC strains, 103 were selected with MDR and XDR characteristics. MDR-UPEC strains were mainly associated with phylogenetic groups D (54.87%) and B2 (39.02%) with a high percentage (≥70%) of several fimbrial genes (ecpA, fimH, csgA, and papGII), an iron uptake gene (chuA), and a toxin gene (hlyA). In addition, a moderate frequency (40–70%) of other genes (iutD, tosA, and bcsA) was observed. XDR-UPEC strains were predominantly associated with phylogenetic groups B2 (47.61%) and D (42.85%), which grouped with ≥80 virulence genes, including ecpA, fimH, csgA, papGII, iutD, and chuA. A moderate frequency (40–70%) of the tosA and hlyA genes was observed. The class 1 and 2 integrons that were identified in the MDR- and XDR-UPEC strains were associated with phylogenetic groups D, B2, and A, while the XDR-UPEC strains that were associated with phylogenetic groups B2, D, and A showed an extended-spectrum beta-lactamase (ESBL) phenotype. The modifying enzymes (aadA1, aadB, aacC, ant1, dfrA1, dfrA17, and aadA4) that were identified in the variable region of class 1 and 2 integrons from the MDR strains showed resistance to gentamycin (56.25 and 66.66%, respectively) and trimethoprim-sulfamethoxazole (84.61 and 66.66%, respectively). The MDR- and XDR-UPEC strains were distributed into seven clusters and were closely related to phylogenic groups B2 and D. The diversity analysis by PFGE showed 42.68% of clones of MDR-UPEC and no clonal association in the XDR-UPEC strains. In conclusion, phylogenetic groups including virulence genes are widely associated with two integron classes (1 and 2) in MDR- and XDR-UPEC strains.
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Affiliation(s)
- Sara A Ochoa
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico GómezMexico City, Mexico; Posgrado en Ciencias Químico-Biológicas, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico NacionalMexico City, Mexico; Laboratorio de Bacteriología Médica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico NacionalMexico City, Mexico
| | - Ariadnna Cruz-Córdova
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez Mexico City, Mexico
| | - Victor M Luna-Pineda
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez Mexico City, Mexico
| | - Juan P Reyes-Grajeda
- Laboratorio de Estructura de Proteínas, Instituto Nacional de Medicina Genómica Mexico City, Mexico
| | - Vicenta Cázares-Domínguez
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez Mexico City, Mexico
| | - Gerardo Escalona
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez Mexico City, Mexico
| | - Ma Eugenia Sepúlveda-González
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez Mexico City, Mexico
| | - Fernanda López-Montiel
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez Mexico City, Mexico
| | - José Arellano-Galindo
- Área de Virología, Laboratorio de Infectología, Hospital Infantil de México Federico Gómez Mexico City, Mexico
| | - Briceida López-Martínez
- Subdirección de Servicios Auxiliares de Diagnóstico, Hospital Infantil de México Federico Gómez Mexico City, Mexico
| | - Israel Parra-Ortega
- Laboratorio Clínico, Hospital Infantil de México Federico Gómez Mexico City, Mexico
| | - Silvia Giono-Cerezo
- Laboratorio de Bacteriología Médica, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional Mexico City, Mexico
| | - Rigoberto Hernández-Castro
- Departamento de Ecología de Agentes Patógenos, Hospital General "Dr. Manuel Gea González," Mexico City, Mexico
| | | | - Juan Xicohtencatl-Cortes
- Laboratorio de Investigación en Bacteriología Intestinal, Hospital Infantil de México Federico Gómez Mexico City, Mexico
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Poormohammadi S, Farahani A, Mohajeri P. Genomic diversity and antimicrobial susceptibility profiling of nasal carriage Staphylococcus aureus isolated from pediatric ward in Western Iran. Saudi J Biol Sci 2016; 26:1-7. [PMID: 30622401 PMCID: PMC6319195 DOI: 10.1016/j.sjbs.2016.10.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/17/2016] [Accepted: 10/02/2016] [Indexed: 12/23/2022] Open
Abstract
Nasal carriage of Staphylococcus aureus (S. aureus) probably causes the transmission of infection between individuals in hospital and community. This study aimed to evaluate the molecular epidemiology and antibiotic resistance pattern of nasal carriage S. aureus in pediatric ward patients and personnel. A total of 122 Nasal samples were taken from 28 personnel and 94 hospitalized patients in the pediatric ward. Minimum Inhibitory Concentration (MIC) to vancomycin and cefoxitin was determined by Agar dilution method strips. All S. aureus isolates were analyzed by pulsed-field gel electrophoresis (PFGE). A total of 41 S. aureus were isolated from the patients. 16 isolates (39.09%) were hospital-associated S. aureus (HA-SA) and 25 (60.97%) were community-associated S. aureus (CA-SA); also, 13 S. aureus isolates were obtained from the personnel. Based on MIC results, all of S. aureus isolates were susceptible to vancomycin, and in 41 patient isolates, 13 isolates (31.7%) were resistant to cefoxitin (MRSA). Of 13 S. aureus isolates of the personnel, 3 (23%) isolates were MRSA. Totally 11 common clones and 13 single clones were obtained. In conclusion the prevalence of CA-SA in the ward was higher than that of HA-SA. In the strains obtained from a hospital ward, there was a high epidemiology, genotypic diversity in the studied ward. However, horizontal transfer of S. aureus was observed between patients and between personnel and patients, which indicated the risk of transmission of resistant strains in the hospital wards.
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Affiliation(s)
- Shiva Poormohammadi
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abbas Farahani
- Department of Microbiology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parviz Mohajeri
- Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
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