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Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients
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Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients
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Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients
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Journal Article
Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients
2018
Overview
Background
Urinary tract infections (UTIs) are one of the most frequent diseases encountered by humans worldwide. The presence of multidrug-resistant (MDR) uropathogenic
Escherichia coli
(UPEC) harboring several virulence factors, is a major risk factor for inpatients. We sought to investigate the rate of antibiotic resistance and virulence-associated genes among the UPECs isolated from an Iranian symptomatic population.
Methods
A total of 126 isolates from inpatients with UTI from different wards were identified as UPEC using the conventional microbiological tests. After identification of UPECs, all the isolates were subjected to antimicrobial susceptibility test and polymerase chain reaction (PCR) to identify the presence of 9 putative virulence genes and their association with the clinical outcomes or antimicrobial resistance.
Results
The data showed that the highest and the lowest resistance rates were observed against ampicillin (88.9%), and imipenem (0.8%), respectively. However, the frequency of resistance to ciprofloxacin was found to be 55.6%. High prevalence of MDR (77.8%) and extended-spectrum β-lactamase (ESBL) (54.8%) were substantial. PCR results revealed the frequency of virulence genes ranged from 0 to 99.2%. Among 9 evaluated genes, the frequency of 4 genes (
fimH
,
sfa
,
iutA
, and PAI marker) was > 50% among all the screened isolates. The
iutA
,
pap GII
, and
hlyA
genes were more detected in the urosepsis isolates with significantly different frequencies. The different combinations of virulence genes were characterized as urovirulence patterns. The isolates recovered from pyelonephritis, cystitis, and urosepsis cases revealed 27, 22, and 6 virulence patterns, respectively. A significant difference was determined between ESBL production with
pap GII
,
iutA
, and PAI marker genes.
Conclusions
Our study highlighted the MDR UPEC with high heterogeneity of urovirulence genes. Considering the high rate of ciprofloxacin resistance, alternative drugs and monitoring of the susceptibility profile for UPECs are recommended.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Adult
/ Aged
/ Anti-Bacterial Agents - therapeutic use
/ Antiinfectives and antibacterials
/ Bacteria
/ Child
/ Cystitis
/ Drug Resistance, Bacterial - genetics
/ E coli
/ Escherichia coli Infections - drug therapy
/ Escherichia coli Infections - epidemiology
/ Escherichia coli Infections - microbiology
/ Female
/ Genes
/ Healthcare-associated infection control
/ Humans
/ Imipenem
/ Infant
/ Iranians
/ Islands
/ LDCs
/ Male
/ Medicine
/ Pyelonephritis - drug therapy
/ Pyelonephritis - epidemiology
/ Pyelonephritis - microbiology
/ Urinary Tract Infections - drug therapy
/ Urinary Tract Infections - epidemiology
/ Urinary Tract Infections - microbiology
/ Urine
/ Uropathogenic Escherichia coli - genetics
/ Uropathogenic Escherichia coli - pathogenicity
