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Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients.
- Source :
-
BMC infectious diseases [BMC Infect Dis] 2018 Nov 15; Vol. 18 (1), pp. 572. Date of Electronic Publication: 2018 Nov 15. - Publication Year :
- 2018
-
Abstract
- 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.<br />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.<br />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.<br />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.
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cystitis drug therapy
Cystitis epidemiology
Cystitis microbiology
Escherichia coli Infections drug therapy
Escherichia coli Infections epidemiology
Female
Humans
Infant
Iran epidemiology
Male
Middle Aged
Pyelonephritis drug therapy
Pyelonephritis epidemiology
Pyelonephritis microbiology
Urinary Tract Infections drug therapy
Urinary Tract Infections epidemiology
Urinary Tract Infections microbiology
Young Adult
Anti-Bacterial Agents therapeutic use
Drug Resistance, Bacterial genetics
Escherichia coli Infections microbiology
Uropathogenic Escherichia coli genetics
Uropathogenic Escherichia coli pathogenicity
Virulence genetics
Virulence Factors genetics
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2334
- Volume :
- 18
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 30442101
- Full Text :
- https://doi.org/10.1186/s12879-018-3467-0