Background: Antibiotic resistance is an increasing phenomenon in many bacterial pathogens including uropathogenic Escherichia coli. Hypothetical anti-virulent agents could be a solution, but first clear virulence associated gene-pool of antibiotic resistant isolates have to be determined. The aim of this study is to investigate the significant associations between genes encoding VFs with antibiotic resistance and phylogenetic groups in UPEC isolates. Results: The majority of 248 UPEC isolates belonged to phylogenetic group B2 (67.3%). The maximum and minimum resistance was attributed to amoxicillin (90.3%) and both fosfomycin and imipenem (1.6%) respectively. 11.3% of isolates were resistant to all antibiotic agents except that of imipenem, nitrofurantoin and fosfomycin. These highly resistant isolates were placed only in group B2 and D. The most prevalent virulence gene was ompA (93.5%). The hlyA was the only virulence gene that was significantly more prevalent in the highly resistant isolates. The ompA, malX and hlyA genes were obviously more abundant in the antibiotic resistant isolates in comparison to susceptible isolates. The papC gene was associated with amoxicillin resistance (p-value = 0.006, odds ratio: 26.00). Conclusions: Increased resistance to first line drugs prescribed for UTIs were detected in CA-UPEC isolates in our study.. Minimal resistance was observed against nitrofurantoin, fosfomycin and imipenem. Therefore, they are introduced for application in empirical therapy of UTIs. Fosfomycin may be the most effective antibiotic agent against highly resistant UPEC isolates. The presence of the ompA, malX and hlyA genes were significantly associated with resistance to different antibiotic agents. We assume that the ability of UPEC isolates to upgrade their antibiotic resistance capacity may occurs in compliance with the preliminary existence of specific virulence associated genes. But, more investigation with higher number of bacterial isolates, further virulence associated genes and comparison of gene pools from CA-UPEC isolates with HA-UPEC are proposed to confirm these finding and discovering new aspects of this association.
Introduction: Klebsiella pneumoniae is a well-known pathogen which causes different kinds of infections including pneumoniae, urinary tract infection, and bloodstream infection. Therefore, the present study aimed to investigate the incidence of carbapenem-resistant K. pneumoniae (CRKP) in Zabol, which is located in Sistan and Baluchestan province, southeast of Iran. Methods: A total of 70 clinical specimens of K. pneumoniae were collected from patients who referred to Amiralmomenin hospital affiliated with Zabol University of Medical Sciences during (December) 2017-2018. Then, resistance to nine different antibiotics was evaluated based on the purpose of the study. Finally, polymerase chain reaction (PCR) amplification was performed using specific primers for detecting blaAIM, blaVIM, blaNDM-1, and blaSPM genes. Results: The highest sensitivities of the isolates were related to ertapenem (n=68, 97.1%), meropenem (n=67, 95.7%), followed by gentamicin (n=65, 92.8%) and amikacin (n=65, 92.8%). In addition, 3 isolates were imipenem-resistant (4.3%), which were metallo-beta-lactamase positive as well. Eventually, based on the results of PCR, two isolates were found to be blaNDM positive. Conclusion: In general, the results of this study revealed that the prevalence of CRKP was low in the region under investigation. Therefore, continued monitoring of antibiotic resistance profile is required for hindering the emergence and spread of drug-resistant bacteria.
Introduction: Urinary tract infections (UTIs) are the most prevalent infections in patients worldwide. Escherichia coli is considered as the most prevalent etiological agent of UTIs. The prevalence of extended-spectrum beta-lactamase (ESBL)-producing isolates is a health care concern worldwide. The aims of this study was to determine antibiotic resistance profiles and the prevalence of the blaCTXM, blaSHV, and blaTEM genes in E. coli isolated from clinical samples obtained from patients with UTIs. Methods: From September 2019 to March 2021, a total of 1200 urine samples were collected and analyzed from patients suspected of having UTI referred to Amir-Al-Momenin hospital of Zabol, Sistan and Baluchistan province, south-east of Iran. Antibiotic resistance patterns and the prevalence of the blaCTXM, blaSHV and blaTEM genes were determined using the disk diffusion method and PCR, respectively. Results: The isolates were mostly resistance against ampicillin and trimethoprim-sulfamethoxazole, with 66% and 54% of all isolates being resistant. Also, the isolates investigated were highly susceptible against meropenem and gentamycin (95%). The prevalence of the blaCTX, blaSHV, and blaTEM genes was 22%, 30%, and 24%, respectively. Conclusion: Resistance against ampicillin and trimethoprim-sulfamethoxazole was high, therefore their prescription must be restricted. In addition, the expressions of the blaCTXM, blaSHV, and blaTEM genes were alarmingly high. In order to control the spread of infections by these isolates, constant monitoring of antibiotic resistance patterns is necessary.
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