Clonal relationships, antimicrobial susceptibilities, and molecular characterization of extended-spectrum beta-lactamase-producing Escherichia coli isolates from urinary tract infections and fecal samples in Southeast Iran

Hashemizadeh, Zahra; Kalantar-Neyestanaki, Davood; Mansouri, Shahla

doi:10.1590/0037-8682-0080-2017

Cited by 22 publications

(22 citation statements)

References 30 publications

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“…38 This finding was inconsistent with our results revealing 82.9%, 40%, and 2.9% of isolates harbored bla CTX-M , bla TEM , and bla SHV , respectively. Based on our findings, the occurrence of bla SHV gene was lower than that reported in Iran 31,37,39 and Portugal, 38 but it was similar to that reported in Turkey. 5 Despite the relative agreement on the higher incidence of ESBLs genes among UPECs, a discrepancy in the prevalence of ESBL producers was observed over different regions, which is probably due to differences in geographical regions, infection control policy, and sample source.…”

Section: Discussionsupporting

confidence: 82%

“…According to some previous studies, the bla CTX-M is the most frequent beta-lactamase in UPEC isolates. 27,31,37 This finding confirms the importance of the spread of bla CTX-M types in ESBL production.…”

Section: Discussionsupporting

confidence: 70%

“…22 The incidence of ESBL-producing isolates among community-acquired UPEC isolates detected in this study (23.1%) was higher than that reported among strains isolated in Brazil (7.1%), 26 Algeria (9%), 27 the United States (7% to 15%), 28 and Turkey (11%), 5 and it was lower than those reported in Iran (32%), 29 (29.6%) 30 and (41%). 31 In addition to increasing antibiotic resistance in KTPs, several factors such as intolerance of patients to some antibiotics and drug toxicity, and standard and appropriate antibiotic therapy for UPEC in KTPs are regarded as one of the complicated challenges. 32 According to antibiotic susceptibility pattern, high resistance to trimethoprim/sulfamethoxazole and quinolones, as well as high effectiveness of carbapenems, amikacin, and nitrofurantoin were reported in KTPs.…”

Section: Discussionmentioning

confidence: 99%

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Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic Escherichia coli Among Iranian Kidney Transplant Patients

Halaji¹,

Shahidi²,

Atapour³

et al. 2020

IDR

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The aim of this study was to investigate the antimicrobial susceptibility pattern and the presence of ESBLs among the uropathogenic Escherichia coli (UPEC) isolated from kidney transplant patients (KTP) and community-acquired urinary tract infections (UTIs) using phenotypic and molecular methods. Materials and Methods: A total of 111 pure cultures of UPEC isolates were collected from 65 and 46 of non-KTP and KTPs with UTIs. The pattern and ESBL production of the strains were evaluated. PCR reaction to detect the presence of bla SHV , bla TEM , and bla CTX-M genes was performed. Results: The results revealed that most of UPEC isolates obtained from KTPs and control group were resistant to trimethoprim/sulfamethoxazole (84.8% vs 46.2%), while carbapenems (100% sensitivity) were the most effective against UPEC isolates. ESBL-producing strains were significantly more frequent in KTPs compared with control group (43.5% vs 23.1%, P = 0.021). The molecular results revealed that 53.2% (59/111), 45% (50/111), and 5.4% (6/111) of isolates harbored bla CTX-M , bla TEM , and bla SHV genes, respectively. Of the genes investigated, bla CTX-M and bla TEM genes were significantly higher among KTP than the control group. Conclusion: Our results showed a high proportion of multidrug-resistant and ESBL-producing isolates, which most of them harbor blaCTX-M. A significant high co-resistance to different classes of antibiotics was reported from ESBL-producing UPEC from KTPs, which remains a serious clinical challenge.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

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Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic Escherichia coli Among Iranian Kidney Transplant Patients

Halaji¹,

Shahidi²,

Atapour³

et al. 2020

IDR

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“…Similarly, in a study from Spain, 24 a significant association was found between UTIs due to ESBL-positive E. coli and male sex. In contrast, in another study in Iran, 23 the production of ESBLs in UPEC isolates of different gender was not significantly different.…”

Section: Esbl-producing Upeccontrasting

confidence: 58%

“…As a result, it can be said that common β-lactam drugs could not effect at least one-third of these UPECs. In another study 23 on E. coli isolates from UTIs in Kerman, Iran, 41% of outpatients had ESBL-positive isolates. A somewhat similar (40%) rate of ESBL producers was reported in UPECs in a study in Pakistan.…”

Section: Esbl-producing Upecmentioning

confidence: 95%

Treatment Failure in Urinary Tract Infections: A Warning Witness for Virulent Multi-Drug Resistant ESBL- Producing Escherichia coli

Naziri¹,

Derakhshandeh²,

Borchaloee³

et al. 2020

IDR

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Background: Global increase in the prevalence of virulent extended-spectrum betalactamase (ESBL)-producing uropathogenic Escherichia coli (UPEC), which is also multidrug resistant (MDR), leads to increase in severity of urinary tract infections (UTIs), decrease in the efficacy of the first-line antibiotics, and therefore increase in the morbidity and mortality rates. Methods: We investigated the distribution of ESBL-producing UPEC in 78 E. coli isolates from community-acquired UTI patients in southern Iran. The prevalence of three major ESBL genes, antimicrobial resistance patterns against 15 conventional antibiotic disks, and the presence of 11 important virulence genes that involve in the development and progression of UTIs were evaluated in these isolates. Results: Of the UPECs, 34.6% were ESBL-positive and 96.3% of the ESBL-producers were MDR. Among the ESBL-producers, 100% harbored bla CTX-M , 63% harbored bla SHV , and 11.1% harbored bla TEM genes. ESBL-producers showed a higher level of resistance to the tested cephalosporins, fluoroquinolones, trimethoprim-sulfamethoxazole, and tetracycline than non-ESBL producers. All isolates were resistant to the tested penicillins. Prevalence of resistance to about two-third of the tested antibiotics was higher than 50% and 93.6% of the isolates were MDR. High prevalence of virulence factors particularly the adhesins (82.1% csgA, 73.1% fimH genes) and siderophore (73.1% sitA gene) was seen in the UPECs. But fortunately in MDR isolates, the virulence score and prevalence of hemagglutinin (tsh), hemolysin toxin (hlyD) and invasin (ibeA) genes were lower than in non-MDR UPECs. Shockingly, among the 15 common antibiotics, only nitrofurantoin (<20% resistance) could be recommended as an appropriate drug for the treatment of UTIs due to our ESBL-producer UPECs. Conclusion: The alarming level of virulent MDR ESBL-producer E. coli strains in this study necessitates the performing of an antibiotic stewardship program, regional screening of ESBL-producers and their virulence properties to select appropriate antibiotic, or designing new therapeutic methods for UTIs by inactivation of the essential virulence factors of UPECs.

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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

Sohrabi,

Fathi,

Mohebi

et al. 2024

Mol Biol Rep

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Clonal relationships, antimicrobial susceptibilities, and molecular characterization of extended-spectrum beta-lactamase-producing Escherichia coli isolates from urinary tract infections and fecal samples in Southeast Iran

Cited by 22 publications

References 30 publications

<p>Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic <em>Escherichia coli</em> Among Iranian Kidney Transplant Patients</p>

<p>Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic <em>Escherichia coli</em> Among Iranian Kidney Transplant Patients</p>

<p>Treatment Failure in Urinary Tract Infections: A Warning Witness for Virulent Multi-Drug Resistant ESBL- Producing <em>Escherichia coli</em></p>

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

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