Distribution of extended-spectrum β-lactam, quinolone and carbapenem resistance genes, and genetic diversity among uropathogenic Escherichia coli isolates in Tehran, Iran

Shahbazi, Sepideh; Karam, Mohammad Reza Asadi; Habibi, Mehri; Talebi, Atefeh; Bouzari, Saeid

doi:10.1016/j.jgar.2018.03.006

Cited by 49 publications

(34 citation statements)

References 30 publications

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“…This high resistance rate may be due to the extensive and routine use of these agents in treatment patients with UTI. 8,22,30,32,35 Similar to our finding, a report from China established that among KTPs, all gram-negative bacteria like UPEC were susceptible to carbapenems (imipenem or meropenem) that might be related to its low usage in routine treatments for UTIs. In this regard, carbapenems such as imipenem and meropenem represent a good choice for serious UTIs.…”

Section: Discussionsupporting

confidence: 89%

“…9 In accordance with our results, one study in northwestern of Iran reported that 40.6% of the UPEC isolates were ESBL producers. 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.…”

Section: Discussioncontrasting

confidence: 62%

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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: 89%

Section: Discussioncontrasting

confidence: 62%

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 antimicrobial susceptibility of E. coli K-12 strains to 5-nitrofurans was examined using the agar dilution and broth microdilution assays as previously described (65,66). The range of drug concentrations tested included 32,28,24,20,16,12,8,4, 2, 1, 0.5, 0.25, 0.125, and 0 g/ml in the agar dilution assay and 80, 64, 48, 32, 16, 8, 4, 2, 1, 0.5, and 0.25 g/ml in the broth microdilution assay. In ahpF-complemented strains, expression of ahpF was under the control of a chimeric P T5-lac promoter of a high-copy-number plasmid, pCA24N::ahpF, and induced by 0.1 mM or 1 mM IPTG.…”

Section: Methodsmentioning

confidence: 99%

Novel 5-Nitrofuran-Activating Reductase in Escherichia coli

Davies

Moon

et al. 2019

Antimicrob Agents Chemother

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The global spread of multidrug-resistant enterobacteria warrants new strategies to combat these pathogens. One possible approach is the reconsideration of “old” antimicrobials, which remain effective after decades of use. Synthetic 5-nitrofurans such as furazolidone, nitrofurantoin, and nitrofurazone are such a class of antimicrobial drugs. Recent epidemiological data showed a very low prevalence of resistance to this antimicrobial class among clinical Escherichia coli isolates in various parts of the world, forecasting the increasing importance of its uses to battle antibiotic-resistant enterobacteria. However, although they have had a long history of clinical use, a detailed understanding of the 5-nitrofurans’ mechanisms of action remains limited. Nitrofurans are known as prodrugs that are activated in E. coli by reduction catalyzed by two redundant nitroreductases, NfsA and NfsB. Furazolidone, nevertheless, retains relatively significant antibacterial activity in the nitroreductase-deficient ΔnfsA ΔnfsB E. coli strain, indicating the presence of additional activating enzymes and/or antibacterial activity of the unreduced form. Using genome sequencing, genetic, biochemical, and bioinformatic approaches, we discovered a novel 5-nitrofuran-activating enzyme, AhpF, in E. coli. The discovery of a new nitrofuran-reducing enzyme opens new avenues for overcoming 5-nitrofuran resistance, such as designing nitrofuran analogues with higher affinity for AhpF or screening for adjuvants that enhance AhpF expression.

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“…ESBL are the predominant source of Enterocacteriaceae resistance to 3rd-and 4th-generation cephalosporins and they developed as a result of mutations in the genes coding for ancestral enzymes blaTEM-1, blaTEM-2, and blaSHV-1 (Dashti et al 2006). Three classes of β-lactamases including TEM and SHV, and since 2000 a new group of ESBL, CTX-M (cefotaximases), were observed among ESBL produced by UPEC (Ojdana et al 2014;Shahbazi et al 2018). Genetic analyses of UPEC from hospitalized patients in different hospital wards in Lodz (Poland) revealed that TEM-1 was present in almost all investigated strains (Adamus-Białek et al 2018).…”

Section: Mechanisms Of Upec Resistance To Antibioticsmentioning

confidence: 99%

Antibiotic Resistance Among Uropathogenic Escherichia coli

Kot

2019

Polish Journal of Microbiology

162

131

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Urinary tract infections (UTIs) belong to the most common community-acquired and nosocomial infections. A main etiological factor of UTIs is uropathogenic Escherichia coli (UPEC). This review describes the current state of knowledge on the resistance of UPEC to antibiotics recommended for the treatment of UTIs based on the available literature data. Nitrofurantoin and fosfomycin are recommended as first-line therapy in the treatment of uncomplicated cystitis, and the resistance to these antimicrobial agents remains low between UPEC. Recently, in many countries, the increasing resistance is observed to trimethoprim-sulfamethoxazole, which is widely used as the first-line antimicrobial in the treatment of uncomplicated UTIs. In European countries, the resistance of UPEC to this antimicrobial agent ranges from 14.6% to 60%. The widespread use of fluoroquinolones (FQs), especially ciprofloxacin, in the outpatients is the cause of a continuous increase in resistance to these drugs. The resistance of UPEC to FQs is significantly higher in developing countries (55.5–85.5%) than in developed countries (5.1–32.0%). Amoxicillin-clavulanic acid is recommended as first line-therapy for pyelonephritis or complicated UTI. Resistance rates of UPEC to amoxicillin-clavulanic acid are regionally variable. In European countries the level of resistance to this antimicrobial ranges from 5.3% (Germany) to 37.6% (France). Increasing rates of UPEC resistance to antimicrobials indicate that careful monitoring of their use for UTI treatment is necessary.

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Distribution of extended-spectrum β-lactam, quinolone and carbapenem resistance genes, and genetic diversity among uropathogenic Escherichia coli isolates in Tehran, Iran

Cited by 49 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>

Novel 5-Nitrofuran-Activating Reductase in Escherichia coli

Antibiotic Resistance Among Uropathogenic Escherichia coli

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