High prevalence of multidrug-resistance uropathogenic Escherichia coli strains, Isfahan, Iran

Abstract

Background and Objectives:Urinary tract infection (UTI) is one of the most frequent infectious diseases and can occur in all age groups. Escherichia coli is the main cause of this infection. Multiple resistances to antimicrobial agents are increasing quickly in E. coli isolates and may complicate therapeutic strategies for UTI. The aim of this study was to determine the antibiotic resistance pattern and the multidrug-resistance (MDR) phenotypes in uropathogenic E. coli (UPEC).Materials and Methods:A total of 135 UPEC isolates were collected from both outpatients (91 isolates) and inpatients (44 isolates) between September, 2012 and February, 2013. In order to determine the MDR among UPEC isolates, we have tested 15 antimicrobial agents and antibiotic susceptibility was done by Kirby-Bauer disk diffusion method.Results:The percentage of MDR isolates (resistant to at least three drug classes such as aminoglycosides, fluoroquinolones, penicillins, cephalosporins, or carbapenems) was 68% in the inpatients and 61% in the outpatients. Antibiotic resistance to ampicillin, ceftazidim, nalidixic acid, and trimethoprim/sulfamethoxazole were higher than 50%. Amikacin, nitrofurantoin, and gentamicin showed markedly greater activity (89.1%, 85.9%, and 82.4% sensitivity, respectively) than other antimicrobial agents. Resistance to meropenem did show either in outpatients or in inpatients.Interpretation and Conclusions:The high prevalence of drug resistance among UTI patients calls for continuous monitoring of the incidence of drug resistance for appropriate empiric selection of antibiotic therapy. Empirical treatment of UTIs should be relied on susceptibility patterns from local studies.

Relationships between Virulence Factors and Antimicrobial Resistance among <italic>Escherichia coli</italic> Isolated from Urinary Tract Infections and Commensal Isolates in Tehran, Iran

“…In contrary to our findings and Saperston et al [ 37 ], others have reported higher antibiotic resistance in outpatients than in inpatients [ 25 , 38 ]. The antibiotic resistance in inpatients could be attributed to the higher rate of antibiotic therapy, which in turn creates selective pressure to evade antibiotic activity.…”

Multidrug- and Extensively Drug-Resistant Uropathogenic Escherichia coli Clinical Strains: Phylogenetic Groups Widely Associated with Integrons Maintain High Genetic Diversity

“…Carbapenems, nitrofutans, and cephalosporins of the 3rd and 4th generations are the most common antibiotics used to treat complicated UTIs (Foxman, 2010). The emergence of MDR- and XDR-UPEC strains has complicated the treatment of UTIs (Dehbanipour et al, 2016). In this study, MDR and XDR-UPEC strains from pediatric patients at HIMFG were analyzed for their phylogeny, integrons, and virulence profile.…”

“…However, the integrons in MDR-UPEC clinical strains and their relationship with virulence factors and clonality have been poorly studied. In recent years, an increase in UPEC strains with an extensively drug-resistant (XDR) profile complicating UTI therapy has been observed (Dehbanipour et al, 2016; Hadifar et al, 2016). The aim of this study was to identify MDR- and XDR-UPEC clinical strains and their virulence genes and phylogenetic groups and to ascertain their relationship with integrons and their genetic diversity.…”

Antibiotic Resistance Among Uropathogenic Escherichia coli

“…Shahbazi et al (2018) showed that all UPEC isolates from patients with UTI in Teheran were negative for carbapenemases. Another study on UPEC isolates from Iran confirmed a lack of resistance to meropenem in isolates from outpatients and inpatients (Faghri et al 2016). Ali et al (2016) described a high activity of meropenem in Pakistan since only 1.3% of UPEC were resistant to this antibiotic.…”