Identification of Extended-Spectrum β-Lactamase Genes and AmpC-β-Lactamase in Clinical Isolates of Escherichia coli Recovered from Patients with Urinary Tract Infections in Kerman, Iran

Abstract

Background: Escherichia coli is the main causative pathogen in urinary tract infections (UTIs). Antibiotic resistance in this bacterium is an important problem in public health. Objectives: The aim of this study was to identify the blaTEM, blaSHV, blaOXA, and blaPER genes and AmpC-β-lactamase in clinical isolates of E. coli recovered from patients with UTIs in Kerman, Iran. Methods: E. coli isolates (N = 105) were analyzed for their antibiotic susceptibility with the disk diffusion method. ESBL and AmpCproducing isolates were detected using phenotypic methods. PCR was used to identify the blaTEM, blaSHV, blaOXA and blaPER genes in ESBL and AmpC-positive isolates. Results: More than 50% of the isolates were multi-drug resistant. The prevalence of ESBLs, AmpC-β-lactamase, blaTEM and blaOXA in the inpatient isolates was 37.2%, 2%, 37.2% and 5.8%, respectively. Further, the prevalence of ESBLs, blaTEM, blaSHV and blaOXA in the outpatient isolates was 42.5%, 24%, 5.5% and 1.8%, respectively. Conclusions: The prevalence of ESBL-producing E. coli strains in the community (outpatients) is higher than that in inpatients in Kerman, Iran. An outbreak of ESBL-producing isolates in the community can be a serious problem for public health, as resistance to other classes of antibiotics such as aminoglycoside and fluoroquinolones is often related with ESBL and AmpC production, therefore, detection of ESBL and AmpC-producing isolates in the community and hospitals is very important for the treatment and prevention of such isolates.

Pathogenic features of urinary Escherichia coli strains causing Asymptomatic Bacteriuria during Pregnancy

“…Findings are in line with the earlier studies in Iran [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. The findings of previous studies as well our current findings indicate that ESBL and AmpC-β-lactamase-producing isolates are typically resistant to others antibiotics such as trimethoprim/sulfamethoxazole and fluoroquinolones [13]. ESBL was detected in 41/105 (43%) of the isolates recovered from patients, and bla CTXM was the commonest genotype (93%).…”

“…Klebsiella pneumonia ATCC 700603 and E. coli ATCC 25922 were used as positive and negative controls respectively. Furthermore, AmpC phenotype was specified by means of compound disk using cefoxitin (FOX), (Mast, UK) with and without boronic acid (Sigma-Aldrich Chemie, , Germany) were used to detect AmpC phenotypes [13].…”

“…DNA was extracted from one single colony of each isolate by incubation in a final volume of 100 μL of distilled water at 95 °C for 10 min followed by centrifugation. PCR was used to detect thirteen genes encoding virulence determinants that are usually associated with the E. coli strains responsible for extraintestinal infections: including (fmH, papC, sfa/focDE, sfaS, kpsMTII, ecpA, ecpR-B, hlyA, cnf-1, papGII, iutA , tratT, and fyuA), genes [5][6][7][8][9][10][11][12][13][14]. Also PCR screening was used for the presence of different beta-lactamase genes (bla TEM , bla SHV , bla CTXM ) (15).…”

Bacterial Uropathogens in Urinary Tract Infection and Antibiotic Susceptibility Pattern in Riyadh Hospital, Saudi Arabia

“…Results of samples collected are donated to all patients included in the study and some sample results were dispatched to physicians for treatment prescription [47][48][49].…”

Detection of Extended - Spectrum Beta - Lactamases in Escherichia coli Isolates and it’s Correlation with Vesicoureteral Reflux Nephropathy

“…Chih et al, in a study about nephropathy in infants with urinary tract infection, evaluated 152 young infants (127 males and 25 females) and concluded that E. coli was the most common pathogen in urinary tract infection and had high ampicillin resistance, and leukocytosis indicated the risk of VUR while fever indicated a risk of pyelonephritis (18). Koshesh et al, in their study, evaluated ESBL E. coli infections and they found that these isolates were higher in communities rather than inpatients (19). Rahman et al in a case -control study reported male gender and high grade reflux as risk factors of nephropathy among children with UTI; also, the current study demonstrated that reflux was seen as a risk factor for urinary tract infections (7).…”