Multidrug Efflux Pump In Relation To Antibiotic Resistance Pattern in Escherichia Coli Strains Isolated From Benha University Hospital

Abstract

Background: Antimicrobial resistance is one of the most serious public health threats of the twenty-first century, Uropathogenic Escherichia coli (UPEC) are one of the main bacteria causing urinary tract infections (UTIs). The rate of UPEC with high resistance towards antibiotics has increased dramatically in recent years. Objectives: This study aimed to assess the antibiotic resistance pattern of UPEC and to detect the relationship of antibiotic resistance with the presence of efflux pump genes (AcrA-AcrB-TolC). Methodology: This study included 50 UPEC strains, Identification of E.coli by Gram stain, culture and biochemical reactions was done, Antibiotic susceptibility for isolated E.coli strains by vitek system and detection of AcrA-AcrB-TolC genes by conventional PCR among isolated strains were also performed. Results: the prevalence of MDR was 70%,UPEC isolates showed high level of resistance to : ampicillin(94%), nalidixic acid (84%), ticacillin (82%), ciprofloxacin (76%) and trimethoprim/sulfamethoxazole (76%), low level of resistance of UPEC to:gentamicin (34%), amoxicillin/clavulinic acid (28%), ceftazidime (21%), cefoxitin (16%), piperacillin/ tazobactam (8%), tobramycin(2%) and ertapenem (2%) but no resistance to amikacin , imipenem and nitrofurantoin. 50%, 66% and 68% of isolates had genes acrA, acrB and tolC respectively. there was a significant correlation between tol C gene and MDR phenotype. Conclusion: the rate of MDR UPEC is rising, efflux pumps play an important role in mediating antibiotic efflux and increase the rate of antibiotic rasistance. The frequency of tol C gene was significantly higher in MDR than non MDR, while the acr A B level showed non significant variation among MDR and non MDR.