Genetic Thromboembolic Risk Factors Associated with Deep Vein Throm-bosis in a Iranian Population

Document Type : Original Article(s)

Authors

1 Instructor, Department of Microbiology, Fasa University of Medical Sciences, (Member of Young Researchers Club, Islamic Azad University), Shiraz, Iran.

2 Student, Department of Microbiology, Isfahan University of Medical Sciences, Isfahan, Iran.

3 Student of PhD, Research Center of Molecular Biology, School of Medicine, Baqiyatallah University, Tehran, Iran.

4 Department of Immunology, Pasteur Institute of Iran, Tehran, Iran.

5 Pediatric Infectious Diseases Research Center, Shahid Beheshti Medical University, Tehran, Iran.

Abstract

Background: Salmonellosis is one of the most important prevalent bacterial infections, after a decade of its recognition. Antibiotic therapy in salmonellosis is restricted to typhoid fever and acute infections. After the first reporting of resistance in S. Typhimurium DT 104, nowadays, developing resistance in Salmonella, specially, ESBL (such as CTX-M) species is an important issue in salmonellosis. In this study, we evaluated bla-ctx-m-type gene in clinical isolates of Salmonella enterica.Methods: In this cross-sectional study, we collected clinical isolates of patients in 18 months. Initially, we surveyed drug sensitivity with disk diffusion method, and then determined MIC of resistant isolates with E-test stripes. The existence of ESBL (extended spectrum beta-lactamase) enzymes was examined by ESBL disks in Double Disk method, and these resistances was evaluated with PCR by using a pair of universal primers.Finding: 36 isolates were sensitive to all of antibiotics, but, in 60 isolates there was at least one resistance. In 45 isolates, there were multi drug resistance (MDR) phenotypes. Resistance to ampicilin was the highest percent, whereas, there was not any resistance to imipenem and ciprofloxacin, which were improved with E-test strips. ESBL evaluation, showed producing cefotaxime ESBL in 5 isolates and ceftazidim ESBL in 4 isolates; 2 isolates of these had bla-ctx-m-type gene in plasmid.Conclusion: Detection of MDR trait, especially extended spectrum beta-lactamases in resistant clinical Salmonella isolates, point to the attention in usage of extended spectrum cephalosporins and detection of resistance rate in a nation level.

Keywords


  1. Su LH, Chiu CH, Chu C, Ou JT. Antimicrobial resistance in nontyphoid Salmonella serotypes: a global challenge. Clin Infect Dis 2004; 39(4): 546-51.
  2. Tauxe RV, Pavia AT. Salmonellosis: nontyphoidal. In: Brachman PS, Evans AS, Editors. Bacterial Infections of Humans: Epidemiology and Control. 3rd ed. New York: Springer; 1998. p: 613-30.
  3. Herikstad H, Motarjemi Y, Tauxe RV. Salmonella surveillance: a global survey of public health serotyping. Epidemiol Infect 2002; 129(1): 1-8.
  4. Edelman R, Levine MM. Summary of an international workshop on typhoid fever. Rev Infect Dis 1986; 8(3): 329-49.
  5. Mermin JH, Townes JM, Gerber M, Dolan N, Mintz ED, Tauxe RV. Typhoid fever in the United States, 1985-1994: changing risks of international travel and increasing antimicrobial resistance. Arch Intern Med 1998; 158(6): 633-8.
  6. Bender JB, Hedberg CW, Boxrud DJ, Besser JM, Wicklund JH, Smith KE, et al. Use of molecular subtyping in surveillance for Salmonella enterica serotype typhimurium. N Engl J Med 2001; 344(3): 189-95.
  7. Popoff MY, Le Minor L. Antigenic formulas of the Salmonella serovars, 7th revision. WHO Collaborating Centre for Reference and Research on Salmonella. Paris: Pasteur Institute; 1997.
  8. Miller SI, Pegues DA. Salmonella species, in-cluding Salmonella typhi. In: Mandell GL, Bennett JE, Dolin R. Principles and Practice of infectious diseases. 5th ed. London: Churchill Livingstone; 2000. p. 2344-63.
  9. Olsen SJ, Bishop R, Brenner FW, Roels TH, Bean N, Tauxe RV, et al. The changing epidemiology of salmonella: trends in serotypes isolated from humans in the United States, 1987-1997. J Infect Dis 2001; 183(5): 753-61.
  10. Glynn MK, Bopp C, Dewitt W, Dabney P, Mokhtar M, Angulo FJ. Emergence of multi-drug-resistant Salmonella enterica serotype typhimurium DT104 infections in the United States. N Engl J Med 1998; 338(19): 1333-8.
  11. Holmberg SD, Wells JG, Cohen ML. Animal-to-man transmission of antimicrobial-resistant Salmonella: investigations of U.S. outbreaks, 1971-1983. Science 1984; 225(4664): 833-5.
  12. Mandal BK. Modern treatment of typhoid fever. J Infect 1991; 22(1): 1–4.
  13. Fey PD, Safranek TJ, Rupp ME, Dunne EF, Ribot E, Iwen PC, et al. Ceftriaxone-resistant salmonella infection acquired by a child from cattle. N Engl J Med 2000; 342(17): 1242-9.
  14. Gilbert DN, Moellering RC, Eliopoulos GM, Sande MA. The Sanford Guide to Antimicrobial Therapy 2006. 19th ed. Sperryville, VA: Antimicrobial Therapy Inc; 2006.
  15. Ercis S, Gulay Z, Gur D, Erdem B, Hascelik G, Tunger A, et al. Types of extended-spectrum beta-lactamases in Salmonella spp. and decreased susceptibility to fluoroquinolones. Proceedings of the 16th European Congress of Clinical Microbiology and Infectious Diseases; 2006 April 4; Nice, France.
  16. Paterson DL. Resistance in gram-negative bacteria: Enterobacteriaceae. Am J Infect Control 2006; 34(5 Suppl 1): S20-8; discussion S64-73.
  17. Livermore DM. Beta-Lactamases in laboratory and clinical resistance. Clin Microbiol Rev 1995; 8(4): 557-84.
  18. Thomson KS, Smith Moland E. Version 2000: the new beta-lactamases of Gram-negative bacteria at the dawn of the new millennium. Microbes Infect 2000; 2(10): 1225-35.
  19. Hasman H, Mevius D, Veldman K, Olesen I, Aarestrup FM. Beta-Lactamases among extended-spectrum beta-lactamase (ESBL)-resistant Salmonella from poultry, poultry products and human patients in The Netherlands. J Antimicrob Chemother 2005; 56(1): 115-21.
  20. Govinden U, Mocktar C, Moodley P, Sturm AW, Essack SY. Geographical evolution of the CTX-M β-lactamase– anupdate. African Journal of Biotechnology 2007; 6(7): 831-9.
  21. Bradford PA. Extended-spectrum beta-lactamases in the 21st century: characterization, epidemiology, and detection of this important resistance threat. Clin Microbiol Rev 2001; 14(4): 933-51.
  22. Tzouvelekis LS, Tzelepi E, Tassios PT, Legakis NJ. CTX-M-type beta-lactamases: an emerging group of extended-spectrum enzymes. Int J Antimicrob Agents 2000; 14(2): 137-42.
  23. Bradford PA, Yang Y, Sahm D, Grope I, Gar-dovska D, Storch G. CTX-M-5, a novel cefotaxime-hydrolyzing beta-lactamase from an outbreak of Salmonella typhimurium in Latvia. Antimicrob Agents Chemother 1998; 42(8): 1980-4.
  24. Bonnet R, Sampaio JL, Labia R, De Champs C, Sirot D, Chanal C, et al. A novel CTX-M beta-lactamase (CTX-M-8) in cefotaxime-resistant Enterobacteriaceae isolated in Brazil. Antimicrob Agents Chemother 2000; 44(7): 1936-42.
  25. Gazouli M, Sidorenko SV, Tzelepi E, Kozlova NS, Gladin DP, Tzouvelekis LS. A plasmid-mediated beta-lactamase conferring resistance to cefotaxime in a Salmonella typhimurium clone found in St Petersburg, Russia. J Antimicrob Chemother 1998; 41(1): 119-21.
  26. Bonnet R. Growing group of extended-spectrum beta-lactamases: the CTX-M enzymes. Antimicrob Agents Chemother 2004; 48(1): 1-14.
  27. Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC. Color atlas and textbook of diagnostic microbiology. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 1997.
  28. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; Fifteenth Informational Supplement. Villanova, PA: Clinical and Laboratory Standards Institute; 2005.
  29. Clinical and Laboratory Standards Institute. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria that Grow Aerobically. 3rd ed. Villanova, PA: Clinical and Laboratory Standards Institute; 1993.
  30. Sirot J. Detection of extended-spectrum plasmid-mediated beta-lactamases by disk diffusion. Clin Microbiol Infect 1996; 2(Suppl 1): S35-S39.
  31. Varma JK, Greene KD, Ovitt J, Barrett TJ, Medalla F, Angulo FJ. Hospitalization and antimicrobial resistance in Salmonella outbreaks, 1984-2002. Emerg Infect Dis 2005; 11(6): 943-6.
  32. Parry CM. Antimicrobial drug resistance in Salmo-nella enterica. Curr Opin Infect Dis 2003; 16(5): 467-72.
  33. Shannon K, French G. Multiple-antibiotic-resistant salmonella. Lancet 1998; 352(9126): 490.
  34. Centers for Disease Control and Prevention. National Antimicrobial Resistance Monitoring System for Enteric Bacteria: annual report, 2002. Atlanta: The Centers for Disease Control and Prevention; 2004.
  35. Rotimi VO, Jamal W, Pal T, Sovenned A, Albert MJ. Emergence of CTX-M-15 type extended-spectrum beta-lactamase-producing Salmonella spp. in Kuwait and the United Arab Emirates. J Med Microbiol 2008; 57(Pt 7): 881-6.
  36. Romero L, Lopez L, Martinez-Martinez L, Guerra B, Hernandez JR, Pascual A. Characterization of the first CTX-M-14-producing Salmonella enterica serotype Enteritidis isolate. J Antimicrob Chemother 2004; 53(6): 1113-4.
  37. Jin Y, Ling JM. CTX-M-producing Salmonella spp. in Hong Kong: an emerging problem. J Med Microbiol 2006; 55(Pt 9): 1245-50.
  38. Weill FX, Perrier-Gros-Claude JD, Demartin M, Coignard S, Grimont PA. Characterization of extended-spectrum-beta-lactamase (CTX-M-15)-producing strains of Salmonella enterica isolated in France and Senegal. FEMS Microbiol Lett 2004; 238(2): 353-8.
  39. Bouallègue-Godet O, Ben Salem Y, Fabre L, Demartin M, Grimont PA, Mzoughi R, et al. Nosocomial outbreak caused by Salmonella enterica serotype Livingstone producing CTX-M-27 extended-spectrum beta-lactamase in a neonatal unit in Sousse, Tunisia. J Clin Microbiol 2005; 43(3): 1037-44.
  40. Govinden U, Mocktar C, Moodley P, Sturm AW, Essack SY. CTX-M-37 in Salmonella enterica serotype Isangi from Durban, South Africa. Int J Antimicrob Agents 2006; 28(4): 288-91.
  41. Shivhare S, Sharda R, Sharma V, Reddy AG. Some aspects of molecular epidemiology & characterisation of Salmonella Typhimurium isolated from man & animals. Indian Journal of Comparative Microbiology Immunology and Infectious Diseases 2000; 21(1): 76-8.
  42. Rahman H. Some aspects of molecular epidemiology & characterisation of Salmonella Typhimurium isolated from man & animals. Indian J Med Res 2002; 115: 108-12.
  43. Dorn CR, Silapanuntakul R, Angrick EJ, Ship-man LD. Plasmid analysis and epidemiology of Salmonella enteritidis infection in three commercial layer flocks. Avian Dis 1992; 36(4): 844-51.
  44. Cruchaga S, Echeita A, Aladueña A, Garcia-Peña J, Frias N, Usera MA. Antimicrobial re-sistance in salmonellae from humans, food and animals in Spain in 1998. J Antimicrob Chemother 2001; 47(3): 315-21.