Journal of Isfahan Medical School

Journal of Isfahan Medical School

The Frequency of Plasmid qnr Genes in Quinolone-Resistant Isolates of Escherichia Coli Causing Urinary Tract Infection

Document Type : Original Article (s)

Authors
Mehdi Ebrahimian 1
Maryam Mohammadi-Sichani 2
1 Department of Microbiology, Naein Branch, Islamic Azad University, Naein, Iran
2 Assistant Professor, Department of Microbiology, Falavarjan Branch, Islamic Azad University, Isfahan, Iran
10.22122/jims.v36i499.10443
Abstract
Background: Escherichia coli is one of the main causes of urinary tract infection in humans. The bacteria have become resistant to antibiotics and its treatment is difficult. The plasmid-dependent resistance to quinolones is increasing in the family of Enterobacteriaceae. This study aimed to assess the frequency of plasmid qnr genes in quinolone-resistant isolates of Escherichia coli causing urinary tract infectionMethods: In this descriptive study, 96 isolates of Escherichia coli were identified. Antibiotic susceptibility of isolates was investigated using disc diffusion method. The presence of qnrA, qnrB, and qnrS plasmids was assessed using molecular methods with specific primers.Findings: Of the 96 isolates examined, 53 isolates (40.16%) were resistant to fluoroquinolone antibiotics. Moreover, the presence of qnrA gene in 18 isolates (33.96%), qnrB gene in 8 isolates (15.1%), and qnrS gene in 5 isolates (9.43%) of 53 isolates resistant to fluoroquinolones was confirmed via polymerase chain reaction (PCR) assay.Conclusion: The results of this study show that genes of plasmid-dependent qnr group have expanded in Isfahan City, Iran. The frequency of the qnrA gene relative to qnrB and qnrS is higher among quinolone-resistant Escherichia coli isolates in Isfahan.
Keywords
Escherichia coli
Fluoroquinolones
Antibiotic Resistance
Plasmid
Urinary tract infections
Polymerase chain reaction
  1. Toval F, Kohler CD, Vogel U, Wagenlehner F, Mellmann A, Fruth A, et al. Characterization of Escherichia coli isolates from hospital inpatients or outpatients with urinary tract infection. J Clin Microbiol 2014; 52(2): 407-18.
  2. Luthje P, Brauner A. Virulence factors of uropathogenic E. coli and their interaction with the host. Adv Microb Physiol 2014; 65: 337-72.
  3. Foxman B. Urinary tract infection syndromes: occurrence, recurrence, bacteriology, risk factors, and disease burden. Infect Dis Clin North Am 2014; 28(1): 1-13.
  4. Pakzad I, Ghafourian S, Taherikalani M, Sadeghifard N, Abtahi H, Rahbar M, et al. qnr Prevalence in extended spectrum beta-lactamases (ESBLs) and none-ESBLs producing Escherichia coli isolated from urinary tract infections in central of Iran. Iran J Basic Med Sci 2011; 14(5): 458-64.
  5. Redgrave LS, Sutton SB, Webber MA, Piddock LJ. Fluoroquinolone resistance: Mechanisms, impact on bacteria, and role in evolutionary success. Trends Microbiol 2014; 22(8): 438-45.
  6. Sato T, Yokota S, Uchida I, Okubo T, Usui M, Kusumoto M, et al. Fluoroquinolone resistance mechanisms in an Escherichia coli isolate, HUE1, without quinolone resistance-determining region mutations. Front Microbiol 2013; 4: 125.
  7. Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC. Koneman's Color atlas and textbook of diagnostic microbiology. Philadelphia, PA: Lippincott Williams and Wilkins; 2005.
  8. Nahon C, Lehman D, Manuselis G. Textbook of diagnostic microbiology. 5th ed. Philadelphia, PA: Saunders; 2015.
  9. Sherkat R, Mostafavizadeh K, Mobarak S, Esmaealian H, Yaran M, Rostami S. Molecular assessment of microbial etiology in urinary tract infection in renal transplant patients with fever. J Isfahan Med Sch 2018; 35(463): 1923-30. [In Persian].
  10. Dehbanipour R, Tahanasab Z, Maleki N, Rezaei A, Faghri J. Antibiotic resistant pattern in escherichia coli derived from outpatients and inpatients with urinary tract infections in Alzahra Hospital, Isfahan, Iran. J Isfahan Med Sch 2017; 34(415): 1674-9. [In Persian].
  11. Robicsek A, Strahilevitz J, Sahm DF, Jacoby GA, Hooper DC. qnr prevalence in ceftazidime-resistant Enterobacteriaceae isolates from the United States. Antimicrob Agents Chemother 2006; 50(8): 2872-4.
  12. Jeong JY, Yoon HJ, Kim ES, Lee Y, Choi SH, Kim NJ, et al. Detection of qnr in clinical isolates of Escherichia coli from Korea. Antimicrob Agents Chemother 2005; 49(6): 2522-4.
  13. Rezazadeh M, Baghchesaraei H, Peymani A. Plasmid-mediated quinolone-resistance (qnr) genes in clinical isolates of escherichia coli collected from several hospitals of Qazvin and Zanjan Provinces, Iran. Osong Public Health Res Perspect 2016; 7(5): 307-12.
  14. Correia S, Poeta P, Hebraud M, Capelo JL, Igrejas G. Mechanisms of quinolone action and resistance: where do we stand? J Med Microbiol 2017; 66(5): 551-9.
  15. Harifi Mood E, Meshkat Z, Izadi N, Rezaei M, Amel JS, Naderi NM. Prevalence of quinolone resistance genes among extended-spectrum B-Lactamase-Producing Escherichia coli in Mashhad, Iran. Jundishapur J Microbiol 2015; 8(12): e16217.
  16. Sedighi I, Arabestani MR, Rahimbakhsh A, Karimitabar Z, Alikhani MY. Dissemination of extended-spectrum beta-lactamases and quinolone resistance genes among clinical isolates of uropathogenic Escherichia coli in children. Jundishapur J Microbiol 2015; 8(7): e19184.
  17. Momtaz H, Karimian A, Madani M, Safarpoor DF, Ranjbar R, Sarshar M, et al. Uropathogenic Escherichia coli in Iran: Serogroup distributions, virulence factors and antimicrobial resistance properties. Ann Clin Microbiol Antimicrob 2013; 12: 8.
  18. Kao CY, Wu HM, Lin WH, Tseng CC, Yan JJ, Wang MC, et al. Plasmid-mediated quinolone resistance determinants in quinolone-resistant Escherichia coli isolated from patients with bacteremia in a university hospital in Taiwan, 2001-2015. Sci Rep 2016; 6: 32281.
  19. Mokhtari-Farsani A, Doosti A, Mohammadalipour Z. Presence of Qnr genes related to resistance to quinolones, first-, second- and third-generation in diarrhoeagenic Escherichia coli. J Patient Saf Infect Control 2016; 4(1): 5-9.
  20. Mansory Jamshidi N, pakzad E, tabaraee B, hadadi A. Frequency of qnr genes in Escherichia coli strains resistant to quinolones isolated from Ilam Imam khomani hospital and Tehran Milad hospital. J Ilam Univ Med Sci 2013; 21(6):16-22. [In Persian].
Journal of Isfahan Medical School
Volume 36, Issue 499 - Serial Number 499
September and October 2018
Pages 1213-1218

  • Receive Date 14 July 2018
  • Accept Date 06 April 2022