The Molecular Investigation of Class 1 and 2 Integrons among the Escherichia Coli Isolated from Urine Samples of Children in Imam Reza Hospital, Kermanshah City, Iran, in 2016

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Infectious Diseases, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Associate Professor, Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Department of Microbiology, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Department of Biostatistics and Epidemiology, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran

5 Associate Professor, Department of Pediatrics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran

Abstract

Background: One of the most successful advances in bacteria is transmission of antibiotic resistance genes by integrons, which leads to the emergence of multiple drug resistant (MDR) species. The aim of this study was to determine the prevalence of class 1 and 2 integron among Escherichia coli (E. coli) isolated from children with urinary tract infection (UTI) in Imam Reza hospital, Kermanshah City, Iran, in 2016.Methods: In this cross-sectional study, 89 Escherichia coli isolates were collected. After identification by biochemical tests, and evaluating antibiotic susceptibility tests using disk diffusion method, the frequency of class 1 and 2 integron were determined using specific primers and polymerase chain reaction (PCR) methods.Findings: Of total of 89 studied samples, 53 (59.03%) isolates were multiple-drug resistant. The highest antibiotic resistance of isolates was to ampicillin (85.4%), and co-trimoxazole (68.5%), and the lowest was to imipenem (12.4%) and nitrofurantoin (16.8%). Frequency of class 1 and class 2 integron were 71.9% and 3.5%, respectively. There was significant relationship between the frequency of integrons and resistance to tetracycline and gentamicin (P < 0.05).Conclusion: The results showed that, in addition to the high prevalence of multiple-drug resistant isolates, the frequency of class I integron was also high in Escherichia coli species. Therefore, identifying frequency of integrons and their relationship with drug resistance patterns in bacterial isolates seems to be necessary.

Keywords


  1. Yousefi-Fatmesari G, Hemmati M, Mortazavi SH, Mansouri F, Azizi M, Etemadimajd M, et al. Frequency of blaCTX-M, blaTEM, and blaSHV genes in Escherichia coli isolated from urine samples of children in Kermanshah City, Iran. J Isfahan Med Sch 2017; 35(430): 551-7. [In Persian].
  2. Eslami M, Ghanbarpour R. Determination of P, S and Afa fimbria coding genes in Escherichia coli isolates from urinary tract infections. J Isfahan Med Sch 2015; 33(331): 546-53. [In Persian].
  3. Khalili M B, Sharifi Yazdi M K, Ebadi M, Sadeh M. Correlation between urine analysis and urine culture in the diagnosis of urinary tract infection in Yazd central laboratory. Tehran Univ Med J 2007; 6(9): 53-8. [In Persian].
  4. Mehr SS, Powell CV, Curtis N. Cephalosporin resistant urinary tract infections in young children. J Paediatr Child Health 2004; 40(1-2): 48-52.
  5. Mobasherizadeh M, Bidoki SK, Mobasherizadeh S. Prevalence of CTX-M genes in Escherichia coli strains in outpatient and inpatient cases with urinary tract infections in Isfahan, Iran. J Isfahan Med Sch 2016; 33(360): 2019-25. [In Persian].
  6. Akya A, Mojarab M, Farshchian M, Ahmadi K. The effect of stem bark extracts of Tamarix ramosissim shrub on Pseudomonas aeruginosa isolates. Sci J Kurdistan Univ Med Sci 2014; 19(4): 128-34. [In persian].
  7. Boucher Y, Labbate M, Koenig JE, Stokes HW. Integrons: Mobilizable platforms that promote genetic diversity in bacteria. Trends Microbiol 2007; 15(7): 301-9.
  8. Hajiahmadi F, Safari N, Alijani P, Rabiei M, Masomian N, Arabestani M R. Assessment of the prevalence of class I and II integrons of Escherichia coli and Klebsiella pneumoniae isolates from hospitals of Hamadan. Sci J Hamadan Univ Med Sci 2016; 23(3): 193-201. [In Persian].
  9. Gillings MR. Integrons: past, present, and future. Microbiol Mol Biol Rev 2014; 78(2): 257-77.
  10. Japoni S, Japoni A, Farshad S, Ali AA, Jamalidoust M. Association between existence of integrons and multi-drug resistance in Acinetobacter isolated from patients in southern Iran. Pol J Microbiol 2011; 60(2): 163-8.
  11. Eslami G, Seyedjavadi S S, Goudarzi H, Fallah F, Goudarzi M. Distribution of integrons among multidrug resistant E. coli and Klebsiella strains. Pajouhesh Dar Pezeshki 2010; 34(1): 61-5. [In Persian].
  12. Ranjbaran M, Zolfaghari M, Japoni-Nejad A, Amouzandeh-Nobaveh A, Abtahi H, Nejad M et al . Molecular investigation of integrons in Escherichia coli and Klebsiella pneumoniae isolated from urinary tract infections. J Mazandaran Univ Med Sci 2013; 23 (105): 20-7. [In Persian].
  13. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing; Twenty-second informational supplement. CLSI document M100-S22. Wayne, PA: CLSI; 2012.
  14. Sun J, Zheng F, Wang F, Wu K, Wang Q, Chen Q, et al. Class 1 integrons in urinary isolates of extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella pneumoniae in Southern China during the past five years. Microb Drug Resist 2013; 19(4): 289-94.
  15. Kahlmeter G. Prevalence and antimicrobial susceptibility of pathogens in uncomplicated cystitis in Europe. The ECO.SENS study. Int J Antimicrob Agents 2003; 22(Suppl 2): 49-52.
  16. Nguyen TV, Le PV, Le CH, Weintraub A. Antibiotic resistance in diarrheagenic Escherichia coli and Shigella strains isolated from children in Hanoi, Vietnam. Antimicrob Agents Chemother 2005; 49(2): 816-9.
  17. Ochoa TJ, Ruiz J, Molina M, Del Valle LJ, Vargas M, Gil AI, et al. High frequency of antimicrobial drug resistance of diarrheagenic Escherichia coli in infants in Peru. Am J Trop Med Hyg 2009; 81(2): 296-301.
  18. Murshed M, Shahnaz S, Abdul Malek M. Detection of resistance gene marker intl1 and antimicrobial resistance pattern of E. coli isolated from surgical site wound infection in Holy Family Red Crescent Medical College Hospital. Bangladesh Journal of Medical Microbiology 2010; 4(2): 19-23.
  19. Kargar M, Mohammadalipour Z, Doosti A, Lorzadeh S, Japoni-Nejad A. High prevalence of class 1 to 3 integrons among multidrug-resistant diarrheagenic Escherichia coli in southwest of Iran. Osong Public Health Res Perspect 2014; 5(4): 193-8.
  20. Masoumian N, Haghi F. Analysis of integrons and associated gene cassettes in clinical isolates of Escherichia coli. J Zanjan Univ Med Sci 2015; 23(99): 74-82. [In Persian].
  21. Ibrahim N, Wajidi MF, Yusof MY, Tay ST. The integron prevalence of extended-spectrum beta-lactamase producing enterobacterial isolates in a Malaysian teaching hospital. Trop Biomed 2011; 28(3): 668-71.
  22. Ahangarzadeh RM, Langarizadeh N, Aghazadeh M. First report of class 1 and class 2 integrons in multidrug-resistant Klebsiella pneumoniae isolates from northwest Iran. Jpn J Infect Dis 2012; 65(3): 256-9.
  23. Memariani M, Najar Peerayeh S, Shokouhi Mostafavi SK, Zahraei Salehi T. Detection of class 1 and 2 integrons among enteropathogenic Escherichia coli isolates. Arch Pediatr Infect Dis 2014; 2(4): e16372.
  24. Farshad S, Japoni A, Hosseini M. Low distribution of integrons among multidrug resistant E. coli strains isolated from children with community-acquired urinary tract infections in Shiraz, Iran. Pol J Microbiol 2008; 57(3): 193-8.
  25. Rao AN, Barlow M, Clark LA, Boring JR, III, Tenover FC, McGowan JE, Jr. Class 1 integrons in resistant Escherichia coli and Klebsiella spp., US hospitals. Emerg Infect Dis 2006; 12(6): 1011-4.
  26. Falakian Z, Nikookar I, Nafisi M, Karimi A, Validi M. Frequency of class 1 integrons among Escherichia coli isolates of patients with urinary tract infection. Iran J Clin Infect Dis 2011; 6(4): 157-60.