Epidemiology of Multidrug Resistant Uropathogenic &lt;i&gt;Escherichia coli&lt;/i&gt; in Iran: a Systematic Review and Meta-Analysis

Hadifar, Shima; Moghoofei, Mohsen; Nematollahi, Shahrzad; Ramazanzadeh, Rashid; Sedighi, Mansour; Salehi‐Abargouei, Amin; Miri, Ali

doi:10.7883/yoken.jjid.2015.652

Cited by 33 publications

(28 citation statements)

References 34 publications

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“…However, the integrons in MDR-UPEC clinical strains and their relationship with virulence factors and clonality have been poorly studied. In recent years, an increase in UPEC strains with an extensively drug-resistant (XDR) profile complicating UTI therapy has been observed (Dehbanipour et al, 2016; Hadifar et al, 2016). The aim of this study was to identify MDR- and XDR-UPEC clinical strains and their virulence genes and phylogenetic groups and to ascertain their relationship with integrons and their genetic diversity.…”

Section: Introductionmentioning

confidence: 99%

Multidrug- and Extensively Drug-Resistant Uropathogenic Escherichia coli Clinical Strains: Phylogenetic Groups Widely Associated with Integrons Maintain High Genetic Diversity

et al. 2016

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In recent years, an increase of uropathogenic Escherichia coli (UPEC) strains with Multidrug-resistant (MDR) and Extensively Drug-resistant (XDR) profiles that complicate therapy for urinary tract infections (UTIs) has been observed and has directly impacted costs and extended hospital stays. The aim of this study was to determine MDR- and XDR-UPEC clinical strains, their virulence genes, their phylogenetic groups and to ascertain their relationship with integrons and genetic diversity. From a collection of 500 UPEC strains, 103 were selected with MDR and XDR characteristics. MDR-UPEC strains were mainly associated with phylogenetic groups D (54.87%) and B2 (39.02%) with a high percentage (≥70%) of several fimbrial genes (ecpA, fimH, csgA, and papGII), an iron uptake gene (chuA), and a toxin gene (hlyA). In addition, a moderate frequency (40–70%) of other genes (iutD, tosA, and bcsA) was observed. XDR-UPEC strains were predominantly associated with phylogenetic groups B2 (47.61%) and D (42.85%), which grouped with ≥80 virulence genes, including ecpA, fimH, csgA, papGII, iutD, and chuA. A moderate frequency (40–70%) of the tosA and hlyA genes was observed. The class 1 and 2 integrons that were identified in the MDR- and XDR-UPEC strains were associated with phylogenetic groups D, B2, and A, while the XDR-UPEC strains that were associated with phylogenetic groups B2, D, and A showed an extended-spectrum beta-lactamase (ESBL) phenotype. The modifying enzymes (aadA1, aadB, aacC, ant1, dfrA1, dfrA17, and aadA4) that were identified in the variable region of class 1 and 2 integrons from the MDR strains showed resistance to gentamycin (56.25 and 66.66%, respectively) and trimethoprim-sulfamethoxazole (84.61 and 66.66%, respectively). The MDR- and XDR-UPEC strains were distributed into seven clusters and were closely related to phylogenic groups B2 and D. The diversity analysis by PFGE showed 42.68% of clones of MDR-UPEC and no clonal association in the XDR-UPEC strains. In conclusion, phylogenetic groups including virulence genes are widely associated with two integron classes (1 and 2) in MDR- and XDR-UPEC strains.

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Section: Introductionmentioning

confidence: 99%

Multidrug- and Extensively Drug-Resistant Uropathogenic Escherichia coli Clinical Strains: Phylogenetic Groups Widely Associated with Integrons Maintain High Genetic Diversity

et al. 2016

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“…E. coli (ATCC 25922) and S. aureus (ATCC 25923) were used as quality control organisms for the antimicrobial susceptibility testing according to CLSI (2018). Multidrug resistant isolates were defined as isolates that demonstrated resistance to ≥ 3 of the following antimicrobial agent categories as previously reported by Khawcharoenporn et al (2013) and Hadifar et al (2016): (1) penicillin: ampicillin, (2) nitrofurans: nitrofurantoin, (3) cephalosporins: cefoxitin, (4) trimethoprime-sulphonamides: cotrimoxazole, (5) aminoglycosides: gentamicin and amikacin, (6) carbapenems: imipenem and, (7) macrolides: erythromycin.…”

Section: Antimicrobial Susceptibility Testingmentioning

confidence: 99%

“…Urinary tract infections are commonly treated with β-lactam antibiotics and fluoroquinolones but the emergence of MDR strains among the leading uropathogens to commonly used antimicrobial agents is on the rise, resulting into impaired treatment of UTIs (Shabbir et al, 2018). According to Khawcharoenporn et al (2013) and Hadifar et al (2016), MDR was described as the non-susceptibility of bacteria to at least one antimicrobial agent in 3 or more antimicrobial classes. The development of the MDR strains in bacterial uropathogens has been attributed to several factors such as female gender, older age, history of UTIs, residence in the nursing home, hospitalization, prior exposure to antimicrobials, urinary catheterization and bacterial factors (Shabbir et al, 2018;Hasan et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Phylogenetic analysis of multidrug resistant E. coli isolates from the urinary tract in Bushenyi district, Uganda using the new Clermont phylotyping method

Odoki¹,

Aliero²,

Tibyangye³

et al. 2020

Afr. J. Microbiol. Res.

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Due to the increasing rates of multidrug resistance (MDR) among the Enterobacteriaceae that cause urinary tract infections (UTIs), selection of antimicrobial agents for empirical therapy is becoming a major challenge. This study determined the antimicrobial resistance profiles, multidrug resistance profiles, multiple antibiotic resistance indices (MARI), factors associated with MDR UTIs and the phylogenetic groups of MDR Escherichia coli strains isolated from the urinary tract among patients attending hospitals in Bushenyi District, Uganda. In this crosssectional study, a total of 86 bacterial uropathogens isolated from 267 study participants suspected to have UTIs were subjected to antimicrobial susceptibility tests using the Kirby Bauer Disk diffusion method. Data for the factors associated with MDR were obtained by the use of questionnaires. Phylogenetic groups of the MDR E. coli were determined using the new Clermont method for phylotyping E. coli. Descriptive and multiple logistic regression statistical tools were used to determine phylogenetic groups, and assess for statistically significant relationship between MDR UTIs and factors suspected to be associated with MDR UTIs respectively. The isolates assigned as group B2 9/12 (75.0%), B1 2/5 (40.0%) and A 2/7 (28.6%) by using the old Clermont method could not be phylotyped using the new Clermont method and were grouped as non-typeable strains of E. coli. Our study demonstrated high prevalence of the non-typeable strains of MDR E. coli, we therefore recommend the use of modern DNA sequencing-based approaches which is the gold standard for genotyping bacteria, that this current study could not afford.

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“…Two of these strains were addressed with antibiotics [47,49]. Resistance to antibiotics was the subject of five studies [52][53][54][55][56]. Associations of antibiotics with infection were addressed in seven articles [57][58][59][60][61][62][63].…”

Section: Review Of E Coli Meta-analyses Based On Clinical Syndromesmentioning

confidence: 99%

“…Immunology topics were the focus in three papers [73][74][75]. Although most meta-analyses included here addressed enteric E. coli infections, there are papers that addressed renal infections [53,54,76] with a fairly good number of E. coli meta-analyses and UTI performed in various contexts such as epidemiology [42,55], intervention [52,54] and prevention [73]. Meta-analyses of E. coli in the context of sepsis/meningitis have so far been confined to mice and infants [58,77].…”

Section: Review Of E Coli Meta-analyses Based On Clinical Syndromesmentioning

confidence: 99%

Evaluating Meta-Analysis Research of <i>Escherichia coli</i>

Pabalan¹,

Singian²,

Tabangay³

et al. 2017

≪i>Escherichia Coli

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This chapter summarizes the progress in Escherichia coli research that used the meta-analysis approach. Using systematic searches for E. coli literature, we tracked meta-analysis publications and analyzed them based on a number of parameters. These included subject/topic (epidemiology, clinical/intervention/prevention and environmental), geographical region (the Americas, Europe and Australasia) and clinical syndrome (enteric, renal, and sepsis/meningitis). These parameters were plotted in terms of time span to obtain a sense of dynamic change or its absence through the years since the turn of the twentieth century. In terms of region, topic and syndrome, highest meta-analysis productivity was attributed to the Americas, clinical/intervention/prevention and enteric, all of which took place in the last 5 years (2011)(2012)(2013)(2014)(2015)(2016). Over the combined time span of 16 years, the Americas significantly dominated meta-analysis outputs when compared to Europe and Australasia (P = 0.003). In conclusion, our findings facilitate awareness of the progress in this field wherein the studied parameters were analyzed for patterns over time and differential rates of publication productivity.

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Epidemiology of Multidrug Resistant Uropathogenic <i>Escherichia coli</i> in Iran: a Systematic Review and Meta-Analysis

Cited by 33 publications

References 34 publications

Multidrug- and Extensively Drug-Resistant Uropathogenic Escherichia coli Clinical Strains: Phylogenetic Groups Widely Associated with Integrons Maintain High Genetic Diversity

Multidrug- and Extensively Drug-Resistant Uropathogenic Escherichia coli Clinical Strains: Phylogenetic Groups Widely Associated with Integrons Maintain High Genetic Diversity

Phylogenetic analysis of multidrug resistant E. coli isolates from the urinary tract in Bushenyi district, Uganda using the new Clermont phylotyping method

Evaluating Meta-Analysis Research of <i>Escherichia coli</i>

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