<p>Characterization of Extended-Spectrum β-Lactamase-Producing Uropathogenic <em>Escherichia coli</em> Among Iranian Kidney Transplant Patients</p>

Abstract

The aim of this study was to investigate the antimicrobial susceptibility pattern and the presence of ESBLs among the uropathogenic Escherichia coli (UPEC) isolated from kidney transplant patients (KTP) and community-acquired urinary tract infections (UTIs) using phenotypic and molecular methods. Materials and Methods: A total of 111 pure cultures of UPEC isolates were collected from 65 and 46 of non-KTP and KTPs with UTIs. The pattern and ESBL production of the strains were evaluated. PCR reaction to detect the presence of bla SHV , bla TEM , and bla CTX-M genes was performed. Results: The results revealed that most of UPEC isolates obtained from KTPs and control group were resistant to trimethoprim/sulfamethoxazole (84.8% vs 46.2%), while carbapenems (100% sensitivity) were the most effective against UPEC isolates. ESBL-producing strains were significantly more frequent in KTPs compared with control group (43.5% vs 23.1%, P = 0.021). The molecular results revealed that 53.2% (59/111), 45% (50/111), and 5.4% (6/111) of isolates harbored bla CTX-M , bla TEM , and bla SHV genes, respectively. Of the genes investigated, bla CTX-M and bla TEM genes were significantly higher among KTP than the control group. Conclusion: Our results showed a high proportion of multidrug-resistant and ESBL-producing isolates, which most of them harbor blaCTX-M. A significant high co-resistance to different classes of antibiotics was reported from ESBL-producing UPEC from KTPs, which remains a serious clinical challenge.

A retrospective cross-sectional survey on nosocomial bacterial infections and their antimicrobial susceptibility patterns in hospitalized patients in northwest of Iran

“…In another definition MDR means non-susceptibility to at minim one agent in three or more antimicrobial categories, XDR means non-susceptibility to at minim one agent in all but two or fewer antimicrobial categories [18]. In bacteria, integrons as transposable elements and extended spectrum β-lactamases (ESBLs) enzymes in a variety of Gram negative bacteria are related to an increased resistance to commonly used antibiotics [19][20][21]. There is no denying the fact that if there is no efficient timely respond, the problem of resistance to antibiotic is becoming a huge difficulty in the future years.…”

Molecular characterization and in silico analysis of mutations associated with extended-spectrum beta-lactamase resistance in uropathogenic Escherichia coli and Klebisiella pneumoniae in two hospitals, Cte dIvoire

“…2018) and in other parts of Africa (Togo et al, 2014;Saravanan et al, 2018;Ouchar et al, 2019), show that the spread of ESBL-producing Enterobacteriaceae in an African context remains a very worrisome phenomenon. The high proportion of uropathogenic strains producing ESBL is thought to be related to the widespread use of third-generation cephalosporins and lack of adequate urinary tract infection (UTI) treatment regarding dosing regimens (Halaji et al, 2020). Indeed, the prevalence of the resistant phenotype is often an accurate reflection of antibiotic prescribing habits (Llor and Bjerrum, 2014).…”

Nitrofurantoin Combined With Amikacin: A Promising Alternative Strategy for Combating MDR Uropathogenic Escherichia coli

“…The use of fluoroquinolones can induce the UPEC to partial or total loss of the pathogenicity islands and lead to cross-resistance of β-lactam drugs ( Soto et al, 2006 ; Rohde et al, 2018 ; Adamus-Bialek et al, 2019 ; Tchesnokova et al, 2019 ). On the other hand, the high prevalence of integrons and plasmids also leads to high levels of antibiotic resistance and virulence genes in clinical urogenic bacteria, such as resistance of extended spectrum β-lactamase (ESBL) producing and to quinolones ( Raeispour and Ranjbar, 2018 ; Abbasi and Ranjbar, 2018 ; Farajzadah Sheikh et al, 2019 ; Halaji et al, 2020a ; Halaji et al, 2020b ). However, the use of nitrofurantoin is contraindicated in patients with renal failure due to metabolites that may cause peripheral neuropathy ( Spring et al, 2001 ).…”