Virulence characterization and clonal analysis of uropathogenic Escherichia coli metallo-beta-lactamase-producing isolates

Abstract

Background Uropathogenic Escherichia coli (UPEC) is a major cause of urinary tract infection (UTI); however, treatment of UTI has been challenging due to increased antimicrobial resistance (AMR). One of the most important types of AMR is carbapenem resistance (CR). CR bacteria are known as an important threat to global public health today. Class B metallo-beta-lactamases (MBLs) are one of the major factors for resistance against carbapenems. We aimed to investigate the characteristics of UPEC isolates producing MBL. Methods A cross-sectional study was conducted from October 2018 to December 2019 in Ahvaz; Iran. UPEC isolates were identified by biochemical and molecular methods. Metallo-beta-lactamase-producing isolates were detected using modified carbapenem inactivation method (mCIM) and EDTA-CIM (eCIM) tests. MBL genes, phylogenetic group, and virulence genes profile of carbapenem resistant isolates were determined. Conjugation assay and plasmid profiling were conducted to evaluate the ability of transferring of CR to other E. coli isolates. Clonal similarity of isolates were assessed using Enterobacterial intergenic repetitive element sequence (ERIC)-PCR. Results Among 406 UPEC isolates, 12 (2.95%) carbapenem-resistant were detected of which 11 were phenotypically MBL-producing strains. Four isolates were resistant to all investigated antimicrobial agents and were considered possible pandrug-resistant (PDR). blaNDM, blaOXA-48, blaIMP-1, and blaIMP-2 genes were found in 9, 5, 1, and 1 isolates, respectively. Among 30 virulence genes investigated, the traT, fyuA followed by fimH, and iutA with the frequency of 8 (66.7%), 8 (66.7%), 7 (58.3%), and 7 (58.3%) were the most identified genes, respectively. Siderophore production was the main virulence trait among carbapenem-resistant UPEC isolates. Except for two, all other isolates showed weak to moderate virulence index. In all recovered isolates, CR was readily transmitted via plasmids to other isolates during conjugation experiments. Conclusion MBL and carbapenemase genes, especially blaNDM and blaOXA-48 are spreading rapidly among bacteria, which can be a threat to global public health. Therefore monitoring the emergence and dissemination of new AMR is necessary to continuously refine guidelines for empiric antimicrobial therapy. Understanding the mechanisms of resistance and virulence in this group of bacteria can play an effective role in providing new therapeutic methods.

Genetic Diversity, Carbapenem Resistance Genes, and Biofilm Formation in UPEC Isolated from Patients with Catheter-Associated Urinary Tract Infection in North of Iran

“…e most susceptible antibiotic was amikacin 84.2%. A comparable form of susceptibility to antibiotics was described against uropathogenic E. coli isolates in previous studies from Iran [31][32][33], and Iraq [34]. Based on what we learned, nitrofurantoin and amikacin seem to be good antibiotics for treating UPEC-related UTIs.…”

Identification of metallo-β-lactamases and AmpC production among Escherichia coli strains isolated from hemodialysis patients with urinary tract infection

“…In a recent study from southwest Iran, each of bla IMP-1 and bla IMP-2 genes were detected in 8.3% of uropathogeneic E. coli isolates, while the bla NDM was detected in 75.0% of isolates. Also, the bla VIM-1 and bla VIM-2 were not detected [ 51 ]. In another study by Deldar Abad Paskeh et al [ 52 ] from Iran, a lower occurrence rates of bla IMP (8.7%) and bla VIM (9.8%) genes were reported in UTI-causing E. coli compared to the current study.…”

Association Between Uropathogenic Escherichia coli Virulence Genes and Severity of Infection and Resistance to Antibiotics

“…21,28,29 Moreover, according to different studies conducted in Iran, ampicillin resistance can reach up to 80%, while resistance to SXT and ciprofloxacin was found in similar ranges to those found in our study (from 45 to 61%). 24,[30][31][32][33] In contrast, Allami et al found a different antibiotic resistance pattern, with SXT resistance of 87%, nitrofurantoin resistance of 45%, and ciprofloxacin resistance of 27%, while antibiotics such as amikacin and imipenem had low resistance (11% and 5%, respectively). 7 Also, a study conducted in Cameroon in 2012 showed how the pattern of antibiotic resistance changes even between cities in the same country.…”