Molecular characterization of quinolone resistant Shigella spp. isolates from patients in Ardabil, Iran
Abstract
Background and Objectives: Shigella is an etiological agent of shigellosis. Antibiotic therapy has a critical role in decreasing serious complications of shigellosis. The present study aimed to determine the multi-drug resistance strains and to detect fluoroquinolone related mutations.
Materials and Methods: In this descriptive, cross sectional study, a total of 113 Shigella isolates were collected from 1280 patients admitted to Bu-Ali hospital in Ardabil province during 2015-17. Antibiotic resistance pattern of isolates was evaluated using Kirby Bauer method and finally, the MICs of ciprofloxacin were determined. In order to determine any mutations in QRDR region, parC and gyrA genes of resistant strains were amplified and sequenced.
Results: Shigella spp. isolates were identified using ipaH amplification and rfc and wbgz genes were used for molecular detection of S. flexneri and S. soneii, respectively. Our results showed that the predominant species in Ardabil province was S. sonnei (69.91%). Most of isolates (82%) were resistant to trimethoprim/sulfamethoxazole (TMP/SMX); 51% were nalidixic acid resistant and 4.4% were floroquinolones resistant. All examined isolates were susceptible to imipenem (100%). Mutation in gyrA and parC genes were detected in all fluoroquinolone resistant isolates (5 isolates). Although, in this study the rate of resistance to ciprofloxacin was low, but in the lack of preventive strategy it will be a major challenge of public health in future.
Conclusion: This study provided information on the prevalence and antimicrobial susceptibility patterns of Shigella isolates in Ardabil province, Iran. Also this study showed a high-level of resistance to commonly used antibiotics among Shigella isolates.
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26. MoezArdalan K, Zali MR, Dallal MM, Hemami MR, Salmanzadeh-Ahrabi SS. Prevalence and pattern of antimicrobial resistance of Shigella species among patients with acute diarrhoea in Karaj, Tehran, Iran. J Health Popul Nutr 2003;21:96-102.
27. Ghavam P, Monajemzadeh M, Haghi Ashtiani MT, Mamishi S, Nodeh Farahani N, Tanzifi P. Shigellosis and changes of antimicrobial susceptibility during six years. Iran J Pediatr 2017; 27(3): e5131.
28. Fàbrega A, Madurga S, Giralt E, Vila J. Mechanism of action of and resistance to quinolones. Microb Biotechnol 2009;2:40-61.
29. Gu B, Qin T-t, Fan W-t, Bi R-r, Chen Y, Li Y, et al. Novel mutations in gyrA and parC among Shigella sonnei strains from Jiangsu Province of China, 2002-2011. Int J Infect Dis 2017;59:44-49.
30. Ranjbar R, Behnood V, Memariani H, Najafi A, Moghbeli M, Mammina C. Molecular characterisation of quinolone-resistant Shigella strains isolated in Tehran, Iran. J Glob Antimicrob Resist 2016;5:26-30.
31. Yaghoubi S, Ranjbar R, Soltan Dallal MM, Shirazi MH, Sharifi-Yazdi MK. Frequency of mutations in quinolone resistance-determining regions and plasmid-mediated quinolone resistance in Shigella isolates recovered from pediatric patients in Tehran, Iran: An Overlooked Problem. Microb Drug Resist 2018;24:699-706.
32. Qin T, Qian H, Fan W, Ma P, Zhou L, Dong C, et al. Newest data on fluoroquinolone resistance mechanism of Shigella flexneri isolates in Jiangsu Province of China. Antimicrob Resist Infect Control 2017;6:97.
33. Sati HF, Bruinsma N, Galas M, Hsieh J, Sanhueza A, Ramon Pardo P, et al. Characterizing Shigella species distribution and antimicrobial susceptibility to ciprofloxacin and nalidixic acid in Latin America between 2000–2015. PLoS One 2019;14(8):e0220445.
34. Abbasi E, Abtahi H, van Belkum A, Ghaznavi-Rad E. Multidrug-resistant Shigella infection in pediatric patients with diarrhea from central Iran. Infect Drug Resist 2019;12: 1535-1544.
2. Partdos CD, Ignatius R, Schneider T. Topley and Wilson's microbiology and microbial infections: Wiley; 2005.
3. Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi AK. Shigellosis. Lancet 2018;391:801-812.
4. Mokomane M, Kasvosve I, Melo Ed, Pernica JM, Goldfarb DM. The global problem of childhood diarrhoeal diseases: emerging strategies in prevention and management. Ther Adv Infect Dis 2018;5:29-43.
5. Hooper DC, Jacoby GA. Mechanisms of drug resistance: quinolone resistance. Ann N Y Acad Sci 2015;1354:12-31.
6. Das A, Natarajan M, Mandal J. The emergence of quinolone resistant Shigella sonnei, Pondicherry, India. PLoS One 2016;11(8):e0160290.
7. Poramathikul K, Bodhidatta L, Chiek S, Oransathid W, Ruekit S, Nobthai P, et al. Multidrug-resistant Shigella infections in patients with diarrhea, Cambodia, 2014-2015. Emerg Infect Dis 2016;22:1640-1643.
8. Azmi IJ, Khajanchi BK, Akter F, Hasan TN, Shahnaij M, Akter M, et al. Fluoroquinolone resistance mechanisms of Shigella flexneri isolated in Bangladesh. PLoS One 2014;9(7):e102533.
9. Tille P. Bailey & Scott's diagnostic microbiology Tille, editor: Elsevier Health Sciences; 2015.
10. Sambrook J, Fritsch EF, Maniatis T. Molecular cloning: a laboratory manual: Cold spring harbor laboratory press; 1989.
11. Teimourpour R, Zare H, Rajabnia R, Yahyapour Y, Meshkat Z. Evaluation of the eukaryotic expression of mtb32C-hbha fusion gene of Mycobacterium tuberculosis in Hepatocarcinoma cell line. Iran J Microbiol 2016;8:132-138.
12. Jean B. Patel MPW. Performance standards for antimicrobial susceptibility testing 27th. In: Institute CaLS, editor. 2017.
13. Ausubel FM, Brent R, Kingston RE, Moore DD, Seidman JG, Struhl K. Current Protocols in Molecular Biology: Wiley; 1988.
14. Teimourpour R. A study on the immune response induced by a DNA vaccine encoding Mtb32C-HBHA antigen of Mycobacterium tuberculosis. Iran J Basic Med Sci 2017;20:1119-1124.
15. Sethabutr O, Venkatesan M, Yam S, Pang LW, Smoak BL, Sang WK, et al. Detection of PCR products of the ipaH gene from Shigella and enteroinvasive Escherichia coli by enzyme linked immunosorbent assay. Diagn Microbiol Infect Dis 2000;37:11-16.
16. Ojha SC, Yean Yean C, Ismail A, Banga Singh K-K. A pentaplex PCR assay for the detection and differentiation of Shigella species. Biomed Res Int 2013;2013:412370.
17. Dutta S, Kawamura Y, Ezaki T, Nair GB, Iida K-I, Yoshida S-I. Alteration in the GyrA subunit of DNA gyrase and the ParC subunit of topoisomerase IV in quinolone-resistant Shigella dysenteriae serotype 1 clinical isolates from Kolkata, India. Antimicrob Agents Chemother 2005;49:1660-1661.
18. Khalil IA, Troeger C, Blacker BF, Rao PC, Brown A, Atherly DE, et al. Morbidity and mortality due to shigella and enterotoxigenic Escherichia coli diarrhoea: the Global Burden of Disease Study 1990–2016. Lancet Infect Dis 2018;18:1229-1240.
19. Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's principles of internal medicine: McGraw-Hill Professional; 2015.
20. Kahsay AG, Muthupandian S. A review on Sero diversity and antimicrobial resistance patterns of Shigella species in Africa, Asia and South America, 2001–2014. BMC Res Notes 2016;9:422.
21. Nodeh Farahani N, Masjedian Jazi F, Nikmanesh B, Asadolahi P, Sadeghi Kalani B, Amirmozafari N. Prevalence and antibiotic susceptibility patterns of Salmonella and Shigella species isolated from pediatric diarrhea in Tehran. Arch Pediatr Infect Dis 2018; 6 (4):e57328.
22. Ghaemi EO, Aslani MM, Moradi AV, Dadgar T, Livani S, Mansourian AR, et al. Epidemiology of Shigella-associated diarrhea in Gorgan, north of Iran. Saudi J Gastroenterol 2007;13:129-132.
23. Sheikh AF, Moosavian M, Abdi M, Heidary M, Shahi F, Jomehzadeh N, et al. Prevalence and antimicrobial resistance of Shigella species isolated from diarrheal patients in Ahvaz, southwest Iran. Infect Drug Resist 2019;12:249-253.
24. Jomezadeh N, Babamoradi S, Kalantar E, Javaherizadeh H. Isolation and antibiotic susceptibility of Shigella species from stool samples among hospitalized children in Abadan, Iran. Gastroenterol Hepatol Bed Bench 2014;7:218-223.
25. Farshad S, Sheikhi R, Japoni A, Basiri E, Alborzi A. Characterization of Shigella strains in Iran by plasmid profile analysis and PCR amplification of ipa genes. J Clin Microbiol 2006;44:2879-2883.
26. MoezArdalan K, Zali MR, Dallal MM, Hemami MR, Salmanzadeh-Ahrabi SS. Prevalence and pattern of antimicrobial resistance of Shigella species among patients with acute diarrhoea in Karaj, Tehran, Iran. J Health Popul Nutr 2003;21:96-102.
27. Ghavam P, Monajemzadeh M, Haghi Ashtiani MT, Mamishi S, Nodeh Farahani N, Tanzifi P. Shigellosis and changes of antimicrobial susceptibility during six years. Iran J Pediatr 2017; 27(3): e5131.
28. Fàbrega A, Madurga S, Giralt E, Vila J. Mechanism of action of and resistance to quinolones. Microb Biotechnol 2009;2:40-61.
29. Gu B, Qin T-t, Fan W-t, Bi R-r, Chen Y, Li Y, et al. Novel mutations in gyrA and parC among Shigella sonnei strains from Jiangsu Province of China, 2002-2011. Int J Infect Dis 2017;59:44-49.
30. Ranjbar R, Behnood V, Memariani H, Najafi A, Moghbeli M, Mammina C. Molecular characterisation of quinolone-resistant Shigella strains isolated in Tehran, Iran. J Glob Antimicrob Resist 2016;5:26-30.
31. Yaghoubi S, Ranjbar R, Soltan Dallal MM, Shirazi MH, Sharifi-Yazdi MK. Frequency of mutations in quinolone resistance-determining regions and plasmid-mediated quinolone resistance in Shigella isolates recovered from pediatric patients in Tehran, Iran: An Overlooked Problem. Microb Drug Resist 2018;24:699-706.
32. Qin T, Qian H, Fan W, Ma P, Zhou L, Dong C, et al. Newest data on fluoroquinolone resistance mechanism of Shigella flexneri isolates in Jiangsu Province of China. Antimicrob Resist Infect Control 2017;6:97.
33. Sati HF, Bruinsma N, Galas M, Hsieh J, Sanhueza A, Ramon Pardo P, et al. Characterizing Shigella species distribution and antimicrobial susceptibility to ciprofloxacin and nalidixic acid in Latin America between 2000–2015. PLoS One 2019;14(8):e0220445.
34. Abbasi E, Abtahi H, van Belkum A, Ghaznavi-Rad E. Multidrug-resistant Shigella infection in pediatric patients with diarrhea from central Iran. Infect Drug Resist 2019;12: 1535-1544.
| Files | ||
| Issue | Vol 11 No 6 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v11i6.2221 | |
| Keywords | ||
| Shigella; Fluoroquinolones; Nalidixic acid; Mutation; Gene | ||
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How to Cite
1.
Teimourpour R, Babapour B, Esmaelizad M, Arzanlou M, Peeri-Doghaheh H. Molecular characterization of quinolone resistant Shigella spp. isolates from patients in Ardabil, Iran. Iran J Microbiol. 2020;11(6):496-501.
