Original Article

Antibiotic resistance pattern and phylogenetic groups of the uropathogenic Escherichia coli isolates from urinary tract infections in Hamedan, west of Iran

Abstract

Background and Objectives: Escherichia coli is the most common causative agent of urinary tract infections (UTIs) in 90-80% of patients in all age groups. Phylogenetic groups of these bacteria are variable and the most known groups are A, B1, B2 and D. The present study aimed to evaluate the phylogenetic groups of E. coli samples obtained from UTIs and their relation with antibiotic resistance patterns of isolates.
Materials and Methods: In this study 113 E. coli isolates were isolated from distinct patients with UTIs referred to Hamadan hospitals. After biochemical and molecular identification of the isolates, typing and phylogenetic grouping of E. coli strains were performed using multiplex PCR targeting chu, yjaA and TSPE4.C2 genes. The anti-microbial susceptibility of the isolates to amikacin, ampicillin, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic acid, ciprofloxacin, cefotaxime, imipenem, aztreonam, gentamicin, meropenem, nitrofurantoin, nalidixic acid and cefazolin was determined using disk diffusion method.
Results: Of 113 isolates, 50 (44.2%), 35 (31%), 23 (20.4%) and 5 (4.4%) of samples belonged to group B2, group D, group A and group B1 phylogenetic groups respectively. All isolates were susceptible to meropenem, imipenem (100%), followed by amikacin (99.1%). The highest resistance rates were observed against ampicillin (74.3%) and nalidixic acid (70.8%). Correlation between phylogenetic groups and antibiotic susceptibilities was significant only with co-amoxiclav (P = 0.006), which had the highest resistance in phylogenetic group A.
Conclusion: Prevalence of different phylogroup and resistance associated with them in E. coli samples could be variable in each region. Therefore, investigating of these items in E. coli infections, could be more helpful in selecting the appropriate antibiotic treatment and epidemiological studies.

1. Murray PR, Rosenthal KS, Pfaller MA (2015). Medical microbiology: Elsevier Health Sciences.
2. Trautner BW, Darouiche RO. Role of biofilm in catheter-associated urinary tract infection. Am J Infect Control 2004;32:177-183.
3. Neamati F, Firoozeh F, Saffary M, Mousavi G. The prevalence of uropathogenic E. coli and detection of some virulence genes isolated from patients referred to Kashan Shahid-Beheshti hospital during 2012-2013. Feyz 2014; 18: 267-274.
4. Najafi A, Hasanpour M, Askary A, Aziemzadeh M, Hashemi N. Distribution of pathogenicity island markers and virulence factors in new phylogenetic groups of uropathogenic Escherichia coli isolates. Folia Microbiol (Praha) 2018; 63:335-343.
5. Grabe M, Bjerklund-Johansen T, Botto H, Çek M, Naber K, Tenke P, et al. Guidelines on urological infections. European association of urology 2015;42. https://uroweb.org/wp-content/uploads/19-Urological-infections_LR2.pdf
6. Ayub M, Amir J, Firdous K, Khan S, Iqbal I. E. coli the most prevalent causative agent urinary tract infection in pregnancy: comparative analysis of susceptibility and resistance pattern of antimicrobials. Arch Clin Microbiol 2016;7:25.
7. Totsika M, Gomes Moriel D, Idris A, A Rogers B, J Wurpel D, Phan M-D, et al. Uropathogenic Escherichia coli mediated urinary tract infection. Curr Drug Targets 2012;13:1386-1399.
8. Mamani M, Nobari N, Alikhani MY, Poorolajal J. Antibacterial susceptibility of Escherichia coli among outpatients with community-acquired urinary tract infection in Hamadan, Iran. J Glob Antimicrob Resist 2015;3:40-43.
9. Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med 2002;113 Suppl 1A:5S-13S.
10. Takahashi A, Kanamaru S, Kurazono H, Kunishima Y, Tsukamoto T, Ogawa O, et al. Escherichia coli isolates associated with uncomplicated and complicated cystitis and asymptomatic bacteriuria possess similar phylogenies, virulence genes, and O-serogroup profiles. J Clin Microbiol 2006;44:4589-4592.
11. Asadi Karam MR, Habibi M, Bouzari S. Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli. Mol Immunol 2019; 108:56-67.
12. Walk ST, Alm EW, Calhoun LM, Mladonicky JM, Whittam TS. Genetic diversity and population structure of Escherichia coli isolated from freshwater beaches. Environ Microbiol 2007;9:2274-2288.
13. Hacker J, Kaper JB. Pathogenicity islands and the evolution of microbes. Annu Rev Microbiol 2000;54:641-679.
14. Bahadori M, Motamedifar M, Derakhshandeh A, Firouzi R, Motamedi Boroojeni A, Alinejad M, et al. Genetic relatedness of the Escherichia coli fecal population and strains causing urinary tract infection in the same host. Microbiologyopen 2019;8(6):e00759.
15. Ejrnæs K. Bacterial characteristics of importance for recurrent urinary tract infections caused by Escherichia coli. Dan Med Bull 2011;58:B4187.
16. Bonacorsi SPP, Clermont O, Tinsley C, Le Gall I, Beaudoin J-C, Elion J, et al. Identification of regions of the Escherichia coli chromosome specific for neonatal meningitis-associated strains. Infect Immun 2000;68:2096-2101.
17. Clermont O, Bonacorsi S, Bingen E. Rapid and simple determination of the Escherichia coli phylogenetic group. Appl Environ Microbiol 2000;66:4555-4558.
18. Soto S, De Anta MJ, Vila J. Quinolones induce partial or total loss of pathogenicity islands in uropathogenic Escherichia coli by SOS-dependent or-independent pathways, respectively. Antimicrob Agents Chemother 2006;50:649-653.
19. Petkovsek Z, Elersic K, Gubina M, Zgur-Bertok D, Erjavec MS. Virulence potential of Escherichia coli isolates from skin and soft tissue infections. J Clin Microbiol 2009;47:1811-1817.
20. Saeed MA, Haque A, Ali A, Mohsin M, Bashir S, Tariq A, et al. Relationship of drug resistance to phylogenetic groups of E. coli isolates from wound infections. J Infect Dev Ctries 2009;3:667-670.
21. Mahon CR, Lehman DC, Manuselis G (2018). Textbook of diagnostic microbiology-e-book: Elsevier Health Sciences.
22. Brooks GF, Morse SA, Brooks GF, Butel JS (2004). Jawetz, Melnick, & Adelberg's Medical Microbiology: Lange Medical Books/McGraw-Hill, Medical Pub. Division.
23. Coura FM, Diniz Sde A, Silva MX, Mussi JM, Barbosa SM, Lage AP, et al. Phylogenetic group determination of Escherichia coli isolated from animals samples. Sci World J 2015; 2015:258424.
24. Iranpour D, Hassanpour M, Ansari H, Tajbakhsh S, Khamisipour G, Najafi A. Phylogenetic groups of Escherichia coli strains from patients with urinary tract infection in Iran based on the new Clermont phylotyping method. Biomed Res Int 2015;2015:846219.
25. Asadi S, Solhju K, Kargar M, Rezaeian AA. Phylogenetic groups of Escherichia coli strains isolated from urinary tract infection in Jahrom city, southern Iran. JMW 2011; 3:245-250.
26. Sohrabi R, Zeighami H. Determination of phylogenetic groups and antibiotic resistance in uropathogenic and commensal Escherichia coli isolated from patients in Zanjan City. J Adv Med Biomed Res 2016;24: 107-118.
27. Blahna MT, Zalewski CA, Reuer J, Kahlmeter G, Foxman B, Marrs CF. The role of horizontal gene transfer in the spread of trimethoprim–sulfamethoxazole resistance among uropathogenic Escherichia coli in Europe and Canada. J Antimicrob Chemother 2006;57:666-672.
28. Alyamani EJ, Khiyami AM, Booq RY, Majrashi MA, Bahwerth FS, Rechkina E. The occurrence of ESBL-producing Escherichia coli carrying aminoglycoside resistance genes in urinary tract infections in Saudi Arabia. Ann Clin Microbiol Antimicrob 2017;16:1.
Files
IssueVol 12 No 5 (2020) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijm.v12i5.4598
Keywords
Escherichia coli; Antibiotic resistance; Phylogenetic group; Urinary tract infections; Multiplex polymerase chain reaction
Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Bakhtiari S, Mahmoudi H, Khosravi Seftjani S, Amirzargar MA, Ghiasvand S, Ghaffari ME, Adabi M. Antibiotic resistance pattern and phylogenetic groups of the uropathogenic Escherichia coli isolates from urinary tract infections in Hamedan, west of Iran. Iran J Microbiol. 2020;12(5):388-394.