Characterization of integrons, extended spectrum beta lactamases and genetic diversity among uropathogenic Escherichia coli isolates from Kerman, south east of Iran
-
Samane Mohebi
,
Zahra Golestani-Hotkani
,
Maryam Foulad-Pour
,
Peivand Nazeri
,
Fahimeh Mohseni
,
Zahra Hashemizadeh
,
Zahra Moghani-Bashi
,
Naser Niksefat
,
Sanaz Rastegar
,
Maryam Khajedadian
,
Zahra Lotfian
,
Hossein Hosseini-Nave
Abstract
Background and Objectives: The study aimed to investigate the distribution of genes encoding integrons, extended spectrum beta-lactamase (ESBL) in E. coli isolated from UTIs, as well as the genetic diversity among the isolates.
Materials and Methods: E. coli isolates were recovered from the patients with UTI in Kerman Iran. Antibiotic susceptibility was done according to CLSI guidelines. The presence of ESBL genes and integrons was evaluated using PCR. PCR and sequencing were applied for the evaluation of cassette content of integrons. Genotyping of the isolates was performed by multiple-locus variable-number tandem repeat analysis (MLVA).
Results: Imipenem was the most effective antibiotic, while the highest resistance was observed to streptomycin. In total 40.2% of isolates were ESBL producers. Of 69 integron-positive isolates, 59 only had class I integrons, 4 only had class II integrons and 6 had both types. The most common gene cassette found within class I integrons was dfrA17-aadA5 (n=27). The E. coli isolates were divided into 16 MLVA clusters.
Conclusion: The current study demonstrated the simultaneous presence of class I integrons and ESBLs involved in the resistance of UPEC isolates to antibacterial agents. Our finding also revealed that the E. coli isolates belonged to diverse clones.
1. Mehdipour Moghaddam MJ, Mirbagheri AA, Salehi Z, Habibzade SM. Prevalence of class 1 integrons and extended spectrum beta lactamases among multi-drug resistant Escherichia coli isolates from north of Iran. Iran Biomed J 2015; 19: 233-239.
2. Nwokolo CJ, Ugwu MC, Ejikeugwu CP, Iroha IR, Esimone CO. Incidence and antibiotic susceptibility profile of uropathogenic Escherichia coli positive for extended spectrum β -lactamase among HIV / AIDS patients in Awka metropolis, Nigeria. Iran J Microbiol 2022; 14: 334-340.
3. Yahiaoui M, Robin F, Bakour R, Hamidi M, Bonnet R, Messai Y. Antibiotic resistance, virulence, and genetic background of community-acquired uropathogenic Escherichia coli from Algeria. Microb Drug Resist 2015; 21: 516-526.
4. Malekzadegan Y, Khashei R, Sedigh Ebrahim-Saraie H, Jahanabadi Z. Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients. BMC Infect Dis 2018; 18: 572.
5. Azam H, Ghezeljeh SM, Mahmoud S. Prevalence of class 1 and 2 integrons among the multidrug resistant uropathogenic strains of Escherichia coli. Asian Biomed 2015; 9: 49-54.
6. Farshad S, Japoni A, Hosseini M. Low distribution of integrons among multidrug resistant E. coli strains isolated from children with community-acquired urinary tract infections in Shiraz, Iran. Pol J Microbiol 2008; 57: 193-198.
7. Adel El-Sokkary MM, Abdelmegeed ES. Characterisation of class 1 integron among Escherichia coli isolated from Mansoura University Hospitals in Egypt. Adv Microbiol 2015; 5: 269-277.
8. Wang J, Stephan R, Zurfluh K, Hächler H, Fanning S. Characterization of the genetic environment of blaESBL genes, integrons and toxin-antitoxin systems identified on large transferrable plasmids in multi-drug resistant Escherichia coli. Front Microbiol 2015; 5: 716.
9. Zeeshan Khan F, Nawaz T, Mirani ZA, Khan S, Raza Y, Kazmi SU. Study of class 1 integrons in multidrug-resistant uropathogenic Escherichia coli isolated from different hospitals in Karachi. Iran J Basic Med Sci 2018; 21: 1079-1082.
10. Taghadosi R, Shakibaie MR, Hosseini-Nave H. Antibiotic resistance, ESBL genes, integrons, phylogenetic groups and MLVA profiles of Escherichia coli pathotypes isolated from patients with diarrhea and farm animals in south-east of Iran. Comp Immunol Microbiol Infect Dis 2019; 63: 117-126.
11. Hosseini-Nave H, Samareh Salavati M, Lashkari M, Ravari MA, Hashemizadeh Z, Seyedi Marghaki F, et al. Distribution of genes encoding virulence factors and multilocus variable-number tandem-repeat analysis (MLVA) of Entero-aggregative Escherichia coli (EAEC) isolated in Iran from patients with diarrhoea. J Med Microbiol 2018; 67: 1334-1339.
12. Hosseini Nave H, Mansouri S, Taati Moghadam M, Moradi M. Virulence gene profile and multilocus variable-number tandem-repeat analysis (MLVA) of Enteroinvasive Escherichia coli (EIEC) isolates from patients with diarrhea in kerman, Iran. Jundishapur J Microbiol 2016; 9(6): e33529.
13. Wayne. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: twenty-third informational supplement M100-S23. Wayne, PA, USA: CLSI; 2013.
14. Rastegar S, Moradi M, Kalantar-Neyestanaki D, Golabi Dehdasht A, Hosseini-Nave H. Virulence factors, capsular serotypes and antimicrobial resistance of hypervirulent Klebsiella pneumoniae and classical Klebsiella pneumoniae in southeast Iran. Infect Chemother 2019; 10.3947/ic.2019.0027.
15. Hosseini Nave H, Mansouri S, Emaneini M, Moradi M. Distribution of genes encoding virulence factors and molecular analysis of Shigella spp. isolated from patients with diarrhea in Kerman, Iran. Microb Pathog 2016; 92: 68-71.
16. Gorgé O, Lopez S, Hilaire V, Lisanti O, Ramisse V, Vergnaud G. Selection and validation of a multilocus variable-number tandem-repeat analysis panel for typing Shigella spp. J Clin Microbiol 2008; 46: 1026-1036.
17. Oliveira-Pinto C, Diamantino C, Oliveira PL, Reis MP, Costa PS, Paiva MC, et al. Occurrence and characterization of class 1 integrons in Escherichia coli from healthy individuals and those with urinary infection. J Med Microbiol 2017; 66: 577-583.
18. Kumar PM, Jaiswal NK, Singh BK, Sharan S, Kumar R, Tiwari SK. Antimicrobial susceptibility patterns of uropathogenic Escherichia coli and their prevalence among people in and around Dhanbad, Jharkhand. East J Med Sci 2017; 2: 1-3.
19. Al-Assil B, Mahfoud M, Hamzeh AR. First report on class 1 integrons and Trimethoprim-resistance genes from dfrA group in uropathogenic E. coli (UPEC) from the Aleppo area in Syria. Mob Genet Elements 2013; 3(3): e25204.
20. Haghighatpanah M, Mojtahedi A. Characterization of antibiotic resistance and virulence factors of Escherichia coli strains isolated from iranian inpatients with urinary tract infections. Infect Drug Resist 2019; 12: 2747-2754.
21. Dia ML, Ngom B, Diagne R, Ka R, Lo S, Cisse MF, et al. Molecular detection of CTX-M-15-type β-lactamases in Escherichia coli strains from Senegal. New Microbes New Infect 2015; 9: 45-46.
22. Wragg R, Harris A, Patel M, Robb A, Chandran H, McCarthy L. Extended spectrum beta lactamase (ESBL) producing bacteria urinary tract infections and complex pediatric urology. J Pediatr Surg 2017; 52: 286-288.
23. Meier S, Weber R, Zbinden R, Ruef C, Hasse B. Extended-spectrum β-lactamase-producing Gram-negative pathogens in community-acquired urinary tract infections: An increasing challenge for antimicrobial therapy. Infection 2011; 39: 333-340.
24. Chinnasami B, Sundaramoorthy S, Sadasivam K, Pasupathy S. Pathogens causing urinary tract infection in children and their in vitro susceptibility to antimicrobial agents-A hospital based study. Biomed Pharmacol J 2016; 9: 377-383.
25. Parajuli NP, Maharjan P, Parajuli H, Joshi G, Paudel D, Sayami S, et al. High rates of multidrug resistance among uropathogenic Escherichia coli in children and analyses of ESBL producers from Nepal. Antimicrob Resist Infect Control 2017; 6: 9.
26. Pourakbari B, Ferdosian F, Mahmoudi S, Teymuri M, Sabouni F, Heydari H, et al. Increase resistant rates and ESBL production between E. coli isolates causing urinary tract infection in young patients from Iran. Braz J Microbiol 2012; 43: 766-769.
27. Kizilca O, Siraneci R, Yilmaz A, Hatipoglu N, Ozturk E, Kiyak A, et al. Risk factors for community‐acquired urinary tract infection caused by ESBL‐producing bacteria in children. Pediatr Int 2012; 54: 858-862.
28. Ebrahim-Saraie HS, Nezhad NZ, Heidari H, Motamedifar A, Motamedifar M. Detection of antimicrobial susceptibility and integrons among extended-spectrum β-lactamase producing uropathogenic Escherichia coli isolates in Southwestern Iran. Oman Med J 2018; 33: 218-223.
29. Hawser SP, Bouchillon SK, Hoban DJ, Badal RE, Hsueh P-R, Paterson DL. Emergence of high levels of extended-spectrum-β-lactamase-producing gram-negative bacilli in the Asia-Pacific region: Data from the study for monitoring antimicrobial resistance trends (SMART) program, 2007. Antimicrob Agents Chemother 2009; 53: 3280-3284.
30. Neamati F, Khorshidi A, Moniri R, Hosseini Tafreshi SA. Molecular epidemiology of antimicrobial resistance of uropathogenic Escherichia coli isolates from patients with urinary tract infections in a tertiary teaching Hospital in Iran. Microb Drug Resist 2020; 26: 60-70.
31. Rasoulinasab M, Shahcheraghi F, Feizabadi MM, Nikmanesh B, Hajihasani A, Aslani MM. Distribution of ciprofloxacin-resistance genes among ST131 and non-ST131 clones of Escherichia coli isolates with ESBL phenotypes isolated from women with urinary tract infection. Iran J Microbiol 2021; 13: 294-302.
32. Pongpech P, Naenna P, Taipobsakul Y, Tribuddharat C, Srifuengfung S. Prevalence of extended-spectrum beta-lactamase and class 1 integron integrase gene intl1 in Escherichia coli from thai patients and healthy adults. Southeast Asian J Trop Med Public Health 2008; 39: 425-433.
33. Hasani A, Purmohammad A, Rezaee MA, Hasani A, Dadashi M. Integron-mediated multidrug and quinolone resistance in extended-spectrum β -lactamase-Producing Escherichia coli and Klebsiella pneumoniae. Arch Pediatr Infect Dis 2017; 5(2): e36616.
34. Ho WS, Balan G, Puthucheary S, Kong BH, Lim KT, Tan LK, et al. Prevalence and characterization of multidrug-resistant and extended-spectrum beta-lactamase-producing Escherichia coli from pediatric wards of a Malaysian hospital. Microb Drug Resist 2012; 18: 408-416.
35. Chen T, Feng Y, Yuan JL, Qi Y, Cao YX, Wu Y. Class 1 integrons contributes to antibiotic resistance among clinical isolates of Escherichia coli producing extended-spectrum beta-lactamases. Indian J Med Microbiol 2013; 31: 385-389.
36. Sun J, Zheng F, Wang F, Wu K, Wang Q, Chen Q, et al. Class 1 Integrons in urinary isolates of extended-spectrum β-Lactamase-producing Escherichia coli and Klebsiella pneumoniae in Southern China during the past five years. Microb Drug Resist 2013; 19: 289-294.
37. Estabraghi E, Salehi TZ, Amini K, Jamshidian M. Molecular identification of extended-spectrum β-lactamase and integron genes in Klebsiella pneumonia. JNMA J Nepal Med Assoc 2016; 54: 72-78.
38. Cheng H, Jiang H, Fang J, Zhu C. Antibiotic resistance and characteristics of integrons in Escherichia coli isolated from Penaeus vannamei at a Freshwater Shrimp Farm in Zhejiang Province, China. J Food Prot 2019; 82: 470-478.
39. Sunde M, Simonsen GS, Slettemeås JS, Böckerman I, Norström M. Integron, plasmid and host strain characteristics of Escherichia coli from humans and food included in the Norwegian antimicrobial resistance monitoring programs. PLoS One 2015; 10(6): e0128797.
40. Shin HW, Lim J, Kim S, Kim J, Kwon GC, Koo SH. Characterization of trimethoprim-sulfamethoxazole resistance genes and their relatedness to class 1 integron and insertion sequence common region in gram-negative bacilli. J Microbiol Biotechnol 2015; 25: 137-142.
41. Kaushik M, Kumar S, Kapoor RK, Virdi JS, Gulati P. Integrons in Enterobacteriaceae: diversity, distribution and epidemiology. Int J Antimicrob Agents 2018; 51: 167-176.
42. Kaushik M, Kumar S, Kapoor RK, Gulati P. Integrons and antibiotic resistance genes in water-borne pathogens: threat detection and risk assessment. J Med Microbiol 2019; 68: 679-692.
43. Firoozeh F, Mahluji Z, Khorshidi A, Zibaei M. Molecular characterization of class 1, 2 and 3 integrons in clinical multi-drug resistant Klebsiella pneumoniae isolates. Antimicrob Resist Infect Control 2019; 8: 59.
44. Yu HS, Lee JC, Kang HY, Jeong YS, Lee EY, Choi CH, et al. Prevalence of dfr genes associated with integrons and dissemination of dfrA17 among urinary isolates of Escherichia coli in Korea. J Antimicrob Chemother 2004; 53: 445-450.
45. Ranjbar R, Memariani H, Sorouri R, Memariani M. Distribution of virulence genes and genotyping of CTX-M-15-producing Klebsiella pneumoniae isolated from patients with community-acquired urinary tract infection (CA-UTI). Microb Pathog 2016; 100: 244-249.
2. Nwokolo CJ, Ugwu MC, Ejikeugwu CP, Iroha IR, Esimone CO. Incidence and antibiotic susceptibility profile of uropathogenic Escherichia coli positive for extended spectrum β -lactamase among HIV / AIDS patients in Awka metropolis, Nigeria. Iran J Microbiol 2022; 14: 334-340.
3. Yahiaoui M, Robin F, Bakour R, Hamidi M, Bonnet R, Messai Y. Antibiotic resistance, virulence, and genetic background of community-acquired uropathogenic Escherichia coli from Algeria. Microb Drug Resist 2015; 21: 516-526.
4. Malekzadegan Y, Khashei R, Sedigh Ebrahim-Saraie H, Jahanabadi Z. Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients. BMC Infect Dis 2018; 18: 572.
5. Azam H, Ghezeljeh SM, Mahmoud S. Prevalence of class 1 and 2 integrons among the multidrug resistant uropathogenic strains of Escherichia coli. Asian Biomed 2015; 9: 49-54.
6. Farshad S, Japoni A, Hosseini M. Low distribution of integrons among multidrug resistant E. coli strains isolated from children with community-acquired urinary tract infections in Shiraz, Iran. Pol J Microbiol 2008; 57: 193-198.
7. Adel El-Sokkary MM, Abdelmegeed ES. Characterisation of class 1 integron among Escherichia coli isolated from Mansoura University Hospitals in Egypt. Adv Microbiol 2015; 5: 269-277.
8. Wang J, Stephan R, Zurfluh K, Hächler H, Fanning S. Characterization of the genetic environment of blaESBL genes, integrons and toxin-antitoxin systems identified on large transferrable plasmids in multi-drug resistant Escherichia coli. Front Microbiol 2015; 5: 716.
9. Zeeshan Khan F, Nawaz T, Mirani ZA, Khan S, Raza Y, Kazmi SU. Study of class 1 integrons in multidrug-resistant uropathogenic Escherichia coli isolated from different hospitals in Karachi. Iran J Basic Med Sci 2018; 21: 1079-1082.
10. Taghadosi R, Shakibaie MR, Hosseini-Nave H. Antibiotic resistance, ESBL genes, integrons, phylogenetic groups and MLVA profiles of Escherichia coli pathotypes isolated from patients with diarrhea and farm animals in south-east of Iran. Comp Immunol Microbiol Infect Dis 2019; 63: 117-126.
11. Hosseini-Nave H, Samareh Salavati M, Lashkari M, Ravari MA, Hashemizadeh Z, Seyedi Marghaki F, et al. Distribution of genes encoding virulence factors and multilocus variable-number tandem-repeat analysis (MLVA) of Entero-aggregative Escherichia coli (EAEC) isolated in Iran from patients with diarrhoea. J Med Microbiol 2018; 67: 1334-1339.
12. Hosseini Nave H, Mansouri S, Taati Moghadam M, Moradi M. Virulence gene profile and multilocus variable-number tandem-repeat analysis (MLVA) of Enteroinvasive Escherichia coli (EIEC) isolates from patients with diarrhea in kerman, Iran. Jundishapur J Microbiol 2016; 9(6): e33529.
13. Wayne. Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: twenty-third informational supplement M100-S23. Wayne, PA, USA: CLSI; 2013.
14. Rastegar S, Moradi M, Kalantar-Neyestanaki D, Golabi Dehdasht A, Hosseini-Nave H. Virulence factors, capsular serotypes and antimicrobial resistance of hypervirulent Klebsiella pneumoniae and classical Klebsiella pneumoniae in southeast Iran. Infect Chemother 2019; 10.3947/ic.2019.0027.
15. Hosseini Nave H, Mansouri S, Emaneini M, Moradi M. Distribution of genes encoding virulence factors and molecular analysis of Shigella spp. isolated from patients with diarrhea in Kerman, Iran. Microb Pathog 2016; 92: 68-71.
16. Gorgé O, Lopez S, Hilaire V, Lisanti O, Ramisse V, Vergnaud G. Selection and validation of a multilocus variable-number tandem-repeat analysis panel for typing Shigella spp. J Clin Microbiol 2008; 46: 1026-1036.
17. Oliveira-Pinto C, Diamantino C, Oliveira PL, Reis MP, Costa PS, Paiva MC, et al. Occurrence and characterization of class 1 integrons in Escherichia coli from healthy individuals and those with urinary infection. J Med Microbiol 2017; 66: 577-583.
18. Kumar PM, Jaiswal NK, Singh BK, Sharan S, Kumar R, Tiwari SK. Antimicrobial susceptibility patterns of uropathogenic Escherichia coli and their prevalence among people in and around Dhanbad, Jharkhand. East J Med Sci 2017; 2: 1-3.
19. Al-Assil B, Mahfoud M, Hamzeh AR. First report on class 1 integrons and Trimethoprim-resistance genes from dfrA group in uropathogenic E. coli (UPEC) from the Aleppo area in Syria. Mob Genet Elements 2013; 3(3): e25204.
20. Haghighatpanah M, Mojtahedi A. Characterization of antibiotic resistance and virulence factors of Escherichia coli strains isolated from iranian inpatients with urinary tract infections. Infect Drug Resist 2019; 12: 2747-2754.
21. Dia ML, Ngom B, Diagne R, Ka R, Lo S, Cisse MF, et al. Molecular detection of CTX-M-15-type β-lactamases in Escherichia coli strains from Senegal. New Microbes New Infect 2015; 9: 45-46.
22. Wragg R, Harris A, Patel M, Robb A, Chandran H, McCarthy L. Extended spectrum beta lactamase (ESBL) producing bacteria urinary tract infections and complex pediatric urology. J Pediatr Surg 2017; 52: 286-288.
23. Meier S, Weber R, Zbinden R, Ruef C, Hasse B. Extended-spectrum β-lactamase-producing Gram-negative pathogens in community-acquired urinary tract infections: An increasing challenge for antimicrobial therapy. Infection 2011; 39: 333-340.
24. Chinnasami B, Sundaramoorthy S, Sadasivam K, Pasupathy S. Pathogens causing urinary tract infection in children and their in vitro susceptibility to antimicrobial agents-A hospital based study. Biomed Pharmacol J 2016; 9: 377-383.
25. Parajuli NP, Maharjan P, Parajuli H, Joshi G, Paudel D, Sayami S, et al. High rates of multidrug resistance among uropathogenic Escherichia coli in children and analyses of ESBL producers from Nepal. Antimicrob Resist Infect Control 2017; 6: 9.
26. Pourakbari B, Ferdosian F, Mahmoudi S, Teymuri M, Sabouni F, Heydari H, et al. Increase resistant rates and ESBL production between E. coli isolates causing urinary tract infection in young patients from Iran. Braz J Microbiol 2012; 43: 766-769.
27. Kizilca O, Siraneci R, Yilmaz A, Hatipoglu N, Ozturk E, Kiyak A, et al. Risk factors for community‐acquired urinary tract infection caused by ESBL‐producing bacteria in children. Pediatr Int 2012; 54: 858-862.
28. Ebrahim-Saraie HS, Nezhad NZ, Heidari H, Motamedifar A, Motamedifar M. Detection of antimicrobial susceptibility and integrons among extended-spectrum β-lactamase producing uropathogenic Escherichia coli isolates in Southwestern Iran. Oman Med J 2018; 33: 218-223.
29. Hawser SP, Bouchillon SK, Hoban DJ, Badal RE, Hsueh P-R, Paterson DL. Emergence of high levels of extended-spectrum-β-lactamase-producing gram-negative bacilli in the Asia-Pacific region: Data from the study for monitoring antimicrobial resistance trends (SMART) program, 2007. Antimicrob Agents Chemother 2009; 53: 3280-3284.
30. Neamati F, Khorshidi A, Moniri R, Hosseini Tafreshi SA. Molecular epidemiology of antimicrobial resistance of uropathogenic Escherichia coli isolates from patients with urinary tract infections in a tertiary teaching Hospital in Iran. Microb Drug Resist 2020; 26: 60-70.
31. Rasoulinasab M, Shahcheraghi F, Feizabadi MM, Nikmanesh B, Hajihasani A, Aslani MM. Distribution of ciprofloxacin-resistance genes among ST131 and non-ST131 clones of Escherichia coli isolates with ESBL phenotypes isolated from women with urinary tract infection. Iran J Microbiol 2021; 13: 294-302.
32. Pongpech P, Naenna P, Taipobsakul Y, Tribuddharat C, Srifuengfung S. Prevalence of extended-spectrum beta-lactamase and class 1 integron integrase gene intl1 in Escherichia coli from thai patients and healthy adults. Southeast Asian J Trop Med Public Health 2008; 39: 425-433.
33. Hasani A, Purmohammad A, Rezaee MA, Hasani A, Dadashi M. Integron-mediated multidrug and quinolone resistance in extended-spectrum β -lactamase-Producing Escherichia coli and Klebsiella pneumoniae. Arch Pediatr Infect Dis 2017; 5(2): e36616.
34. Ho WS, Balan G, Puthucheary S, Kong BH, Lim KT, Tan LK, et al. Prevalence and characterization of multidrug-resistant and extended-spectrum beta-lactamase-producing Escherichia coli from pediatric wards of a Malaysian hospital. Microb Drug Resist 2012; 18: 408-416.
35. Chen T, Feng Y, Yuan JL, Qi Y, Cao YX, Wu Y. Class 1 integrons contributes to antibiotic resistance among clinical isolates of Escherichia coli producing extended-spectrum beta-lactamases. Indian J Med Microbiol 2013; 31: 385-389.
36. Sun J, Zheng F, Wang F, Wu K, Wang Q, Chen Q, et al. Class 1 Integrons in urinary isolates of extended-spectrum β-Lactamase-producing Escherichia coli and Klebsiella pneumoniae in Southern China during the past five years. Microb Drug Resist 2013; 19: 289-294.
37. Estabraghi E, Salehi TZ, Amini K, Jamshidian M. Molecular identification of extended-spectrum β-lactamase and integron genes in Klebsiella pneumonia. JNMA J Nepal Med Assoc 2016; 54: 72-78.
38. Cheng H, Jiang H, Fang J, Zhu C. Antibiotic resistance and characteristics of integrons in Escherichia coli isolated from Penaeus vannamei at a Freshwater Shrimp Farm in Zhejiang Province, China. J Food Prot 2019; 82: 470-478.
39. Sunde M, Simonsen GS, Slettemeås JS, Böckerman I, Norström M. Integron, plasmid and host strain characteristics of Escherichia coli from humans and food included in the Norwegian antimicrobial resistance monitoring programs. PLoS One 2015; 10(6): e0128797.
40. Shin HW, Lim J, Kim S, Kim J, Kwon GC, Koo SH. Characterization of trimethoprim-sulfamethoxazole resistance genes and their relatedness to class 1 integron and insertion sequence common region in gram-negative bacilli. J Microbiol Biotechnol 2015; 25: 137-142.
41. Kaushik M, Kumar S, Kapoor RK, Virdi JS, Gulati P. Integrons in Enterobacteriaceae: diversity, distribution and epidemiology. Int J Antimicrob Agents 2018; 51: 167-176.
42. Kaushik M, Kumar S, Kapoor RK, Gulati P. Integrons and antibiotic resistance genes in water-borne pathogens: threat detection and risk assessment. J Med Microbiol 2019; 68: 679-692.
43. Firoozeh F, Mahluji Z, Khorshidi A, Zibaei M. Molecular characterization of class 1, 2 and 3 integrons in clinical multi-drug resistant Klebsiella pneumoniae isolates. Antimicrob Resist Infect Control 2019; 8: 59.
44. Yu HS, Lee JC, Kang HY, Jeong YS, Lee EY, Choi CH, et al. Prevalence of dfr genes associated with integrons and dissemination of dfrA17 among urinary isolates of Escherichia coli in Korea. J Antimicrob Chemother 2004; 53: 445-450.
45. Ranjbar R, Memariani H, Sorouri R, Memariani M. Distribution of virulence genes and genotyping of CTX-M-15-producing Klebsiella pneumoniae isolated from patients with community-acquired urinary tract infection (CA-UTI). Microb Pathog 2016; 100: 244-249.
| Files | ||
| Issue | Vol 15 No 5 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijm.v15i5.13867 | |
| Keywords | ||
| Uropathogenic Escherichia coli; Drug resistance; Integrons; Extended spectrum beta-lactamase; Tandem repeat sequences | ||
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How to Cite
1.
Mohebi S, Golestani-Hotkani Z, Foulad-Pour M, Nazeri P, Mohseni F, Hashemizadeh Z, Moghani-Bashi Z, Niksefat N, Rastegar S, Khajedadian M, Lotfian Z, Hosseini-Nave H. Characterization of integrons, extended spectrum beta lactamases and genetic diversity among uropathogenic Escherichia coli isolates from Kerman, south east of Iran. Iran J Microbiol. 2023;15(5):616-624.
