Fri, May 9, 2025
1- Faculty of Basic science, Rasht branch, Islamic Azad University, Rasht, Iran
2- Faculty of Basic science, Rasht branch, Islamic Azad University, Rasht, Iran ,tshafighi@yahoo.com
3- Doctor of Veterinary Medicine, graduated from Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
2- Faculty of Basic science, Rasht branch, Islamic Azad University, Rasht, Iran ,
3- Doctor of Veterinary Medicine, graduated from Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran
Abstract: (23 Views)
Background and objectives: Urinary tract infection (UTI) caused by Uropathogenic Escherichia coli (UPEC) is a worldwide health problem. Virulence factors (VFs) expressed by UPEC strains promote the pathogenicity of bacteria in the urinary tract. Treatment of the infection is often difficult due to the high antimicrobial resistance of E. coli. This study aimed to determine VFs and the antibiotic susceptibility pattern of isolated UPEC strains in the north of Iran.
Methods: 105 urine samples were collected from females with UTIs, in north of Iran, Rasht. The samples were cultured on EMB agar and MacConkey agar. The plates were incubated at 37°C for 24 h and the pure isolates were identified using Gram-stains and standard biochemical tests. The presence of six VF genes including papC, sfa/foc, fimH, afa, ibeA and neuC were identified by polymerase chain reaction (PCR) in UPEC strains and verified by direct sequencing. Antibiotic susceptibility test (AST) was performed by disk diffusion method based on the Clinical and Laboratory Standards Institute (CLSI) guidelines.
Results: 65.71% isolates were identified as E. coli. The most frequent virulence gene was fimH (100%) and the least one was afa (1.44%). The highest and the lowest antibiotic resistance rates were observed against Cephazolin (66.66%), and Gentamicin (24.63%), respectively. Indeed, the prevalence of multiple drug resistance (MDR) was determined as 73.91%.
Conclusion: Our study highlighted the importance of local monitoring in UPEC isolates due to the high genetic mutation capacity of the pathogen, environmental and patient properties to recommend the best strategies against UTIs.
Methods: 105 urine samples were collected from females with UTIs, in north of Iran, Rasht. The samples were cultured on EMB agar and MacConkey agar. The plates were incubated at 37°C for 24 h and the pure isolates were identified using Gram-stains and standard biochemical tests. The presence of six VF genes including papC, sfa/foc, fimH, afa, ibeA and neuC were identified by polymerase chain reaction (PCR) in UPEC strains and verified by direct sequencing. Antibiotic susceptibility test (AST) was performed by disk diffusion method based on the Clinical and Laboratory Standards Institute (CLSI) guidelines.
Results: 65.71% isolates were identified as E. coli. The most frequent virulence gene was fimH (100%) and the least one was afa (1.44%). The highest and the lowest antibiotic resistance rates were observed against Cephazolin (66.66%), and Gentamicin (24.63%), respectively. Indeed, the prevalence of multiple drug resistance (MDR) was determined as 73.91%.
Conclusion: Our study highlighted the importance of local monitoring in UPEC isolates due to the high genetic mutation capacity of the pathogen, environmental and patient properties to recommend the best strategies against UTIs.
Keywords: Uropathogenic Escherichia coli, Urinary tract infections, Virulence factor, Multiple drug resistance, antimicrobial susceptibility pattern
Research Article: Research Article |
Subject:
Microbiology
Received: 2022/12/10 | Accepted: 2023/09/12
Received: 2022/12/10 | Accepted: 2023/09/12
References
1. Bravata-Alcantara JC, Bello-Lopez JM, Cortes-Ortiz IA, Mendez-Velazquez JJ, Aviles-Soto B, Quintas-Granados LI, et al. Distribution of Virulence and Antimicrobial Resistance Genes in Phylogenetic Groups of Escherichia coli Strains Isolated from Mexican Patients with Urinary Infection. Jundishapur Journal of Microbiology. 2019;12(3):1-9. [DOI:10.5812/jjm.83711]
2. Sarowska J, Futoma-Koloch B, Jama-Kmiecik A, Frej-Madrzak M, Ksiazczyk M, Bugla-Ploskonska G, et al. Virulence factors, prevalence and potential transmission of extraintestinal pathogenic Escherichia coli isolated from different sources: recent reports. Gut pathogens. 2019;11(1):10. [DOI:10.1186/s13099-019-0290-0] [PMID] []
3. Hadifar S, Moghoofei M, Nematollahi S, Ramazanzadeh R, Sedighi M, Salehi-Abargouei A, et al. Epidemiology of multi drug resistant uropathogenic Escherichia coli in Iran: a systematic review and meta-analysis. Japanese journal of infectious diseases. 2016:JJID. 2015.652.
4. Staji H, Rassouli M, Jourablou S. Comparative virulotyping and phylogenomics of Escherichia coli isolates from urine samples of men and women suffering urinary tract infections. Iranian journal of basic medical sciences. 2019;22(2):211.
5. Jahandeh N, Ranjbar R, Behzadi P, Behzadi E. Uropathogenic Escherichia coli virulence genes: invaluable approaches for designing DNA microarray probes. Central European journal of urology. 2015;68(4):452. [DOI:10.5173/ceju.2015.625]
6. Ghazvini H, Taheri K, Edalati E, Miri A, Sedighi M, MIRKALANTARI S. Virulence factors and antimicrobial resistance in uropathogenic Escherichiacoli strains isolated from cystitis and pyelonephritis. Turkish journal of medical sciences. 2019;49(1):361-7. [DOI:10.3906/sag-1805-100] [PMID] []
7. Baby S, Karnaker VK, Geetha RK. Determination of Adhesion Encoding Genes of Uropathogenic Escherichia coli. Avicenna Journal of Clinical Microbiology and Infection. 2018;5(2):20-6. [DOI:10.34172/ajcmi.2018.04]
8. Watt S, Lanotte P, Mereghetti L, Moulin-Schouleur M, Picard B, Quentin R. Escherichia coli strains from pregnant women and neonates: intraspecies genetic distribution and prevalence of virulence factors. Journal of clinical microbiology. 2003;41(5):1929-35. [DOI:10.1128/JCM.41.5.1929-1935.2003] [PMID] []
9. Zhao R, Shi J, Shen Y, Li Y, Han Q, Zhang X, et al. Phylogenetic distribution of virulence genes among ESBL-producing uropathogenic Escherichia coli isolated from long-term hospitalized patients. Journal of clinical and diagnostic research: JCDR. 2015;9(7):DC01. [DOI:10.7860/JCDR/2015/13234.6157] [PMID] []
10. 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 microbiologica. 2018;63(3):335-43. [DOI:10.1007/s12223-017-0570-3] [PMID]
11. Alizade H. Escherichia coli in Iran: an overview of antibiotic resistance: a review article. Iranian journal of public health. 2018;47(1):1.
12. Organization WH. Global antimicrobial resistance surveillance system ( GLASS) report: early implementation 2017-2018. 2018.
13. Mac Faddin JF. Biochemical tests for identification of medical bacteria: Williams & Wilkins Co.; 1976.
14. Boc A, Diallo AB, Makarenkov V. T-REX: a web server for inferring, validating and visualizing phylogenetic trees and networks. Nucleic acids research. 2012;40(W1):W573-W9. [DOI:10.1093/nar/gks485] [PMID] []
15. Baghban Z, Valizadeh Z. Determination of TraT Gene in Isolated Escherichia Coli Isolated from Patients Referred to Abadan Hospitals During 2017-2018. 2019.
16. Ananias M, Yano T. Serogroups and virulence genotypes of Escherichia coli isolated from patients with sepsis. Brazilian Journal of Medical and Biological Research. 2008;41(10):877-83. [DOI:10.1590/S0100-879X2008001000008] [PMID]
17. Ahmed N, Zeshan B, Naveed M, Afzal M, Mohamed M. Antibiotic resistance profile in relation to virulence genes fimH, hlyA and usp of uropathogenic E. coli isolates in Lahore, Pakistan. Tropical Biomedicine. 2019;36(2):559-68.
18. Düzgün AÖ, Okumuş F, Saral A, Çiçek AÇ, Cinemre S. Determination of antibiotic resistance genes and virulence factors in Escherichia coli isolated from Turkish patients with urinary tract infection. Revista da Sociedade Brasileira de Medicina Tropical. 2019;52. [DOI:10.1590/0037-8682-0499-2018] [PMID]
19. Dehbanipour R, Rastaghi S, Sedighi M, Maleki N, Faghri J. High prevalence of multidrug-resistance uropathogenic Escherichia coli strains, Isfahan, Iran. Journal of natural science, biology, and medicine. 2016;7(1):22. [DOI:10.4103/0976-9668.175020] [PMID] []
20. Moghaddam MJM, 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. Iranian biomedical journal. 2015;19(4):233.
21. Issazadeh K, Naghibi SN, Khoshkholgh-Pahlaviani MRM. Drug resistance and serotyping of uropathogenic Escherichia coli among Patients with urinary tract infection in Rasht, Iran. Zahedan Journal of Research in Medical Sciences. 2015;17(6). [DOI:10.17795/zjrms989]
22. Mashayekhi F, Moghny M, Faramarzpoor M, Yahaghi E, Khodaverdi Darian E, Tarhriz V, et al. Molecular characterization and antimicrobial resistance of uropathogenic Escherichia coli. Iranian Journal of Biotechnology. 2014;12(2):32-40. [DOI:10.5812/ijb.16833]
23. Dormanesh B, Dehkordi FS, Hosseini S, Momtaz H, Mirnejad R, Hoseini MJ, et al. Virulence factors and o-serogroups profiles of uropathogenic Escherichia coli isolated from Iranian pediatric patients. Iranian Red Crescent Medical Journal. 2014;16(2). [DOI:10.5812/ircmj.14627]
24. Habibian R, Khayyat Khameneie M, Sedighian H, Daneshi F, Bagheri Moghadam M, Mahboobi M. Virulence factor diversity between imipenem resistant and imipenem susceptible strains of Escherichia coli isolated from hospitalized patients with severe urinary tract infections. Biosciences Biotechnology Research Asia. 2014;11(2):469-77. [DOI:10.13005/bbra/1297]
25. Tabasi M, Karam MRA, Habibi M, Yekaninejad MS, Bouzari S. Phenotypic assays to determine virulence factors of uropathogenic Escherichia coli (UPEC) isolates and their correlation with antibiotic resistance pattern. Osong public health and research perspectives. 2015;6(4):261-8. [DOI:10.1016/j.phrp.2015.08.002] [PMID] []
26. Abbasi H, Ranjbar R. The prevalence of quinolone resistance genes of A, B, S in Escherichia coli strains isolated from three major hospitals in Tehran, Iran. Central European journal of urology. 2018;71(1):129. [DOI:10.5173/ceju.2018.1539]
27. Rezaee R, Talebreza A, Ziari K, Behnod V, Emampour BFS. Distribution of virulence factors and antimicrobial resistance properties of uropathogenic Escherichia coli isolated from diabetic and healthy males suffered from urinary tract infections. Biosciences Biotechnology Research Asia. 2016;13(2):931-7. [DOI:10.13005/bbra/2117]
28. Raeispour M, Ranjbar R. Antibiotic resistance, virulence factors and genotyping of Uropathogenic Escherichia coli strains. Antimicrobial Resistance & Infection Control. 2018;7(1):118. [DOI:10.1186/s13756-018-0411-4] [PMID] []
29. Derakhshandeh A, Firouzi R, Motamedifar M, Arabshahi S, Novinrooz A, Boroojeni AM, et al. Virulence characteristics and antibiotic resistance patterns among various phylogenetic groups of uropathogenic Escherichia coli isolates. Japanese journal of infectious diseases. 2015;68(5):428-31. [DOI:10.7883/yoken.JJID.2014.327] [PMID]
30. Derakhshandeh A, Firouzi R, Motamedifar M, Motamedi Boroojeni A, Bahadori M, Arabshahi S, et al. Distribution of virulence genes and multiple drug‐resistant patterns amongst different phylogenetic groups of uropathogenic Escherichia coli isolated from patients with urinary tract infection. Letters in applied microbiology. 2015;60(2):148-54. [DOI:10.1111/lam.12349] [PMID]
31. Malekzadegan Y, Khashei R, Ebrahim-Saraie HS, Jahanabadi Z. Distribution of virulence genes and their association with antimicrobial resistance among uropathogenic Escherichia coli isolates from Iranian patients. BMC infectious diseases. 2018;18(1):572. [DOI:10.1186/s12879-018-3467-0] [PMID] []
32. 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 medical journal. 2018;33(3):218. [DOI:10.5001/omj.2018.40] [PMID] []
33. Adib N, Ghanbarpour R, Solatzadeh H, Alizade H. Antibiotic resistance profile and virulence genes of uropathogenic Escherichia coli isolates in relation to phylogeny. Trop Biomed. 2014;31(1):17-25.
34. Kazemnia A, Ahmadi M, Dilmaghani M. Antibiotic resistance pattern of different Escherichia coli phylogenetic groups isolated from human urinary tract infection and avian colibacillosis. Iranian biomedical journal. 2014;18(4):219.
35. Firoozeh F, Saffari M, Neamati F, Zibaei M. Detection of virulence genes in Escherichia coli isolated from patients with cystitis and pyelonephritis. International Journal of Infectious Diseases. 2014;29:219-22. [DOI:10.1016/j.ijid.2014.03.1393] [PMID]
36. Neamati F, Firoozeh F, Saffari M, Zibaei M. Virulence genes and antimicrobial resistance pattern in uropathogenic Escherichia coli isolated from hospitalized patients in Kashan, Iran. Jundishapur journal of microbiology. 2015;8(2). [DOI:10.5812/jjm.17514] [PMID] []
37. Mohajeri P, Darfarin G, Farahani A. Genotyping of ESBL producing Uropathogenic Escherichia coli in west of Iran. International journal of microbiology. 2014;2014. [DOI:10.1155/2014/276941] [PMID] []
38. Rahdar M, Rashki A, Miri HR, Ghalehnoo MR. Detection of pap, sfa, afa, foc, and fim adhesin-encoding operons in uropathogenic Escherichia coli isolates collected from patients with urinary tract infection. Jundishapur journal of microbiology. 2015;8(8). [DOI:10.5812/jjm.22647]
39. Shookohi M, Rashki A. Prevalence of toxigenic genes in Escherichia Coli isolates from hospitalized patients in Zabol, Iran. Int J Enteric Pathog. 2016;4(1):1-5. [DOI:10.17795/ijep29222]
40. Rashki A, Rahdar M, Ghalehnoo ZR. Characterization of Uropathogenic Escherichia coli: Distribution of Adhesin-Encoding Genes and O-Serotypes Among Ciprofloxacin Susceptible and Resistant Isolates. Jundishapur Journal of Microbiology. 2019;12(9):1-. [DOI:10.5812/jjm.89179]
41. Sheikh AF, Goodarzi H, Yadyad MJ, Aslani S, Amin M, Jomehzadeh N, et al. Virulence-associated genes and drug susceptibility patterns of uropathogenic Escherichia coli isolated from patients with urinary tract infection. Infection and Drug Resistance. 2019;12:2039. [DOI:10.2147/IDR.S199764] [PMID] []
42. Pourzare M, Derakhshan S, Roshani D. Distribution of uropathogenic virulence genes in Escherichia coli isolated from children with urinary tract infection in Sanandaj, Iran. Archives of Pediatric Infectious Diseases. 2017;5(3). [DOI:10.5812/pedinfect.41995]
43. Boroumand M, Sharifi A, Manzouri L, Khoramrooz SS, Khosravani SA. Evaluation of pap and sfa genes relative frequency P and S fimbriae encoding of uropathogenic Escherichia coli isolated from hospitals and medical laboratories; Yasuj City, Southwest Iran. Iran Red Crescent Med J. 2019;21(8). [DOI:10.5812/ircmj.89499]
44. Baghban Z, Valizadeh Z. Evaluation of the antibiotic resistance and prevalence of uropathogenic Escherichia coli and detection of traT gene in isolated from patients referred to Abadan hospitals during 2017-2018. Armaghane danesh. 2019;24(2):238-46.
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Enamad
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.