پذیرفته شده و در حال انتشار                   برگشت به فهرست مقالات | برگشت به فهرست نسخه ها

Ethics code: 90/90-392-01

XML English Abstract Print


چکیده:   (287 مشاهده)
Background and Objective: Uropathogenic Escherichia coli (UPEC) strains are the primary causative agents of urinary tract infections (UTIs). Molecular characterization of UPEC strains plays a crucial role in infection management, as molecular determinants contribute to antibiotic resistance (AR). This study aimed to investigate the antibiotic resistance profiles, prevalence of ESBL, integron, and pathogenicity island markers, and the genetic relatedness of UPEC isolates using PFGE.
Methods: Urine samples were collected from catheterized ICU patients. UPEC isolates were identified by standard biochemical tests. Antimicrobial susceptibility was assessed using the disk diffusion method. Resistance markers (ESBLs, integrons, PAIs) were detected by PCR, and genetic clustering was performed using PFGE with XbaI restriction enzyme.
Results: Of the 50 UPEC isolates, the highest resistance rates were observed against piperacillin (80%), ampicillin (76%), and cotrimoxazole (68%), while imipenem (94%) and amikacin (86%) showed the highest susceptibility. MDR and XDR phenotypes were detected in 62% and 22% of isolates, espectively. PFGE analysis revealed 38 distinct pulsotypes, indicating substantial genetic diversity. Among resistance markers, the most prevalent were PAI-IV536 (80%), PAI-IICFT073 (70%), and Int1 (66%), whereas Int3 was absent in all isolates."
Conclusion: The UPEC population studied exhibits high genetic diversity and a notable burden of multidrug resistance. The strong association between integrons (particularly Int1) and resistance phenotypes suggests that horizontal gene transfer is a major driver of antimicrobial resistance dissemination. Continuous molecular surveillance is critical to prevent the spread of these resistant clones in healthcare settings.
 
     
نوع مطالعه: مقاله پژوهشی | موضوع مقاله: Epidemiologic Studies
دریافت: 1405/3/23 | پذیرش: 1405/5/25

فهرست منابع
1. Bal M, Pati S, Biswas S, Suar M, Ranjit M, Rana R. Escherichia coli associated urinary tract infection: Epidemiology and possible strategies for control. One Health Bullet. 2025;5(2):51-7. [DOI:10.4103/ohbl.ohbl_56_24]
2. Bhuiya S, Kaushik S, Logheeswaran J, Karthika P, Prathiviraj R, Selvin J, et al. Emergence of recurrent urinary tract infection: Dissecting the mechanism of antimicrobial resistance, host-pathogen interaction, and hormonal imbalance. Microb Pathogen. 2025;206:107698. [DOI:10.1016/j.micpath.2025.107698] [PMID]
3. Larkin C, Valappil SP, Palanisamy N. Global prevalence of nitrofurantoin-resistant uropathogenic Escherichia coli (UPEC) in humans: a systematic review and meta-analysis.J Antimicrob Chemother. 2025;80(10):2609-21. [DOI:10.1093/jac/dkaf305] [PMID] [PMCID]
4. Dziuba A, Białek J, Wawszczak-Kasza M, Janczura J, Dulębska J. The role of intracellular bacterial communities of uropathogenic Escherichia Coli in chronic urinary tract infection and new therapeutic ideas. Curr Clin Microbiol Rep. 2025;12(1):16. [DOI:10.1007/s40588-025-00253-0]
5. 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):107.
6. Tamas V, Ulloa ER, Kumaraswamy M, Dahesh S, Zurich R, Nizet V, et al. Extended-spectrum β-lactamase-producing Escherichia coli and pediatric UTIs: A review of the literature and selected experimental observations. Antibiotics (Basel, Switzerland). 2025;14(12). [DOI:10.3390/antibiotics14121284] [PMID] [PMCID]
7. Zhuo C, Xu Y, Yu Y. Expert consensus on clinical management strategies for infections caused by extended-spectrum β-lactamase-producing Enterobacterales(2025). Med J Peking :union: Med College Hospital. 2025;16(5):1102-19.
8. Park J, Joo EY, Lee J-E, Kim SJ. Clinical impacts and management of urinary tract infections caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae in children: a narrative review. Child Kidney Dis. 2025;29(3):104-11. [DOI:10.3339/ckd.25.028] [PMID] [PMCID]
9. Halaji M, Feizi A, Mirzaei A, Sedigh Ebrahim-Saraie H, Fayyazi A, Ashraf A, et al. The global prevalence of class 1 integron and associated antibiotic resistance in Escherichia coli from patients with urinary tract infections. A systematic review and meta-analysis. Microb Drug Resist (Larchmont, NY). 2020;26(10):1208-18. [DOI:10.1089/mdr.2019.0467] [PMID]
10. Shao F, Li D, Wang J, Tuo Z, Wang Z, Wei W, et al. Beta-lactamase-mediated antibiotic resistance in urinary tract infections: Mechanisms and therapeutic strategies. Urogenit Tract Infect. 2025;20(2):67-81. [DOI:10.14777/uti.2550012006]
11. Keramati N, Zeighami H, Haghi F. Frequency of class I and II integrons in metalobetalactamase producing clinical isolates of Pseudomonas Aeruginosa. J Adv Med Biomed Res. 2014;22(94):111.
12. Varghese A, Saleena UV, Bhat G, Ke V, Am C. Comparison of genetic factors of Escherichia coli in patients with urosepsis and urinary tract infections. A systematic review. Rev Res Med Microbiol. 2023;34(2). [DOI:10.1097/MRM.0000000000000331]
13. Etefia EU, Ben SA. Virulence markers, phylogenetic evolution, and molecular techniques of uropathogenic Escherichia coli. J Natur Sci Med. 2020;3(1). [DOI:10.4103/JNSM.JNSM_31_19]
14. Azimzadeh N, Derakhshandeh A, Motamedifar M, Naziri Z. Clonal relatedness, phylotyping and antimicrobial susceptibility of extended- spectrum-beta-lactamase producing uropathogenic Escherichia coli isolates from outpatients and inpatients. Infect Disorder Drug Target. 2020;20(5):659-66. [DOI:10.2174/1871526519666190715152118] [PMID]
15. Kao CY, Zhang YZ, Yang DC, Chen PK, Teng CH, Lin WH, et al. Characterization of host and escherichia coli strains causing recurrent urinary tract infections based on molecular typing. BMC Microbiol. 2023;23(1):90. [DOI:10.1186/s12866-023-02820-1] [PMID] [PMCID]
16. Saladin M, Cao VT, Lambert T, Donay JL, Herrmann JL, Ould-Hocine Z, et al. Diversity of CTX-M beta-lactamases and their promoter regions from Enterobacteriaceae isolated in three Parisian hospitals. FEMS Microbiol Lett. 2002;209(2):161-8. [DOI:10.1111/j.1574-6968.2002.tb11126.x] [PMID]
17. Arlet G, Rouveau M, Philippon A. Substitution of alanine for aspartate at position 179 in the SHV-6 extended-spectrum beta-lactamase. FEMS Microbiol Lett. 1997;152(1):163-7. [DOI:10.1111/j.1574-6968.1997.tb10423.x] [PMID]
18. Machado E, Cantón R, Baquero F, Galán JC, Rollán A, Peixe L, et al. Integron content of extended-spectrum-beta-lactamase-producing Escherichia coli strains over 12 years in a single hospital in Madrid, Spain. Antimicrob Agent Chemother. 2005;49(5):1823-9. [DOI:10.1128/AAC.49.5.1823-1829.2005] [PMID] [PMCID]
19. Moradpoor Shamami A, Anvari M,Pourmoshtagh H,Shafighi S, Seddigh Ebrahim-Saraie H. Serogroup and pathogenicity island marker distributions among uropathogenic Escherichia coli isolates in Rasht, Iran. Jundishapur J Microbiol. 2023;16(1). [DOI:10.5812/jjm-132754]
20. Smelov V NK, Bjerklund Johansen TE. Improved classification of urinary tract infection: Future considerations. Europ Urol Suppl. 2016;15:10. [DOI:10.1016/j.eursup.2016.04.002]
21. Tandogdu Z, Cek M, Wagenlehner F, Naber K, Tenke P, van Ostrum E, et al. Resistance patterns of nosocomial urinary tract infections in urology departments: 8-year results of the global prevalence of infections in urology study. W J Urol. 2014;32(3):791-801. [DOI:10.1007/s00345-013-1154-8] [PMID]
22. Sun DH, Lv DF, Mi ZH, Hu LQ, Huang Y, Gao X, et al. Investigation of antibiotic resistance determinants and virulence factors of uropathogenic Escherichia coli. J Antibiotic. 2020;73(5):314-9. [DOI:10.1038/s41429-020-0284-7] [PMID]
23. 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 Pathogen. 2019;11:10. [DOI:10.1186/s13099-019-0290-0] [PMID]
24. Miri ST, Dashti A, Mostaan S, Kazemi F, Bouzari S. Identification of different Escherichia coli pathotypes in north and north-west provinces of Iran. Iran J Microbiol. 2017;9(1).
25. Issazadeh K NS, Khoshkholgh-Pahlaviani MRM. Drug resistance and serotyping of uropathogenic Escherichia coli among patients with urinary tract infection in Rasht, Iran. Zahedan J Res Med Sci. 2015;27(17):6. [DOI:10.17795/zjrms989]
26. Mohajeri P, Darfarin G, Farahani A. Genotyping of ESBL producing uropathogenic Escherichia coli in west of Iran. Int J Microbiol. 2014;2014(1):276941. [DOI:10.1155/2014/276941] [PMID] [PMCID]
27. 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 J Microbiol. 2015;8(2):e17514. [DOI:10.5812/jjm.17514] [PMID] [PMCID]
28. Alkhudhairy M, Saki M, Seyed-Mohammadi S, Jomehzadeh N, Khoshnood S, Moradzadeh M, et al. Integron frequency of Escherichia coli strains from patients with urinary tract infection in Southwest of Iran. J Acute Dis. 2019;8:113-7. [DOI:10.4103/2221-6189.259110]
29. Ferdosi-Shahandashti E, Javanian M, Moradian-Kouchaksaraei M, Yeganeh B, Bijani A, Motevaseli E, et al. Resistance patterns of Escherichia coli causing urinary tract infection. Caspian J Int Med. 2015;6(3):148-51.
30. 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(4):233-9.
31. Gholipour A, Soleimani N, Shokri D, Mobasherizadeh S, Kardi M, Baradaran A. Phenotypic and molecular characterization of extended-spectrum β-lactamase produced by Escherichia coli, and Klebsiella pneumoniae isolates in an educational hospital. Jundishapur J Microbiol. 2014;7(10):e11758. [DOI:10.5812/jjm.11758] [PMID] [PMCID]
32. Tacão M, Moura A, Correia A, Henriques I. Co-resistance to different classes of antibiotics among ESBL-producers from aquatic systems. Water Res. 2014;48:100-7. [DOI:10.1016/j.watres.2013.09.021] [PMID]
33. Bourély C, Cazeau G, Jarrige N, Jouy E, Haenni M, Lupo A, et al. Co-resistance to amoxicillin and tetracycline as an indicator of multidrug resistance in Escherichia coli isolates from animals. Front Microbiol. 2019;10:2288. [DOI:10.3389/fmicb.2019.02288] [PMID] [PMCID]
34. Bush K. Bench-to-bedside review: The role of beta-lactamases in antibiotic-resistant Gram-negative infections. Crit care (London, England). 2010;14(3):224. [DOI:10.1186/cc8892] [PMID] [PMCID]
35. Bush K. Past and present perspectives on β-lactamases. Antimicrob Agent Chemother. 2018;62(10). [DOI:10.1128/AAC.01076-18] [PMID] [PMCID]
36. Yekani M, Memar MY, Baghi HB, Sefidan FY, Alizadeh N, Ghotaslou R. Association of integrons with multidrug-resistant isolates among phylogenic groups of uropathogenic Escherichia Coli. Microbiol Res [Internet]. 2018; 9(1):[7484 p.]. [DOI:10.4081/mr.2018.7484]
37. Rawat D, Nair D. Extended-spectrum β-lactamases in gram negative bacteria. J Global Infect Dis. 2010;2(3):263-74. [DOI:10.4103/0974-777X.68531] [PMID] [PMCID]
38. Mirza S, Jadhav S, Misra RN, Das NK. Coexistence of β-lactamases in community-acquired infections in a tertiary care hospital in India. Int J Microbiol. 2019;2019:7019578. [DOI:10.1155/2019/7019578] [PMID] [PMCID]
39. Hemati Z, Ghanbarpour R, Alizade H. The distribution of beta lactamase genes in Escherichia coli phylotypes isolated from diarrhea and UTI cases in northwest Iran. Adv Clin Experiment Med. 2014;23(4):523-9. [DOI:10.17219/acem/37217] [PMID]

بازنشر اطلاعات
Creative Commons License این مقاله تحت شرایط Creative Commons Attribution-NonCommercial 4.0 International License قابل بازنشر است.

کلیه حقوق این وب سایت متعلق به Journal of Advances in Medical and Biomedical Research می باشد.

طراحی و برنامه نویسی : یکتاوب افزار شرق

© 2026 CC BY-NC 4.0 | Journal of Advances in Medical and Biomedical Research

Designed & Developed by : Yektaweb