A Molecular and Genetic Study of Antibiotic Resistance Genes in Escherichia coli Isolated from Selected Iraqi Patients
DOI:
https://doi.org/10.52783/jns.v14.1854Abstract
Urinary tract infections (UTIs) are among the most common bacterial infections and, as such, Escherichia coli (E. coli) is the most frequently found uropathogen. The aim of this study was to evaluate the resistance gene prevalence of bacterial isolates in 40 urine samples from patients with UTIs, as well as antibiotic resistance rates. E. coli comprised 50%; Klebsiella pneumoniae, 20%; Proteus spp., 15%; Staphylococcus spp., 10%; and Enterobacter spp., 5%. We confirmed the presence of resistance genes by molecular identification using PCR; in 90% of the isolates, we found Sul1 and in 5% dfrA. Sulfamethoxazole resistance (85%) and trimethoprim resistance (12.5%) were found by antibiotic susceptibility testing. No significant differences in bacterial prevalence or resistance patterns by gender or age were found in these results by statistical analysis. To combat the expanding threat of antibiotic resistance in UTIs, these findings highlight the need for antimicrobial stewardship programs and molecular diagnostic algorithms. Results from this study help to define the genetic mechanisms of resistance, underscore the continued need for sustained surveillance and appropriately targeted interventions to reduce the spread of resistant pathogens and improve treatment outcomes.
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F. Amiri, M. Rooshan, M. Ahmady, and M. Soliamani, "Hygiene practices and sexual activity associated with urinary tract infection in pregnant women," EMHJ-Eastern Mediterranean Health Journal, 15 (1), 104-110, 2009, 2009.
F. Zare, F. Mohammadzadeh Rostami, and M. Shahsafi, "Prevalence and pattern of antibiotic resistance of gram-negative bacteria isolated from urinary tract infections in patients referring to Neka Laboratories-Iran," International Journal of Biomedicine and Public Health, vol. 1, no. 1, pp. 30-36, 2018.
K. H. Kim et al., "The Clinical Guidelines for Acute Uncomplicated Cystitis and Acute Uncomplicated Pyelonephritis," Urogenital Tract Infection, vol. 12, no. 2, pp. 55-64, 2017.
D. S. Ipe, L. Sundac, W. H. Benjamin Jr, K. H. Moore, and G. C. Ulett, "Asymptomatic bacteriuria: prevalence rates of causal microorganisms, etiology of infection in different patient populations, and recent advances in molecular detection," FEMS microbiology letters, vol. 346, no. 1, pp. 1-10, 2013.
J. Matuszkiewicz-Rowińska, J. Małyszko, and M. Wieliczko, "Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems," Archives of medical science: AMS, vol. 11, no. 1, p. 67, 2015.
M. A. Croxen and B. B. Finlay, "Molecular mechanisms of Escherichia coli pathogenicity," Nature Reviews Microbiology, vol. 8, no. 1, pp. 26-38, 2010.
S. O. Anyadoh-Nwadike, S. I. Okorondu, I. O. Obiajuru, P. O. Nwadike, F. Nwaokorie, and J. Akerele, "Comparative study of the prevalence and antibiogram of bacterial isolates from the urinary and genital tracts of antenatal patients," IOSR Journal of Pharmacy and Biological Sciences, vol. 10, no. 1, pp. 15-19, 2015.
Abdulsahib, S. S. (2021). Identification of the respiratory tract infection due to methicillin-resistant by TaqMan real-time PCR. Medical Journal of Cell Biology, 9(2), 86-92.
Roca et al., "The global threat of antimicrobial resistance: science for intervention," New microbes and new infections, vol. 6, pp. 22-29, 2015.
Adebisi, Giaze, T.R, "Drug utilization pattern in pregnancy amongst inpatient and outpatient groups in a specialist hospital, north-western nigeria," International Journal of Pharmacy and Pharmaceutical Sciences, vol. 9, no. 3, pp. 84–87, 2017.
P. Huovinen, L. Sundström, G. Swedberg, and O. Sköld, "Trimethoprim and sulphonamide resistance," Antimicrobial agents and chemotherapy, vol. 39, no. 2, p. 279, 1995.
Rafeeq, H. F., & Sharba, Z. A. (2022). The incidence of Extended-spectrum β-lactamase enzymes and their connection to virulence genes in community-acquired urinary tract infection.
O. Sköld, "Resistance to trimethoprim and sulfonamides," Veterinary research, vol. 32, no. 3-4, pp. 261-273, 2001.
J. A. Settepani, "The hazard of using chloramphenicol in food animals," Journal of the American Veterinary Medical Association, vol. 184, no. 8, pp. 930-931, 1984.
C. Pezzella, A. Ricci, E. DiGiannatale, I. Luzzi, and A. Carattoli, "Tetracycline and streptomycin resistance genes, transposons, and plasmids in Salmonella enterica isolates from animals in Italy," Antimicrobial agents and chemotherapy, vol. 48, no. 3, pp. 903-908, 2004.
P.-E. Fournier, G. Dubourg, and D. Raoult, "Clinical detection and characterization of bacterial pathogens in the genomics era," Genome medicine, vol. 6, no. 11, pp. 1-15, 2014.
Abdulsahib, S. S. (2021). Identification of the respiratory tract infection due to methicillin-resistant by TaqMan real-time PCR. Medical Journal of Cell Biology, 9(2), 86-92
CLSI, Performance standards for antimicrobial susceptibility testing, CLSI document M100-S27. 2017.
C. Toro et al., "Genetic analysis of antibiotic-resistance determinants in multidrug-resistant Shigella strains isolated from Chilean children," Epidemiology & Infection, vol. 133, no. 1, pp. 81-86, 2005.
T. T. H. Van, J. Chin, T. Chapman, L. T. Tran, and P. J. Coloe, "Safety of raw meat and shellfish in Vietnam: an analysis of Escherichia coli isolations for antibiotic resistance and virulence genes," International journal of food microbiology, vol. 124, no. 3, pp. 217-223, 2008.
G. Sabat, P. Rose, W. Hickey, and J. Harkin, "Selective and sensitive method for PCR amplification of Escherichia coli 16S rRNA genes in soil," Applied and environmental microbiology, vol. 66, no. 2, pp. 844-849, 2000.
J. A. Jolley and D. A. Wing, "Pyelonephritis in pregnancy," Drugs, vol. 70, no. 13, pp. 1643- 1655, 2010.
G. L. Paniagua-Contreras et al., "Comprehensive expression analysis of pathogenicity genes in uropathogenic Escherichia coli strains," Microbial pathogenesis, vol. 103, pp. 1-7, 2017.
E. G. Sweedan, "Estimate Antimicrobial activity and Anti-biofilm formation of bark Cinnamomum zeylanicum on Klebsiella pneumoniae isolated from Urinary Tract Infections," Iraqi Journal of Science, vol. 59, no. 3C, pp. 1560-1566, 2018.
Boye et al., "Asymptomatic urinary tract infections in pregnant women attending antenatal clinic in Cape Coast, Ghana," E3 J Med Res, vol. 1, no. 6, pp. 74 83, 2012.
R. Raksha, H. Srinivasa, and R. Macaden, "Occurrence and characterisation of uropathogenic Escherichia coli in urinary tract infections," Indian journal of medical microbiology, vol. 21, no. 2, p. 102, 2003.
Sonawane, Kailas D., et al. "Structural insights and inhibition mechanism of TMPRSS2 by experimentally known inhibitors Camostat mesylate, Nafamostat and Bromhexine hydrochloride to control SARS-coronavirus-2: A molecular modeling approach." Informatics in medicine unlocked 24 (2021): 100597.
D. Müller et al., "Identification of unconventional intestinal pathogenic Escherichia coli isolates expressing intermediate virulence factor profiles by using a novel single-step multiplex PCR," Applied and environmental microbiology, vol. 73, no. 10, p. 3380, 2007.
J. Bien, O. Sokolova, and P. Bozko, "Role of uropathogenic Escherichia coli virulence factors in development of urinary tract infection and kidney damage," International journal of nephrology, vol. 2012, 2012.
K. Gupta, D. Scholes, and W. E. Stamm, "Increasing prevalence of antimicrobial resistance among uropathogens causing acute uncomplicated cystitis in women," Jama, vol. 281, no. 8, pp. 736-738, 1999.
W. Kern, M. Oethinger, A. Jellen-Ritter, and S. Levy, "Non-target gene mutations in the development of fluoroquinolone resistance in Escherichia coli," Antimicrobial Agents and Chemotherapy, vol. 44, no. 4, pp. 814-820, 2000.
Y. Kausar, S. K. Chunchanur, S. D. Nadagir, L. Halesh, and M. Chandrasekhar, "Virulence factors, serotypes and antimicrobial suspectibility pattern of Escherichia coli in urinary tract infections," Al Ameen J Med Sci, vol. 2, no. 1, pp. 47-51, 2009.
H. Momtaz et al., "Uropathogenic Escherichia coli in Iran: serogroup distributions, virulence factors and antimicrobial resistance properties," Annals of clinical microbiology and antimicrobials, vol. 12, no. 1, pp. 1-12, 2013.
Mohammed, Ali Abdulmawjood, et al. "Molecular insights into the inhibition of early stages of Aβ peptide aggregation and destabilization of Alzheimer's Aβ protofibril by dipeptide D-Trp-Aib: A molecular modelling approach." International Journal of Biological Macromolecules 242 (2023): 124880.
S. Babypadmini and B. Appalaraju, "Extended spectrum-lactamases in urinary isolates of Escherichia coli and Klebsiella pneumoniae-prevalence and susceptibility pattern in a tertiary care hospital," Indian Journal of medical microbiology, vol. 22, no. 3, p. 172, 2004.
K. Zurfluh, M. Glier, H. Hächler, and R. Stephan, "Replicon typing of plasmids carrying blaCTXM- 15 among Enterobacteriaceae isolated at the environment, livestock and human interface," Science of the Total Environment, vol. 521, pp. 75-78, 2015.
H. M. H. Al-Hasani and M. Hussein, "Study antibacterial activity of honey against some common species of pathogenic bacteria," Iraqi Journal of Science, vol. 59, no. 1A, pp. 30-7, 2018.
P. Guilfoile and I. E. Alcamo, Antibiotic-resistant bacteria. Infobase Publishing, 2007.
Fàbrega, S. Madurga, E. Giralt, and J. Vila, "Mechanism of action of and resistance to quinolones," Microbial biotechnology, vol. 2, no. 1, pp. 40-61, 2009.
D. C. Kaur, J. S. Puri, S. S. Kulkarni, and A. Jayawant, "Prevalence of Amp C β lactamases in clinical isolates of E. coli from a tertiary care rural hospital," Int J Pharm and Pharmaceut Sci, vol. 7, pp. 165-168, 2015.
F. C. Tenover, "Mechanisms of antimicrobial resistance in bacteria," The American journal of medicine, vol. 119, no. 6, pp. S3-S10, 2006.
N. Fatima and S. Ishrat, "Frequency and risk factors of asymptomatic bacteriuria during pregnancy," Journal of the College of Physicians and Surgeons--pakistan: JCPSP, vol. 16, no. 4, pp. 273-275, 2006.
Gavali, Laxman V., et al. "Novel terephthalaldehyde bis (thiosemicarbazone) Schiff base ligand and its transition metal complexes as antibacterial Agents: Synthesis, characterization and biological investigations." Results in Chemistry 7 (2024): 101316.
Assefa, D. Asrat, Y. Woldeamanuel, A. Abdella, and T. Melesse, "Bacterial profile and drug susceptibility pattern of urinary tract infection in pregnant women at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia," Ethiopian medical journal, vol. 46, no. 3, pp. 227-235, 2008.
S. Bouzari, A. Jafari, and M. Zarepoor, "Distribution of genes encoding toxins and antibiotic resistance patterns in diarrhoeagenic Escherichia coli isolates in Tehran," EMHJ-Eastern Mediterranean Health Journal, 13 (2), 287-293, 2007, 2007.
F. Mashayekhi et al., "Molecular characterization and antimicrobial resistance of uropathogenic Escherichia coli," Iranian Journal of Biotechnology, vol. 12, no. 2, pp. 32-40, 2014.
Kamble, S. A., Barale, S. S., Mohammed, A. A., Paymal, S. B., Naik, N. M., & Sonawane, K. D. (2024). Structural insights into the potential binding sites of Cathepsin D using molecular modelling techniques. Amino Acids, 56(1), 33.
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