Detection of qnrB Gene among Quinolone Resistant Escherichia coli Isolated from Kermanshah Hospitals

Document Type : Original Research

Authors
S. Koshki 1
Z. Mozaffari 2
1 Department of Biology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran
2 Department of Biology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran.
10.29252/iem.6.4.251
Abstract
Background: Urinary tract infections are considered as a major health concern. Escherichia coli is the most common cause of urinary tract infections. The presence of qnr plasmid genes in bacteria is the main cause of resistance to quinolones. The aim of this study was to investigate the antibiotic resistance pattern and prevalence of qnrB gene in E. coli strains isolated from patients with urinary tract infections.

Materials & Methods: In this cross-sectional study, samples were taken from patients with urinary tract infections, referred to Kermanshah hospitals during the spring of 2017. E. coli strains were identified by biochemical tests. Then antibiotic susceptibility testing was performed for the isolates by the disc diffusion method. Following that, qnrB resistance gene was detected by PCR; finally, data were analyzed by SPSS software Ver. 23.

Findings: In this study, 105 E. coli strains were isolated from urine specimens. The strains resistance rate to nalidixic acid, ciprofloxacin, and ofloxacin antibiotics was 62.85, 38.09, and 33.33%, respectively. PCR results showed that 67 strains (63.8%) had qnrB gene, and 38 strains (36.19%) lacked this gene. Logistic regression analysis showed that there was a significant relationship between the presence of qnrB gene and nalidixic resistance.

Conclusion: The results of this study show that the frequency of qnrB gene among the E. coli strains isolated from urinary tract infections is fairly high in Kermanshah. Therefore, it is necessary to do further investigates using molecular techniques and to take serious preventive measures.

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1. Johnston M. Escherichia coli--a review. The journal of the Royal Society for the Promotion of Health. 2000;120(2):81.
2. Foxman B. The epidemiology of urinary tract infection. Nature Reviews Urology. 2010;7(12):653.
3. Shahbazi S, Karam MRA, Habibi M, Talebi A, Bouzari S. Distribution of extended-spectrum β-lactam, quinolone and carbapenem resistance genes, and genetic diversity among uropathogenic Escherichia coli isolates in Tehran, Iran. Journal of global antimicrobial resistance. 2018;14:118-125.
4. Nicolle LE. Urinary tract infection in long-term care facilities. Healthcare infection. 2014;19(1):4-12.
5. Lutter SA, Currie ML, Mitz LB, Greenbaum LA. Antibiotic resistance patterns in children hospitalized for urinary tract infections. Archives of pediatrics & adolescent medicine. 2005;159(10):924-928.
6. Kothari A, Sagar V. Antibiotic resistance in pathogens causing community-acquired urinary tract infections in India: a multicenter study. The Journal of Infection in Developing Countries. 2008;2(05):354-358.
7. Kim K-Y, Park J-H, Kwak H-S, Woo G-J. Characterization of the quinolone resistance mechanism in foodborne Salmonella isolates with high nalidixic acid resistance. International journal of food microbiology. 2011;146(1):52-56.
8. Chen X, Zhang W, Pan W, Yin J, Pan Z, Gao S, et al. Prevalence of qnr, aac (6′)-Ib-cr, qepA, and oqxAB in Escherichia coli isolates from humans, animals, and the environment. Antimicrobial agents and chemotherapy. 2012;56(6):3423-3427.
9. AKBARI NF, Mirsalehian A, Hamidian M, MIRAFSHAR M, JABAL AF, PAZHAND O, et al. Antimicrobial susceptibility testing of Escherichia coli strains isolated from urinary tract infections to fluoroquinolones and detection of gyrA mutations in resistant strains. 2007.
10. Soltan Dallal MM, Aghamirzaei HM, Mehrabadi JF, Lari AR, Sabbaghi A, Eshraghian MR, et al. Molecular detection of TEM and AmpC (Dha, mox) broad spectrum β-lactamase in clinical isolates of Escherichia coli. Tehran University Medical Journal. 2010;68(6).
11. Muhammad I, Uzma M, Yasmin B, Mehmood Q, Habib B. Prevalence of antimicrobial resistance and integrons in Escherichia coli from Punjab, Pakistan. Brazilian Journal of Microbiology. 2011;42(2):462-466.
12. Moreno E, Prats G, Sabaté M, Pérez T, Johnson JR, Andreu A. Quinolone, fluoroquinolone and trimethoprim/sulfamethoxazole resistance in relation to virulence determinants and phylogenetic background among uropathogenic Escherichia coli. Journal of Antimicrobial Chemotherapy. 2006;57(2):204-211.
13. Talan DA, Krishnadasan A, Abrahamian FM, Stamm WE, Moran GJ, Group EINS. Prevalence and risk factor analysis of trimethoprim-sulfamethoxazole—and fluoroquinolone-resistant Escherichia coli infection among emergency department patients with pyelonephritis. Clinical infectious diseases. 2008;47(9):1150-1158.
14. AbdollahiKheirabadi S, Najafipour S, Kafilzadeh F, Abdollahi A, Jafari S, Moravej A. Evaluation of Drug Resistance Pattern of Escherichia coli Strains Isolated from Fasa Vali-e-Asr Hospital Patients. Journal of Fasa University of Medical Sciences. 2013;2(4):273-278.
15. Zhou K, Zhou L, Lim QE, Zou R, Stephanopoulos G, Too H-P. Novel reference genes for quantifying transcriptional responses of Escherichia coli to protein overexpression by quantitative PCR. BMC molecular biology. 2011;12(1):18.
16. Shin SY, Kwon KC, Park JW, Song JH, Ko YH, Sung JY, et al. Characteristics of aac (6')-Ib-cr gene in extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae isolated from Chungnam area. The Korean journal of laboratory medicine. 2009;29(6):541-550.
17. Soleimani-Asl Y, Zibaei M, Firoozeh F. Detection of qnrA gene among quinolone-resistant Escherichia coli isolated from urinary tract infections in Khorram Abad during 2011-2012. Feyz Journal of Kashan University of Medical Sciences. 2013;17(5).
18. Momtaz H, Karimian A, Madani M, Dehkordi FS, Ranjbar R, Sarshar M, et al. Uropathogenic Escherichia coli in Iran: serogroup distributions, virulence factors and antimicrobial resistance properties. Annals of clinical microbiology and antimicrobials. 2013;12(1):8.
19. Park KS, Lee JH, Jeong DU, Lee JJ, Wu X, Jeong BC, et al. Determination of pentapeptide repeat units in Qnr proteins by the structure-based alignment approach. Antimicrobial agents and chemotherapy. 2011;55(9):4475-4478.
20. Shyamala R, Deepalatha C. The Resistance Pattern of Escherichia coli to Trimethoprim in a tertiary care hospital.
21. Cai X, Li C, Huang J, Li Y. Prevalence of plasmid-mediated quinolone resistance qnr genes in Central China. African Journal of Microbiology Research. 2011;5(8):975-978.
22. Mansory Jamshidi N, Pakzad E, Tabaraee B, Hadadi A. Frequency of qnr genes in Escherichia coli strains resistant to quinolones isolated from Ilam Imam khomani hospital and Tehran Milad hospital. scientific journal of ilam university of medical sciences. 2013;21(6):16-22.
23. Akya A, Chegenelorestani R, Elahi A, Hamzavi Y. Frequency of Plasmid-mediated Quinolone Resistance Genes in Extended-spectum β-lactamase-producing Escherichia coli. Journal of Mazandaran University of Medical Sciences. 2017;27(151):41-51.
Infection Epidemiology and Microbiology
Volume 6, Issue 4
November 2020
Pages 251-258