High frequency of integrons and efflux pump in Uropathogenic Escherichia coli isolated from Iranian kidney and non-kidney transplant patients

Background and Aim : Due to the important role of integrons and efflux pumps in increasing drug resistance, the aim of this study was to investigate the frequency of integrons and efflux pump in UPEC isolated from Iranian KTPs and non-KTP.Methods : A case-control study was performed on ۱۱۱ UPEC isolates obtained from ۴۶ KTPs (group A) and ۶۵ non-KTP (group B) who were diagnosed with a UPEC-associated UTI between June ۲۰۱۹ to October ۲۰۱۹ at three laboratory center and two nephrology private clinic in Isfahan, Iran. These isolates were further confirmed as E. coli based on phenotyping and genotyping test. Antimicrobial susceptibility was determined using the disc diffusion method, and the presence of integron and efflux pump genes was detected by polymerase chain reaction.Results : In this study, a total of ۱۱۱ confirmed UPEC were isolated, in group A, ۶۹.۶% and ۳۰.۴% isolates were collected from female and male, while ۶۹.۲% and ۳۰.۸% isolates were obtained from female and male in group B, respectively. The frequency of integron genes was as follows: ۶۰.۹% and ۲۸.۳% isolates of group A and ۴۷.۷% and ۲۱.۶% isolates of group B carried int۱ and int۲, respectively. In both groups with int۱-positive, the highest resistance was to co-trimoxazole with (۸۹.۳%) and (۶۷.۷%), respectively. The lowest antibiotic resistance rates in groups A and B with int۱-positive were seen against piperacillin/tazobactam (۱۴.۳%) and nitrofurantoin (۹.۷%), respectively. All three genes acrA, acrB, and tolC were present simultaneously in ۶۸.۵% (۷۶/۱۱۱) isolates, ۷۱.۸% (۳۳/۴۶) isolates of group A, and ۶۶.۲% (۴۳/۶۵) isolates of group B.Conclusion : Our data indicated a significant relationship between the presence of integrons and several antibiotics such as co-trimoxazole and cefixime. Furthermore, RND efflux pumps such as AcrAB-TolC play an important role in gram-negative bacteria in the removal of toxic substances and antibiotics.

کلیدواژه ها:

Urinary tract infection ، Escherichia coli ، kidney transplantation ، Integron ، Efflux pump