Genetic diversity, Distribution of Carbapenem ResistanceGenes and Evaluation of the biofilm production in UropathogenicEscherichia coli isolates from patients with urinary catheter in North ofIran

Background and Aim : Infections due to carbapenem-resistant Enterobacteriaceae (CRE) areassociated in patients with urinary catheter alarming rate of emergency status. The aim of thisstudy was to investigate the antimicrobial resistance patterns and molecular mechanisms ofcarbapenem resistance among UPEC. Additionally, the potential of isolates to produce biofilms,as well as their clonal and genetic diversity, were investigated.Methods : A cross-sectional study was accomplished on a collection of ۷۶ non-duplicate UPECisolates obtained from CAUTIs from May ۲۰۲۱ to September ۲۰۲۱. The modified carbapeneminactivation method (mCIM) and EDTA-modified carbapenem inactivation method (eCIM) testwas performed for the detection of carbapenemase and metallo-β-lactamase activity. Also, thepresence of carbapenemases genes were determined using PCR assays. In ۹۶-well microtiterplates, biofilm development was evaluated. ERIC-PCR was used to investigate the clonal andgenetic variety of isolates.Results : A total of ۷۶ confirmed UPEC isolates were obtained from patients mentioned toteaching hospital in Babol, Iran. The results of antibiotic susceptibility testing revealed high rateof antibiotic resistance against nalidixic acide (۸۱.۶%) and trimethoprim-sulfamethoxazole(۸۰.۳%). Among UPEC isolates, ۶۳.۲% and ۱۳.۲% of UPEC isolates were positive for MBLproduction. The frequencies of the studied genes are in order of blaNDM (۱۴.۵%), blaoxa-۲۳(۲.۶%) and blaoxa-۴۸ (۲.۶%). Forty–two isolates (۵۵.۳ %) were positive to the capability ofbiofilm formation. ERIC-PCR revealed that UPEC isolates could be categorized in nine clustersA-I and five isolates were categorized as singleton.Conclusion : The high prevalence of MDR and carbapenemase producing isolates among theUPEC strain in this investigation is concerning. Moreover, the blaNDM was the most frequentcause of producing metallo-beta-lactamase and carbapenemase. Furthermore, a high incidence ofbiofilm producer isolates, which was found in hospitalized patients, is a severe problem in thisstudy. Also, analysis revealed a partial genetic similarity among the studied isolates, indicatingthat the same UPEC clones may have spread to other hospital units.

کلیدواژه ها:

Escherichia coli ، UPEC ، UTI ، carbapenem resistance ، biofilm