title: Determination of integron frequency by a polymerase chain reaction-restriction fragment length polymorphism method in multidrug-resistant Escherichia coli, which causes urinary tract infections.
abstract: The purpose of this study was to determine the presence of integrons in Escherichia coli, which cause urinary tract infections, and to define the association between integrons and antimicrobial susceptibility. Susceptibility of 200 isolates from urine samples of patients suffering from urinary tract infections to 13 antibiotics was determined by the Kirby-Bauer disk diffusion method. The existence of class1 and 2 integrons in resistant isolates was assessed by polymerase chain reaction-restriction fragment length polymorphism and sequencing. Antibiotic resistance patterns were observed as follows: amoxicillin 78%, tetracycline 76.1%, co-trimoxazole 67.7%, cephalotin 60%, nalidixic acid 57.4%, chloramphenicol 49%, gentamicin 46.4%, ceftazidim 38.1%, ciprofloxacin 36.2%, nitrofurantoin 33.5%, amikacin 32.1%, norfloxacin 36.1%, and imipenem 27.1%. Of 200 isolates, 155 (77.5%) were multidrug resistant (MDR). The existence of integrons was confirmed in 50.3% of isolates. Three class 1 integron types, aadA2 being the most frequently found, and four class 2 integron types are described. Significant association between resistance to gentamicin, co-trimoxazole, cephalotin, ceftazidim, imipenem, chloramphenicol, and nalidixic acid with the existence of integrons was observed. Multidrug resistance suggests that the strategy for treatment of patients with E.coli infections needs to be revised. Furthermore, it was shown that integrons may be partly responsible for multidrug resistance. Imipenem and norfloxacin were the most effective antibiotics against isolates.
authors: Shahid Beheshti University of Medical Sciences, Mofid Children's Hospital, Pediatric Infections Research Center, Tehran, Iran.
authors: Fatemeh
authors: F
authors: Fallah
authors: Abdollah
authors: A
authors: Karimi
authors: Mehdi
authors: M
authors: Goudarzi
authors: Farideh
authors: F
authors: Shiva
authors: Masoumeh
authors: M
authors: Navidinia
authors: Mana Hadipour
authors: MH
authors: Jahromi
authors: Raheleh Sadat
authors: RS
authors: Sajadi Nia
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D006801:Humans; D015378:Imipenem / Q000494:pharmacology / Q000627:therapeutic use*; D032023:Integrons / Q000235:genetics*; D008297:Male; D008826:Microbial Sensitivity Tests; D009643:Norfloxacin / Q000494:pharmacology / Q000627:therapeutic use*; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D056689:Uropathogenic Escherichia coli / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification
chemical_list: D000900:Anti-Bacterial Agents; D015378:Imipenem; D009643:Norfloxacin