title: High Frequency of Class 1 Integrons in Escherichia coli Isolated From Patients With Urinary Tract Infections in Yasuj, Iran.
abstract: BACKGROUND
  Most urinary tract infections (UTI) are caused by Escherichia coli. Integrons have an important role in distributing antibiotic resistance genes among bacteria.
  
  
  OBJECTIVE
  The aim of this study was to investigate the presence of class 1, 2 and 3 integrons and their association with antibiotic resistance in E. coli isolated from patient with UTI in Yasuj, Iran.
  
  
  METHODS
  In this cross-sectional study a total of 200 E. coli were collected from 1820 patients diagnosed with UTI that had been referred to two clinical laboratories between February 2013 and November 2014 in Yasuj city, southwest of Iran. Susceptibility of isolates to 11 different antibiotics was determined by the disk agar diffusion method. multiplex-polymerase chain reaction (PCR) was used for detection of class 1, 2 and 3 integrons. The data were analyzed using the SPSS software (version 16) and the chi-square test. A P value of < 0.05 was considered statistically significant.
  
  
  RESULTS
  The highest rate of resistance was observed toward cephalothin (99%) and amoxicillin (76%) while only two (1%) isolates showed resistance to imipenem. Overall, 79% of isolates were multi drug resistant (MDR). Class 1 and 2 integrons were detected in 104 (52%) and 5 (2.5%) isolates respectively, while none of the isolates were positive for class 3 integrons. A significant association was observed between the presence of integrons and resistance to co-trimoxazole, nalidixic acid, ciprofloxacin, amoxicillin, ceftazidime and tetracycline (P < 0.05).
  
  
  CONCLUSIONS
  High MDR isolates of E. coli were observed in this study. The significant association between class 1 integrons and resistance to ciprofloxacin, nalidixic acid, co-trimoxazole, amoxicillin, ceftazidime and tetracycline showed that class 1 integrons have an important role in resistance to these antibiotics in this region.
authors.affiliation: Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, IR Iran.
authors.forename: Seyed Sajjad
authors.initials: SS
authors.lastname: Khoramrooz
authors.affiliation: Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, IR Iran.
authors.forename: Asghar
authors.initials: A
authors.lastname: Sharifi
authors.affiliation: Student Research Committee, Yasuj University of Medical Sciences, Yasuj, IR Iran.
authors.forename: Mahboubeh
authors.initials: M
authors.lastname: Yazdanpanah
authors.affiliation: Student Research Committee, Yasuj University of Medical Sciences, Yasuj, IR Iran.
authors.forename: Seyed Ali Asghar
authors.initials: SA
authors.lastname: Malek Hosseini
authors.affiliation: Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Emaneini
authors.affiliation: School of Veterinary Medicine, Shiraz University, Shiraz, IR Iran.
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Gharibpour
authors.affiliation: Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Najmeh
authors.initials: N
authors.lastname: Parhizgari
authors.affiliation: Department of Microbiology, School of Medicine, Shahrood University of Medical Sciences, Shahrood, IR Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mirzaii
authors.affiliation: Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Zoladl
authors.affiliation: Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, IR Iran.
authors.forename: Seyed Abdolmajid
authors.initials: SA
authors.lastname: Khosravani
keywords: Escherichia coli; Integrons; Multidrug Resistant; Urinary Tract Infections