Detection of classⅠintegrons with phenotypic ESBL detection among enterobacteriaceae isolated from patients with urinary tract infection in Sulaimani provenance/ Iraq

Authors

  • Karzan Taha Abubaker Department of Microbiology, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.
  • Khanda Abdullateef Anoar Department of Microbiology, College of Medicine, University of Sulaimani, Sulaymaniyah, Iraq.

DOI:

https://doi.org/10.22317/imj.v6i3.1190

Keywords:

Class I integron, ESBL, Enterobacteriaceae, UTI

Abstract

Objectives: This study aims to evaluate class Ⅰ integrons and ESBL detection in members of Enterobacteriaceae obtained from Urinary tract infection samples.

Methods: Four hundred mid-stream urine sample were collected from patients admitting to Shar teaching hospital, Sulaimani teaching hospital, Anwar Shexa medical city hospital with signs and symptoms of UTI, and inoculated on different culture media. Colony morphology, gram staining, and VITEK 2 compact were used for bacterial identification, antibiotic profile and ESBL screened phenotypically by antibiotic profile results and double disk synergy test and confirmed by combined disk test methods. Conventional PCR was used to detect classⅠ Integron by using a specific primer and the result was analyzed, sequenced and uploaded into NCBI.

Results: Among four hundred samples the prevalence rate of Enterobacteriaceae was 67.03 which includes 86 E. coli, 32 Klebsiella pneumoniae, and two isolates of Proteus mirabilis, according to the antibiotic profile, the most sensitive antibiotic among all three isolates were Imipenem, meropenem, and nitrofurantoin, while most resistance antibiotic were nalidixic acid and third generation cephalosporin. The prevalence rate of ESBL-producing Enterobacteriaceae was 56.6% by the confirmatory test which was a combined disk test, and the prevalence rate of classⅠintegron was 54.2%.

Conclusion: A significant majority of the isolates under study had integrons gene and were ESBL positive. As a result, proactive antibiotic surveillance systems are required in both clinical and community settings in order to stop the occurrence and spread of antibiotic resistance genes among diverse bacterial species.

References

Tan CW, Chlebicki MP. Urinary tract infections in adults. Singapore medical journal. 2016;57(9):485.

Öztürk R, Murt A. Epidemiology of urological infections: a global burden. World journal of urology. 2020;38(11):2669-79.

Price TK, Hilt EE, Dune TJ, Mueller ER, Wolfe AJ, Brubaker L. Urine trouble: should we think differently about UTI? International urogynecology journal. 2018;29(2):205-10.

Wilson ML, Gaido L. Laboratory diagnosis of urinary tract infections in adult patients. Clinical infectious diseases. 2004;38(8):1150-8.

ONDARI DM. URINARY TRACT INFECTIONS CAUSED BY ENTERIC BACTERIA AND ANTIBIOTIC SENSITIVITY AMONG SYMPTOMATIC MALES VISITING SPECIAL TREATMENT CENTER, NAIROBI CITY COUNTY, KENYA. 2020.

Eiamphungporn W, Schaduangrat N, Malik AA, Nantasenamat C. Tackling the antibiotic resistance caused by class A β-lactamases through the use of β-lactamase inhibitory protein. International Journal of Molecular Sciences. 2018;19(8):2222.

Clinical, Institute LS. Performance standards for antimicrobial susceptibility testing. Clinical and Laboratory Standards Institute Wayne, PA; 2020.

Boucher Y, Labbate M, Koenig JE, Stokes H. Integrons: mobilizable platforms that promote genetic diversity in bacteria. Trends in microbiology. 2007;15(7):301-9.

Kargar M, Mohammadalipour Z, Doosti A, Lorzadeh S, Japoni-Nejad A. High prevalence of class 1 to 3 integrons among multidrug-resistant diarrheagenic Escherichia coli in southwest of Iran. Osong public health and research perspectives. 2014;5(4):193-8.

Holm A, Aabenhus R. Urine sampling techniques in symptomatic primary-care patients: a diagnostic accuracy review. BMC family practice. 2016;17(1):1-9.

Karah N, Rafei R, Elamin W, Ghazy A, Abbara A, Hamze M, et al. Guideline for urine culture and biochemical identification of bacterial urinary pathogens in low-resource settings. Diagnostics. 2020;10(10):832.

Yakupoğulları Y, Otlu B, Celik B, HG GB. Performance of MALDI-TOF MS for the identification of gram-negative bacteria grown on eosin methylene blue (EMB) agar: A simple method for improving the effectiveness of identification. Mikrobiyoloji bulteni. 2019;53(1):1-11.

Weinstein MP, Lewis JS. The clinical and laboratory standards institute subcommittee on antimicrobial susceptibility testing: background, organization, functions, and processes. Journal of clinical microbiology. 2020;58(3):e01864-19.

Kaur J, Chopra S, Sheevani GM. Modified double disc synergy test to detect ESBL production in urinary isolates of Escherichia coli and Klebsiella pneumoniae. Journal of clinical and diagnostic research: JCDR. 2013;7(2):229.

Anoar KA, Ali FA, Omer SA. Phenotypic detection of metallo-lactamase enzyme among Gram-negative bacteria isolated from burn patients in Sulaimani, Iraq. Int J Curr Microbiol Appl Sci. 2014;3:315-25.

Lan Y, Zhou M, Jian Z, Yan Q, Wang S, Liu W. Prevalence of pks gene cluster and characteristics of Klebsiella pneumoniae‐induced bloodstream infections. Journal of clinical laboratory analysis. 2019;33(4):e22838.

Ali FA. Distribution of CTX-M gene among Escherichia coli strains isolated from different clinical samples in Erbil City. Iraqi Journal of Biotechnology. 2018;17(1).

McLellan LK, Hunstad DA. Urinary tract infection: pathogenesis and outlook. Trends in molecular medicine. 2016;22(11):946-57.

Majeed HT, Aljanaby AAJ. Antibiotic susceptibility patterns and prevalence of some extended spectrum beta-lactamases genes in gram-negative bacteria isolated from patients infected with urinary tract infections in Al-Najaf City, Iraq. Avicenna journal of medical biotechnology. 2019;11(2):192.

Hamza NM. Prevalence of Bacteria in urinary Tract Infections in COVID-19 Patients In Erbil City. 2022.

Silva A, Costa E, Freitas A, Almeida A. Revisiting the Frequency and Antimicrobial Resistance Patterns of Bacteria Implicated in Community Urinary Tract Infections. Antibiotics. 2022;11(6):768.

Ahmad S, Ali F, Qureshi SA, Uzma B, Shakeela Q, Sabir MS, et al. The evaluation of antibiotic susceptibility pattern and associated risk factors of UTI in tertiary care hospital of Peshawar. Pakistan journal of pharmaceutical sciences. 2022;35(3 (Special)):897-903.

Naqid IA, Hussein NR, Balatay A, Saeed KA, Ahmed HA. Antibiotic susceptibility patterns of uropathogens isolated from female patients with urinary tract infection in Duhok province, Iraq. Jundishapur Journal of Health Sciences. 2020;12(3).

Osman AA. Antibiotic Resistance of Bacteria isolated in Urinary Tract Infections in Erbil City. Zanco Journal of Pure and Applied Sciences. 2019;31(4):42-9.

Woldemariam HK, Geleta DA, Tulu KD, Aber NA, Legese MH, Fenta GM, et al. Common uropathogens and their antibiotic susceptibility pattern among diabetic patients. BMC infectious diseases. 2019;19(1):1-10.

Jameel AY, Artoshi DM. Prevalence of Urinary Tract Infections and Their Antimicrobial Sensitivity Among Diabetic and Non Diabetic Patients in Zakho. Science Journal of University of Zakho. 2019;7(4):125-31.

Storme O, Tirán Saucedo J, Garcia-Mora A, Dehesa-Dávila M, Naber KG. Risk factors and predisposing conditions for urinary tract infection. Therapeutic advances in urology. 2019;11:1756287218814382.

Maharjan G, Khadka P, Siddhi Shilpakar G, Chapagain G, Dhungana GR. Catheter-associated urinary tract infection and obstinate biofilm producers. Canadian journal of infectious diseases and medical microbiology. 2018;2018.

Arunachalam U, Ponmudi C, Solanke PV, Das D, Vignesh N, Pawade P. A study about urinary tract infection among patients attending tertiary care hospital. International Surgery Journal. 2017;4(8):2620-2.

Ahani F, Pirouzi A, Mohsenzadeh M, Khaledi A. Evaluate the presence of class 1 integrons among uropathogenic Escherichia coli recovered from children urinary tract infection; a systematic review and meta-analysis. Gene Reports. 2020;20:100698.

Polse R, Yousif S, Assafi M. Prevalence and antimicrobial susceptibility patterns of uropathogenic E. coli among people in Zakho, Iraq. International Journal of Research in Medical Sciences. 2016;4(4):1219-23.

Gatya Al-Mayahie SM, Al-Guranie DRdT, Hussein AA, Bachai ZA. Prevalence of common carbapenemase genes and multidrug resistance among uropathogenic Escherichia coli phylogroup B2 isolates from outpatients in Wasit Province/Iraq. PloS one. 2022;17(1):e0262984.

Abdulrahman IS. Antimicrobial Susceptibility Pattern of Pathogenic Bacteria Causing Urinary Tract Infections at Azadi Hospital In Duhok CityKurdistan Region of Iraq. Science Journal of University of Zakho. 2018;6(2):46-50.

Ahmed HS. LABORATORY INVESTIGATIONS OF URINARY TRACT INFECTIONS USING BACTERIOLOGICAL AND BIOCHEMICAL METHODS AND THEIR ANTIBIOTICS SENSITIVITY. Plant Archives. 2020;20(2):2425-30.

Quan J, Dai H, Liao W, Zhao D, Shi Q, Zhang L, et al. Etiology and prevalence of ESBLs in adult community-onset urinary tract infections in East China: A prospective multicenter study. Journal of Infection. 2021;83(2):175-81.

Erol B, Culpan M, Caskurlu H, Sari U, Cag Y, Vahaboglu H, et al. Changes in antimicrobial resistance and demographics of UTIs in pediatric patients in a single institution over a 6-year period. Journal of pediatric urology. 2018;14(2):176. e1-. e5.

Salih MK, Alrabadi NI, Thalij KM, Hussien AS. Isolation of pathogenic gram-negative bacteria from urinary tract infected patients. Open Journal of Medical Microbiology. 2016;6(02):59.

Pishtiwan AH, Khadija KM. Prevalence of blaTEM, blaSHV, and blaCTX-M genes among ESBL-producing Klebsiella pneumoniae and Escherichia coli isolated from thalassemia patients in Erbil, Iraq. Mediterranean journal of hematology and infectious diseases. 2019;11(1).

Mohamed ES, Khairy RM, Abdelrahim SS. Prevalence and molecular characteristics of ESBL and AmpC β-lactamase producing Enterobacteriaceae strains isolated from UTIs in Egypt. Antimicrobial Resistance & Infection Control. 2020;9(1):1-9.

Azargun R, Sadeghi MR, Barhaghi MHS, Kafil HS, Yeganeh F, Oskouee MA, et al. The prevalence of plasmid-mediated quinolone resistance and ESBL-production in Enterobacteriaceae isolated from urinary tract infections. Infection and drug resistance. 2018;11:1007.

Pormohammad A, Pouriran R, Azimi H, Goudarzi M. Prevalence of integron classes in Gram-negative clinical isolated bacteria in Iran: a systematic review and meta-analysis. Iranian Journal of Basic Medical Sciences. 2019;22(2):118.

Mobaraki S, Aghazadeh M, Barhaghi MHS, Memar MY, Goli HR, Gholizadeh P, et al. Prevalence of integrons 1, 2, 3 associated with antibiotic resistance in Pseudomonas aeruginosa isolates from Northwest of Iran. BioMedicine. 2018;8(1).

Deng Y, Bao X, Ji L, Chen L, Liu J, Miao J, et al. Resistance integrons: class 1, 2 and 3 integrons. Annals of clinical microbiology and antimicrobials. 2015;14(1):1-11.

Tayh G, Al Laham N, Ben Yahia H, Ben Sallem R, Elottol AE, Ben Slama K. Extended-spectrum β-lactamases among Enterobacteriaceae isolated from urinary tract infections in Gaza strip, Palestine. BioMed research international. 2019;2019.

Abd El-Rahman S, Ismail Y, Alhusseini NF, Abbas S. Role of integrons in multi drug resistant extended-spectrum-lactamase-producing enterobacteriaceae. Journal of Microbiology and Antimicrobials. 2014;6(7):104-10.

Shams F, Hasani A, Rezaee MA, Nahaie MR, Hasani A, Haghi MHSB, et al. Carriage of class 1 and 2 integrons in quinolone, extended-spectrum-β-lactamase-producing and multi drug resistant E. coli and K. pneumoniae: High burden of antibiotic resistance. Advanced pharmaceutical bulletin. 2015;5(3):335.

Malek M, Amer FA, Allam A, El-Sokkary R, Gheith T, Arafa M. Occurrence of classes I and II integrons in Enterobacteriaceae collected from Zagazig University Hospitals, Egypt. Frontiers in microbiology. 2015;6:601.

Akya A, Lorestani RC, Rostamian M, Elahi A, Baakhshii S, Aliabadi M, et al. The relationship of class I integron gene cassettes and the multidrug-resistance in extended-spectrum β-lactamase producing isolates of Escherichia coli. Archives of Pediatric Infectious Diseases. 2019;7(3).

Delarampour A, Ghalehnoo ZR, Khademi F, Vaez H. Antibiotic resistance patterns and prevalence of class I, II and III Integrons among clinical isolates of Klebsiella pneumoniae. Le infezioni in medicina. 2020;28(1):64-9.

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Published

2022-09-26

How to Cite

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Taha Abubaker K, Anoar KA. Detection of classⅠintegrons with phenotypic ESBL detection among enterobacteriaceae isolated from patients with urinary tract infection in Sulaimani provenance/ Iraq. Iraq Med J [Internet]. 2022 Sep. 26 [cited 2024 Nov. 25];6(3). Available from: https://mail.iraqmedj.org/index.php/imj/article/view/1190

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