Farzi Nastaran, Yadegar Abbas, Sadeghi Amir, Asadzadeh Aghdaei Hamid, Marian Smith Sinéad, Raymond Josette, Suzuki Hidekazu, Zali Mohammad Reza
Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran.
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran 1985717411, Iran.
J Clin Med. 2019 Nov 17;8(11):2004. doi: 10.3390/jcm8112004.
The high prevalence of antibiotic resistance in has become a great challenge in Iran. The genetic mutations that contribute to the resistance have yet to be precisely identified. This study aimed to investigate the prevalence of antibiotic resistance and virulence markers in Iranian isolates and to analyze if there is any association between resistance and genotype. Antibiotic susceptibility patterns of 68 isolates were investigated against metronidazole, clarithromycin, amoxicillin, rifampicin, ciprofloxacin, levofloxacin, and tetracycline by the agar dilution method. The , , , , and 23S rRNA genes of the isolates were sequenced. The virulence genotypes were also determined using PCR. Metronidazole resistance was present in 82.4% of the isolates, followed by clarithromycin (33.8%), ciprofloxacin (33.8%), rifampicin (32.4%), amoxicillin (30.9%), levofloxacin (27.9%), and tetracycline (4.4%). Overall, 75% of the isolates were resistant to at least two antibiotics tested and considered as a multidrug resistance (MDR) phenotype. Most of the metronidazole-resistant isolates carried frameshift mutations in both and genes, and premature termination occurred in positions Q5Stop and Q50Stop, respectively. Amino acid substitutions M191I, G208E, and V199A were predominantly found in gene of fluoroquinolone-resistant isolates. A2143G and C2195T mutations of 23S rRNA were found in four clarithromycin-resistant isolates. Interestingly, significant associations were found between resistance to metronidazole (MNZ) and -, -, and -positive genotypes, with = 0.0002, = 0.0001, and = 0.0001, respectively. Furthermore, a significant association was found between "on" status and resistance to amoxicillin (AMX) ( = 0.02). The prevalence of antibiotic resistance is high in our region, particularly that of metronidazole, clarithromycin, ciprofloxacin, and MDR. Simultaneous screening of virulence and resistance genotypes can help clinicians to choose the appropriate therapeutic regime against infection.
[病原体名称]抗生素耐药性在伊朗的高流行率已成为一项巨大挑战。导致耐药性的基因突变尚未得到精确鉴定。本研究旨在调查伊朗[病原体名称]分离株中抗生素耐药性和毒力标志物的流行情况，并分析耐药性与基因型之间是否存在关联。采用琼脂稀释法对68株[病原体名称]分离株进行了针对甲硝唑、克拉霉素、阿莫西林、利福平、环丙沙星、左氧氟沙星和四环素的药敏试验。对分离株的[相关基因名称1]基因、[相关基因名称2]基因、[相关基因名称3]基因、[相关基因名称4]基因和23S rRNA基因进行了测序。还使用聚合酶链反应（PCR）确定了毒力基因型。82.4%的分离株存在甲硝唑耐药性，其次是克拉霉素（33.8%）、环丙沙星（33.8%）、利福平（32.4%）、阿莫西林（30.9%）、左氧氟沙星（27.9%）和四环素（4.4%）。总体而言，75%的分离株对至少两种测试抗生素耐药，并被视为多重耐药（MDR）表型。大多数甲硝唑耐药分离株在[相关基因名称1]基因和[相关基因名称2]基因中均发生移码突变，分别在Q5Stop和Q50Stop位置出现过早终止。在耐氟喹诺酮分离株的[相关基因名称3]基因中主要发现氨基酸替代M191I、G208E和V199A。在4株克拉霉素耐药分离株中发现了23S rRNA的A2143G和C2195T突变。有趣的是，发现对甲硝唑（MNZ）的耐药性与[相关基因名称4]阳性基因型、[相关基因名称5]阳性基因型和[相关基因名称6]阳性基因型之间存在显著关联，P值分别为0.0002、0.0001和0.0001。此外，发现[相关基因名称7]“开启”状态与对阿莫西林（AMX）的耐药性之间存在显著关联（P = 0.02）。我们地区[病原体名称]抗生素耐药性的流行率很高，尤其是甲硝唑、克拉霉素、环丙沙星和多重耐药的耐药率。同时筛查毒力和耐药基因型有助于临床医生选择针对[病原体名称]感染的合适治疗方案。
