Javed Saima, Mirani Zulfiqar Ali, Pirzada Zaid Ahmed
Department of Microbiology, University of Karachi, Karachi, Pakistan.
Pakistan Council of Scientific and Industrial Research Laboratories Complex, Karachi, Pakistan.
Pak J Pharm Sci. 2020 Nov;33(6):2643-2649.
The emergence of multidrug resistance in uropathogenic Escherichia coli (UPEC) is associated with the presence of drug resistant plasmids and integrons which facilitate horizontal gene transfer which impose serious challenges in patients with urinary tract infections (UTIs). The proposed research study is designed to determine emerging antibiotic resistance trends and the presence of plasmids and class 1 integron in UPEC. A total 74 strains of urinary pathogens were procured among them 50 UPEC isolates were selected and their antibiotic resistance pattern was performed by CLSI guidelines. Plasmid DNA of UPEC strains was extracted by kit method and profiling was done using gel electrophoresis. Class 1 integron genes intI1, sul1 and qacEΔ1 were detected by multiplex PCR in UPEC. Among gram negative urinary isolates, 50 (68%) isolates were E. coli, while the rest were Klebsiella, Pseudomonas, Enterobacter etc. All the tested UPEC were totally resistant to quinolones while sensitive to fosfomycin, imipenem and colistin antibiotics. Majority of multidrug resistant UPEC showed common resistant phenotype of fluoroquinolones, cephalosporins, sulfamethoxazole/trimethoprim and aminoglycosides. Out of the 50 UPEC isolates 46 (92%) were multi-drug resistant having one to three plasmids of more than 1kb and 41 (82%) possessed class 1 integron genes. Over all association between antibiotic resistance and presence of class 1 integron genes showed statistically significant results (p<0.05). Our results also depict a strong correlation between multidrug resistance and presence of class 1 integron in UPEC isolates (p<0.05). The presence of multiple plasmid bands in MDR E. coli strains and high prevalence of class 1 integrons indicate the role of plasmids and integrons in the horizontal transmission of antibiotic resistance genes in UPEC.
尿路致病性大肠杆菌（UPEC）中多重耐药性的出现与耐药质粒和整合子的存在有关，这些质粒和整合子促进水平基因转移，给尿路感染（UTIs）患者带来了严峻挑战。拟开展的研究旨在确定UPEC中新兴的抗生素耐药趋势以及质粒和1类整合子的存在情况。共采集了74株尿路病原体菌株，从中选取了50株UPEC分离株，并按照CLSI指南进行了抗生素耐药模式分析。采用试剂盒法提取UPEC菌株的质粒DNA，并通过凝胶电泳进行分析。通过多重PCR在UPEC中检测1类整合子基因intI1、sul1和qacEΔ1。在革兰氏阴性尿路分离株中，50株（68%）为大肠杆菌，其余为克雷伯菌、假单胞菌、肠杆菌等。所有检测的UPEC对喹诺酮类药物完全耐药，而对磷霉素、亚胺培南和黏菌素类抗生素敏感。大多数多重耐药UPEC表现出对氟喹诺酮类、头孢菌素类、磺胺甲恶唑/甲氧苄啶和氨基糖苷类药物的常见耐药表型。在50株UPEC分离株中，46株（92%）为多重耐药，具有1至3个大于1kb的质粒，41株（82%）拥有1类整合子基因。总体而言，抗生素耐药性与1类整合子基因的存在之间的关联显示出具有统计学意义的结果（p<0.05）。我们的结果还表明，UPEC分离株中的多重耐药性与1类整合子的存在之间存在强相关性（p<0.05）。多重耐药大肠杆菌菌株中多个质粒条带的存在以及1类整合子的高流行率表明质粒和整合子在UPEC中抗生素耐药基因水平传播中的作用。
