Generic placeholder image

Anti-Infective Agents

Editor-in-Chief

ISSN (Print): 2211-3525
ISSN (Online): 2211-3533

Research Article

Two Years Study of Frequency and Antimicrobial Resistance Patterns of Escherichia coli Strains Isolated from Clinical Specimens in Northern Iran

Author(s): Zahra Norouzi Bazgir, Mehrdad Gholami and Hamid Reza Goli*

Volume 21, Issue 1, 2023

Published on: 04 October, 2022

Article ID: e150822207490 Pages: 9

DOI: 10.2174/2211352520666220815145503

Price: $65

Abstract

Background: According to the reports from the World Health Organization, increased use of antibiotics and bacterial resistance has become a worldwide issue. Resistance to antimicrobial agents in Escherichia coli clinical strains is increasing.

Objective: The objective of this study was to determine the antibiotic resistance patterns and frequency of multidrug resistance (MDR) phenotype in E. coli isolated from patients in two major hospitals in Sari, north Iran.

Methods: In this descriptive-analytical study, a total of 13322 clinical specimens were collected from patients. All the specimens were evaluated to determine the presence of E. coli strains using conventional biochemical tests and API kit. Susceptibility testing against twelve antibiotics was determined using the disk-diffusion method. Results were interpreted in accordance with the Clinical and Laboratory Standard Institute (CLSI) protocol.

Results: Out of 13322 studied samples, 964 (7.23%) E. coli strains were identified. In two hospitals, high resistance to ampicillin and cefalexin was presented in 621 (64.4%) and 402 (41.7%) isolates, respectively. The highest antibiotic resistance was observed in the burn unit, the burn intensive care unit (ICU) and the burn restoration section, while all the strains (eight) that were isolated from the neonatal-ICU, were sensitive to all the tested antibiotics except cefalexin, nitrofurantoin, nalidixic acid, and ampicillin. Also, strains isolated from urine, wound, stool, and blood samples were resistant to all tested antibiotics.

Conclusion: Increased resistance to different antibiotics in burn hospitals has created increasing concern. Very high resistance to some antibiotics indicates that these drugs are misused in therapeutic centers and highlights that infection control measures should be arranged in the ICUs of our hospitals.

Keywords: Escherichia coli, antibiotic resistance, multidrug-resistant, nosocomial infections, clinical specimens, neonatal ICU.

Graphical Abstract
[1]
Pormohammad, A.; Nasiri, M.J.; Azimi, T. Prevalence of antibiotic resistance in Escherichia coli strains simultaneously isolated from humans, animals, food, and the environment: A systematic review and meta-analysis. Infect. Drug Resist., 2019, 12, 1181-1197.
[http://dx.doi.org/10.2147/IDR.S201324] [PMID: 31190907]
[2]
Sahoo, K.C.; Tamhankar, A.J.; Sahoo, S.; Sahu, P.S.; Klintz, S.R.; Lundborg, C.S. Geographical variation in antibiotic-resistant Escherichia coli isolates from stool, cow-dung and drinking water. Int. J. Environ. Res. Public Health, 2012, 9(3), 746-759.
[http://dx.doi.org/10.3390/ijerph9030746] [PMID: 22690160]
[3]
Amiri, P.; Pournajaf, A.; Shavalipour, A.; Tayebi, Z.; Goudarzi, H.; Eslami, G. Evaluation of antimicrobial resistance in the beta-lactamase producing Escherichia coli isolated from urinary tract infection in the patients referring to Taleghani hospital of Tehran. Tabari Biomed. Stud. Res. J., 2015, 1(2), 11-19.
[4]
Makvana, S.; Krilov, L.R. Escherichia coli infections. Pediatr. Rev., 2015, 36(4), 167-170.
[http://dx.doi.org/10.1542/pir.36.4.167] [PMID: 25834220]
[5]
Dubreuil, J.D. Fruit extracts to control pathogenic Escherichia coli: A sweet solution. Heliyon, 2020, 6(2), e03410.
[http://dx.doi.org/10.1016/j.heliyon.2020.e03410] [PMID: 32099927]
[6]
Heidary, M.; Momtaz, H.; Madani, M. Characterization of diarrheagenic antimicrobial resistant Escherichia coli isolated from pediatric patients in Tehran, Iran. Iran. Red Crescent Med. J., 2014, 16(4), e12329.
[http://dx.doi.org/10.5812/ircmj.12329] [PMID: 24910786]
[7]
Sheikhalizadeh, V.; Ahangarzadeh Rezaee, M.; Langarizadeh, N.; Goli, H.R. Different features of Escherichia coli and Klebsiella pneumoniae in children and adults. Res. Mole. Med., 2018, 6(1), 30-40.
[PMID: 30134812]
[8]
Allocati, N.; Masulli, M.; Alexeyev, M.F.; Di Ilio, C. Escherichia coli in Europe: An overview. Int. J. Environ. Res. Public Health, 2013, 10(12), 6235-6254.
[http://dx.doi.org/10.3390/ijerph10126235] [PMID: 24287850]
[9]
Ibrahim, M.E.; Bilal, N.E.; Hamid, M.E. Increased multi-drug resistant Escherichia coli from hospitals in Khartoum state, Sudan. Afr. Health Sci., 2012, 12(3), 368-375.
[PMID: 23382754]
[10]
Mobasherizadeh, S.; Shokri, D.; Zargarzadeh, A.H.; Jalalpour, S.; Ebneshahidi, S.A.; Sajadi, M. Antimicrobial resistance surveillance among hospitalized and non-hospitalized extend-spectrum beta-lactamase producing Escherichia coli from four tertiary-care hospitals in Isfahan, Iran; 2008-2011. Afr. J. Microbiol. Res., 2012, 6(5), 953-959.
[http://dx.doi.org/10.5897/AJMR-11-943]
[11]
Clinical and laboratory standard, Institute. Performance standards for antimicrobial susceptibility testing; twenty-seven informational supplement M100-S27, 2017.
[12]
Saeed, W.M.; Ghanem, S.; El Shafey, H.M.; Manzoor, N. Assessment of antimicrobial resistance patterns in Escherichia coli isolated from clinical samples in Madinah, Saudi Arabia. Afr. J. Microbiol. Res., 2018, 12(13), 321-326.
[http://dx.doi.org/10.5897/AJMR2018.8836]
[13]
Ali, F.A. Distribution of CTX-M gene among Escherichia coli strains isolated from different clinical samples in Erbil City. Iran. J. Biotechnol., 2018, 17(1), 78-90.
[14]
Acharya, M.; Joshi, P.R.; Thapa, K.; Aryal, R.; Kakshapati, T.; Sharma, S. Detection of metallo-β-lactamases-encoding genes among clinical isolates of Pseudomonas aeruginosa in a tertiary care hospital, Kathmandu, Nepal. BMC Res. Notes, 2017, 10(1), 718.
[http://dx.doi.org/10.1186/s13104-017-3068-9] [PMID: 29216906]
[15]
Haghighatpanah, M.; Mojtahedi, A. Characterization of antibiotic resistance and virulence factors of Escherichia coli strains isolated from Iranian inpatients with urinary tract infections. Infect. Drug Resist., 2019, 12, 2747-2754.
[http://dx.doi.org/10.2147/IDR.S219696] [PMID: 31564925]
[16]
Hadizadeh, M.; Norouzi, A.; Taghadosi, R.; Mohebi, S.; Mohammadi, M.; Hasanzade, A.; Moghadam, M.T. Prevalence of qnr, intI, and intII genes in extendedspectrum beta-lactamase (ESBL)-producing Escherichia coli isolated from clinical samples in Iran. Trop. J. Pharm. Res., 2017, 16(1), 141-147.
[http://dx.doi.org/10.4314/tjpr.v16i1.18]
[17]
Church, D.; Elsayed, S.; Reid, O.; Winston, B.; Lindsay, R. Burn wound infections. Clin. Microbiol. Rev., 2006, 19(2), 403-434.
[http://dx.doi.org/10.1128/CMR.19.2.403-434.2006 ] [PMID: 16614255]
[18]
Shams, S.; Hashemi, A.; Esmkhani, M.; Kermani, S.; Shams, E.; Piccirillo, A. Imipenem resistance in clinical Escherichia coli from Qom, Iran. BMC Res. Notes, 2018, 11(1), 314.
[http://dx.doi.org/10.1186/s13104-018-3406-6] [PMID: 29776449]
[19]
Kirac, S.; Keskin, D.; Karahasanoglu, F.B. Antimicrobial resistance and sensitivity among isolates of Klebsiella spp from urine samples in Denizli, Turkey. J. Pure Appl. Microbiol., 2014, 8(3), 2163-2166.
[20]
Badamchi, A.; Javadinia, S.; Farahani, R.; Solgi, H.; Tabatabaei, A. Molecular detection of plasmid-mediated quinolone resistant genes in uropathogenic E. coli from tertiary referral hospital in Tehran, Iran. Arch Pharmacol Ther., 2019, 1(1), 19-24.
[21]
Rajabnia, M.; Forghani, M.S.; Hasani, S.; Bahadoram, M.; Mohammadi, M.; Barahman, M. Prevalence and antibiotic resistance pattern of extended spectrum beta lactamase producing Escherichia coli isolated from urinary tract infection. J. Renal Inj. Prev., 2019, 8(2), 78-81.
[http://dx.doi.org/10.15171/jrip.2019.15]
[22]
Alkhudhairy, M.K.; Saki, M.; Seyed–Mohammadi, S.; Jomehzadeh, N.; Khoshnood, S.; Moradzadeh, M. Integron frequency of Escherichia coli strains from patients with urinary tract infection in Southwest of Iran. J. Acute Dis., 2019, 8(3), 113.
[http://dx.doi.org/10.4103/2221-6189.259110]
[23]
Ventola, C.L. The antibiotic resistance crisis: Part 1: Causes and threats. PT., 2015, 40(4), 277-283.
[PMID: 25859123]
[24]
Neamati, F; Khorshidi, A; Moniri, R; Hosseini, T.S.A. Molecular epidemiology of antimicrobial resistance of uropathogenic Escherichia coli isolates from patients with urinary tract infections in a tertiary teaching hospital in Iran. Microb. Drug Resist., 2020, 26(1), 60-70.
[25]
Ali, I.; Rafaque, Z.; Ahmed, S.; Malik, S.; Dasti, J.I. Prevalence of multi-drug resistant uropathogenic Escherichia coli in Potohar region of Pakistan. Asian Pac. J. Trop. Biomed., 2016, 6(1), 60-66.
[http://dx.doi.org/10.1016/j.apjtb.2015.09.022]
[26]
MKK, F; Ma, R Detection of metallo-\b {eta}-lactamases-encoding genes among clinical isolates of Escherichia coli in a tertiary care hospital, Malaysia arXiv preprint arXiv:190405198, 2019.
[27]
Iliyasu, M.; Uba, A.; Agbo, E. Phenotypic detection of multidrug resistant extended-spectrum beta-lactamase (ESBL) producing Escherichia coli from clinical samples. Afr. J. Cell. Pathol., 2018, 9(2), 25-32.
[http://dx.doi.org/10.5897/AJCPath2018.0004]
[28]
Alwash, M.S.; Al-Rafyai, H.M. Antibiotic resistance patterns of diverse Escherichia coli phylogenetic groups isolated from the Al-Hillah river in Babylon Province, Iraq. ScientificWorldJournal, 2019, 2019, 5927059.
[29]
Viderman, D.; Brotfain, E.; Khamzina, Y.; Kapanova, G.; Zhumadilov, A.; Poddighe, D. Bacterial resistance in the intensive care unit of developing countries: Report from a tertiary hospital in Kazakhstan. J. Glob. Antimicrob. Resist., 2019, 17, 35-38.
[http://dx.doi.org/10.1016/j.jgar.2018.11.010] [PMID: 30448518]
[30]
Shakya, S.; Edwards, J.; Gupte, H.A.; Shrestha, S.; Shakya, B.M.; Parajuli, K.; Kattel, H.P.; Shrestha, P.S.; Ghimire, R.; Thekkur, P. High multidrug resistance in urinary tract infections in a tertiary hospital, Kathmandu, Nepal. Public Health Action, 2021, 11(1)(Suppl. 1), 24-31.
[http://dx.doi.org/10.5588/pha.21.0035] [PMID: 34778012]
[31]
Rezaee, M.A.; Sheikhalizadeh, V.; Hasani, A. Detection of integrons among multi-drug resistant (MDR) Escherichia coli strains isolated from clinical specimens in northern West of Iran. Braz. J. Microbiol., 2011, 42(4), 1308-1313.

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy