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Infectious Disorders - Drug Targets

Editor-in-Chief

ISSN (Print): 1871-5265
ISSN (Online): 2212-3989

Research Article

The Emergence of Quaternary Ammonium Compounds Resistance in Escherichia coli Isolated from Hospitals of Qazvin, Iran

Author(s): Narges Habibollah-Pourzereshki, Amir Peymani* and Fatemeh Keshavarz-Saleh

Volume 20 , Issue 4 , 2020

Page: [455 - 460] Pages: 6

DOI: 10.2174/1871526519666191009145825

Price: $65

Abstract

Introduction: Escherichia coli is one of the most important agents involved in healthcare-associated infection, and resistance to quantum ammonium compounds (QACs) has become a major challenge for infection control practitioners. The aim of the current study was to determine the frequency of qacE and qacEΔ1 genes in E. coli isolated from hospitalized patients in Qazvin, Iran.

Material and Methods: In the current cross-sectional study, 102 E. coli were collected from hospitals of Qazvin. All bacterial isolates were identified using standard laboratory methods and the antimicrobial susceptibility was evaluated by Kirby-Baer test. The presence of qacE and qacEΔ1 genes was investigated using polymerase chain reaction (PCR) technique.

Results: In this study, 65 (63.7%) isolates showed a multidrug resistance (MDR) pattern which was resistant to at least three classes of antimicrobials including ß-lactams, aminoglycosides, and fluoroquinolones. The highest rates of resistance were observed against cefotaxime (75.5%) and nalidixic acid (66.7%). The PCR showed that 5 (4.9%) isolates harbored qacE gene, 62 (60.8%) isolates qacEΔ1, and 10 (9.8%) isolates carried both genes, simultaneously. There was a significant relationship between the QACs resistance and MDR pattern (P=0.03).

Conclusion: This study indicated a significant resistance rate against disinfectant compounds in the studied hospitals. However, more attention should be paid to this critical issue in the infection control committees of the hospitals.

Keywords: Escherichia coli, quantum ammonium compounds, qacE, qacEΔ1, Kirby-Baer test, cefotaxime, fluoroquinolones.

[1]
Jain, S.; Khety, Z. Changing antimicrobial resistance pattern of isolates from an ICU over a 2 year period. J. Assoc. Physicians India, 2012, 60, 27-28, 33.
[PMID: 23029718]
[2]
De Francesco, M.A.; Ravizzola, G.; Peroni, L.; Negrini, R.; Manca, N. Urinary tract infections in Brescia, Italy: etiology of uropathogens and antimicrobial resistance of common uropathogens. Med. Sci. Monit., 2007, 13(6), BR136-BR144.
[PMID: 17534228]
[3]
McDonnell, G.; Russell, A.D. Antiseptics and disinfectants: activity, action, and resistance. Clin. Microbiol. Rev., 1999, 12(1), 147-179.
[http://dx.doi.org/10.1128/CMR.12.1.147] [PMID: 9880479]
[4]
Joyce, M.D.; Jennings, M.C.; Santiago, C.N.; Fletcher, M.H.; Wuest, W.M.; Minbiole, K.P. Natural product-derived quaternary ammonium compounds with potent antimicrobial activity. J. Antibiot. (Tokyo), 2016, 69(4), 344-347.
[http://dx.doi.org/10.1038/ja.2015.107] [PMID: 26577453]
[5]
Buffet-Bataillon, S.; Tattevin, P.; Bonnaure-Mallet, M.; Jolivet-Gougeon, A. Emergence of resistance to antibacterial agents: the role of quaternary ammonium compounds--a critical review. Int. J. Antimicrob. Agents, 2012, 39(5), 381-389.
[http://dx.doi.org/10.1016/j.ijantimicag.2012.01.011] [PMID: 22421329]
[6]
Poole, K. Mechanisms of bacterial biocide and antibiotic resistance. J. Appl. Microbiol., 2002, 92(Suppl.), 55S-64S.
[http://dx.doi.org/10.1046/j.1365-2672.92.5s1.8.x] [PMID: 12000613]
[7]
Gillings, M.R.; Xuejun, D.; Hardwick, S.A.; Holley, M.P.; Stokes, H.W. Gene cassettes encoding resistance to quaternary ammonium compounds: a role in the origin of clinical class 1 integrons? ISME J., 2009, 3(2), 209-215.
[http://dx.doi.org/10.1038/ismej.2008.98] [PMID: 18923456]
[8]
Alam, M.M.; Kobayashi, N.; Uehara, N.; Watanabe, N. Analysis on distribution and genomic diversity of high-level antiseptic resistance genes qacA and qacB in human clinical isolates of Staphylococcus aureus. Microb. Drug Resist., 2003, 9(2), 109-121.
[http://dx.doi.org/10.1089/107662903765826697] [PMID: 12820795]
[9]
DeMarco, C.E.; Cushing, L.A.; Frempong-Manso, E.; Seo, S.M.; Jaravaza, T.A.; Kaatz, G.W. Efflux-related resistance to norfloxacin, dyes, and biocides in bloodstream isolates of Staphylococcus aureus. Antimicrob. Agents Chemother., 2007, 51(9), 3235-3239.
[http://dx.doi.org/10.1128/AAC.00430-07] [PMID: 17576828]
[10]
Galluzzi, L.; Virtanen, P.; Karp, M. A real-time analysis of QacR-regulated multidrug resistance in Staphylococcus aureus. Biochem. Biophys. Res. Commun., 2003, 301(1), 24-30.
[http://dx.doi.org/10.1016/S0006-291X(02)02992-3] [PMID: 12535635]
[11]
Kazama, H.; Hamashima, H.; Sasatsu, M.; Arai, T. Distribution of the antiseptic-resistance genes qacE and qacE delta 1 in gram-negative bacteria. FEMS Microbiol. Lett., 1998, 159(2), 173-178.
[PMID: 9503610]
[12]
Kücken, D.; Feucht, H.; Kaulfers, P. Association of qacE and qacEDelta1 with multiple resistance to antibiotics and antiseptics in clinical isolates of Gram-negative bacteria. FEMS Microbiol. Lett., 2000, 183(1), 95-98.
[http://dx.doi.org/10.1016/S0378-1097(99)00636-9] [PMID: 10650208]
[13]
Brooks, G.F.; Carroll, K.C.; Butel, J.S.; Morse, S.A.; Mietzner, T.A. Medical Microbiology; United States. 25th ed; The McGrawHill Companies., 2010, Chapter15, p. 219..
[14]
Clinical and Laboratory Standards Institute (CLSI). Performance standards for antimicrobial susceptibility testing Twenty-third informational supplement M100-S23 2013. 2013.
[15]
Mahzounieh, M.; Khoshnood, S.; Ebrahimi, A.; Habibian, S.; Yaghoubian, M. Detection of antiseptic-resistance genes in Pseudomonas and Acinetobacter spp. isolated from burn pa-tients. Jundishapur J. Nat. Pharm. Prod., 2014, 9(2)e15402
[http://dx.doi.org/10.17795/jjnpp-15402] [PMID: 24872941]
[16]
Bass, L.; Liebert, C.A.; Lee, M.D.; Summers, A.O.; White, D.G.; Thayer, S.G.; Maurer, J.J. Incidence and characterization of integrons, genetic elements mediating multiple-drug resistance, in avian Escherichia coli. Antimicrob. Agents Chemother., 1999, 43(12), 2925-2929.
[http://dx.doi.org/10.1128/AAC.43.12.2925] [PMID: 10582884]
[17]
Kahlmeter, G. Prevalence and antimicrobial susceptibility of pathogens in uncomplicated cystitis in Europe. The ECO.SENS study. Int. J. Antimicrob. Agents, 2003, 22(Suppl. 2), 49-52.
[http://dx.doi.org/10.1016/S0924-8579(03)00229-2] [PMID: 14527771]
[18]
Romão, C.; Miranda, C.A.; Silva, J.; Mandetta Clementino, M.; de Filippis, I.; Asensi, M. Presence of qacEΔ1 gene and susceptibility to a hospital biocide in clinical isolates of Pseudomonas aeruginosa resistant to antibiotics. Curr. Microbiol., 2011, 63(1), 16-21.
[http://dx.doi.org/10.1007/s00284-011-9934-0] [PMID: 21479930]
[19]
Ghafouri, M.; Hashemi, S.A.; Azimian, A.; Garevani, T. Seyed.Sharifi, S.H. Evaluation of antibiotic resistance to bac-teria isolated from patients with nosocomial infections hospi-talized in Imam Reza in Bojnurd City in 2013. JRUMS, 2015, 14(7), 599-610.
[20]
Xiang, L.; Wang, X.K.; Li, Y.W.; Huang, X.P.; Wu, X.L.; Zhao, H.M.; Li, H.; Cai, Q.Y.; Mo, C.H. Analysis of trace quaternary ammonium compounds (QACs) in vegetables us-ing ultrasonic-assisted extraction and gas chromatography-mass spectrometry. J. Agric. Food Chem., 2015, 63(30), 6689-6697.
[http://dx.doi.org/10.1021/acs.jafc.5b01828] [PMID: 26165915]
[21]
Oggioni, M.R.; Furi, L.; Coelho, J.R.; Maillard, J.Y.; Martínez, J.L. Recent advances in the potential interconnection between antimicrobial resistance to biocides and antibiotics. Expert Rev. Anti Infect. Ther., 2013, 11(4), 363-366.
[http://dx.doi.org/10.1586/eri.13.16] [PMID: 23566146]
[22]
Shafaati, M.; Boroumand, M.; Nowroozi, J.; Amiri, P.; Kazemian, H. Correlation between qacE and qacEΔ1 efflux pump genes, antibiotic and disinfectant resistant among clini-cal isolates of E. coli. Recent. Pat. Antiinfect. Drug. Discov., 2016, 11(2), 189-195.
[PMID: 27527725]
[23]
Azadpour, M.; Nowroozi, J.; Goudarzi, G.R.; Mahmoudvand, H. Presence of qacEΔ1 and cepA genes and susceptibility to a hospital biocide in clinical isolates of Klebsiella pneumoniae in Iran. Trop. Biomed., 2015, 32(1), 109-115.
[PMID: 25801259]
[24]
Naparstek, L.; Carmeli, Y.; Chmelnitsky, I.; Banin, E.; Navon-Venezia, S. Reduced susceptibility to chlorhexidine among extremely-drug-resistant strains of Klebsiella pneumoniae. J. Hosp. Infect., 2012, 81(1), 15-19.
[http://dx.doi.org/10.1016/j.jhin.2012.02.007] [PMID: 22463977]
[25]
Dehbanipour, R.; Rastaghi, S.; Sedighi, M.; Maleki, N.; Faghri, J. High prevalence of multidrug-resistance uropathogenic Escherichia coli strains, Isfahan, Iran. J. Nat. Sci. Biol. Med., 2016, 7(1), 22-26.
[http://dx.doi.org/10.4103/0976-9668.175020] [PMID: 27003964]
[26]
Taheri, M.; Saleh, M.; Nemati, A.H.; Ariana, M.; Shojaei, E.; Mardani, M.; Katouli, M.; Pooya, M. Antibiotic resistance pat-tern and phylogenetic groups of the uropathogenic Escherich-ia coli isolates recovered from the urinary catheters of the hospitalized patients. J. Med. Microbiol. Infec. Dis., 2016, 4(3-4), 76-82.
[27]
Khoramrooz, S.S.; Sharifi, A.; Yazdanpanah, M. Malek Hos-seini, S.A.; Emaneini, M.; Gharibpour, F.; Parhizgari, N.; Mir-zaii, M.; Zoladl, M.; Khosravani, S.A. High frequency of class 1 integrons in Escherichia coli isolated from patients with uri-nary tract infections in Yasuj, Iran. Iran. Red Crescent Med. J., 2016, 18(1)e26399
[http://dx.doi.org/10.5812/ircmj.26399] [PMID: 26889395]
[28]
Japoni, A.; Gudarzi, M.; Farshad, S.; Basiri, E.; Ziyaeyan, M.; Alborzi, A.; Rafaatpour, N. Assay for integrons and pattern of antibiotic resistance in clinical Escherichia coli strains by PCR-RFLP in Southern Iran. Jpn. J. Infect. Dis., 2008, 61(1), 85-88.
[PMID: 18219144]
[29]
Mehta, M.; Bhardwaj, S.; Sharma, J. Prevalence and antibiotic susceptibility pattern of multi- drug resistant Escherichia coli isolates from urinary tract infection (UTI) patients. Int. J. Life. Sci. Pharm. Res., 2012, 2, 6-11.
[30]
Ansari, S.; Nepal, H.P.; Gautam, R.; Shrestha, S.; Neopane, P.; Gurung, G.; Chapagain, M.L. Community acquired multi-drug resistant clinical isolates of Escherichia coli in a tertiary care center of Nepal. Antimicrob. Resist. Infect. Control, 2015, 4, 15.
[http://dx.doi.org/10.1186/s13756-015-0059-2] [PMID: 25937923]
[31]
Salem, M.M.; Magdy, M.; Alhosiny, I.M. Distribution of classes 1 and 2 integrons among multi drug resistant E. coli isolated from hospitalized patients with urinary tract infection in Cairo, Egypt. AJBAS, 2010, 4(3), 398-407.
[32]
Kibret, M.; Abera, B. Antimicrobial susceptibility patterns of E. coli from clinical sources in northeast Ethiopia. Afr. Health Sci., 2011, 11(Suppl. 1), S40-S45.
[http://dx.doi.org/10.4314/ahs.v11i3.70069] [PMID: 22135643]
[33]
Ngwai, Y.B.; Akpotu, M.O.; Obidake, R.E.; Sounyo, A.A.; Onanuga, A.; Origbo, S.O. Antimicrobial susceptibility of Escherichia coli and other coliforms isolated from urine of asymptomatic students in Bayelsa State, Nigeria. Afr. J. Microbiol. Res., 2011, 5(3), 184-191.
[34]
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]
[35]
Ghadiri, H.; Vaez, H.; Razavi-Azarkhiavi, K.; Rezaee, R.; Haji-Noormohammadi, M.; Rahimi, A.A.; Vaez, V.; Kalantar, E. Prevalence and Antibiotic susceptibility patterns of extended- spectrum ß-lactamase and metallo-ß-lactamase–producing uropathogenic Escherichia coli isolates. Lab. Med., 2014, 45(4), 291-296.
[http://dx.doi.org/10.1309/LMHEP4VQHEY2POOK] [PMID: 25316659]
[36]
Mashayekhi, F.; Moghny, M.; Faramarzpoor, M.; Yahaghi, E. Khodaverdi.Darian, E.; Tarhriz, V.; Dormanesh, B. Molecular characterization and antimicrobial resistance of uropathogenic Escherichia coli. Iranian J. Biotechnol., 2014, 12(2)e16833
[37]
Kafilzadeh, F.; Farsimadan, F. Investigating multidrug efflux pumps in relation to the antibiotic resistance pattern in Esche-richia coli strains from patients in Iran. Biomed. Res., 2016, 27(4), 1130-1135.
[38]
Chen, L.; Xia, D.J. Comparison of disinfectant-resistant genes in Escherichia coli between hospital-acquired infection and community-acquired infection., Chin. J. Microecol, 2013, 2, 015..
[39]
Wang, W.; Mao, J.; Weizhen, X.U. Drug-resistance and disin-fectant-resistant genes of chlorhexidine-sulfadiazine-resistant Escherichia coli isolates. Zhongguo Yiyuan Ganranxue Zazhi, 2006, 0(03)
[40]
Wang, J.D.; Zhou, L.Z.; Qian, X.M. Study on disinfectant-sulfanilamide resistance genes of successively isolated strains of Escherichia coli., Chin. J. Disinfect, 2007, 4(013).
[41]
Zhang, Y.; Chen, Y.; Wang, W.; Han, L.; Han, X.; Liu, Y.; Cao, Y. Carriage of disinfectant resistance genes in clinically isolated Escherichia coli and minimal inhibitory concentration of five disinfectants. Can. J. Infect. Control, 2016, 15(5), 289-293.
[42]
Khan, F.Z.; Nawaz, T.; Mirani, Z.A.; Khan, S.; Raza, Y.; Kazmi, S.U. Study of class 1 integrons in multidrug-resistant uropathogenic Escherichia coli isolated from different hospi-tals in Karachi. Iran. J. Basic. Med. Sci., 2018, 21(10), 1079-1082.

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