Volume 7, Issue 4 (10-2019)                   JoMMID 2019, 7(4): 120-126 | Back to browse issues page

XML Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Norouzian H, Shahrokhi N, Sabeti S, Bouzari S, Pooya M. Evaluation of Quinolone Resistance in Escherichia coli Isolates Recovered from Urine and Feces of Patients with Acute or Recurrent Urinary Tract Infection. JoMMID. 2019; 7 (4) :120-126
URL: http://jommid.pasteur.ac.ir/article-1-216-en.html
Molecular Biology Department, Pasteur Institute of Iran, Tehran, Iran
Abstract:   (3550 Views)
Introduction: Antibiotic resistance, especially in Gram-negative uropathogens such as Escherichia coli, is the main barrier to treat urinary tract infection (UTI). In recent years, the dramatically increased resistance of E. coli to quinolones, a group of widely used antibiotics, has become a significant concern. Methods: In this descriptive cross-sectional study, we collected 261 E. coli isolates from the urine and stool samples of patients, referred to or hospitalized at Loghman hospital in Tehran, Iran, with either acute or recurrent UTI. The susceptibility testing for quinolones was performed by the disk diffusion method according to the recent protocols. Results: The frequency of resistant E. coli isolates was higher against nalidixic acid than ciprofloxacin and norfloxacin (67.8% vs. 48.7% and 44.1% respectively). When comparing acute and recurrent phases of UTI, in the urine samples, no significant difference was seen in the frequency of resistant isolates against nalidixic acid and norfloxacin, while this frequency against ciprofloxacin was significantly higher in recurrent UTI (68% vs. 48.2%). However, in the stool samples, the frequency of resistant isolates against nalidixic acid was higher in recurrent UTI (77.1% vs. 55.7%), while no significant difference was seen against ciprofloxacin and norfloxacin in these phases. Conclusion: Regarding the antibiotic type and frequency of the administration, the resistance pattern of E. coli to quinolones seems to differ in acute and recurrent phases of UTI.
Full-Text [PDF 548 kb]   (491 Downloads)    
Type of Study: Original article | Subject: Infectious diseases and public health
Received: 2019/09/22 | Accepted: 2020/01/6 | Published: 2020/03/12

1. 1. Dielubanza EJ, Schaeffer AJ. Urinary tract infections in women. Med Clin North Am. 2011; 95 (1): 27-41. [DOI:10.1016/j.mcna.2010.08.023]
2. Grossman Z, Miron D. Imaging and follow-up of children with first febrile Urinary Tract Infection (UTI). Harefuah. 2009; 148 (10): 716-20, 32.
3. Kumarasamy KK, Toleman MA, Walsh TR, Bagaria J, Butt F, Balakrishnan R, et al. Emergence of a new antibiotic resistance mechanism in India, Pakistan, and the UK: a molecular, biological, and epidemiological study. Lancet Infect Dis. 2010; 10 (9): 597-602. [DOI:10.1016/S1473-3099(10)70143-2]
4. Dyar OJ, Hoa NQ, Trung NV, Phuc HD, Larsson M, Chuc NT, et al. High prevalence of antibiotic resistance in commensal Escherichia coli among children in rural Vietnam. BMC Infect Dis. 2012; 12 (1): 92. [DOI:10.1186/1471-2334-12-92]
5. Pooya M, Saleh M, Mir-Marashi F, Bouzari S, Mardani M. The comparison of MDR and ESBL patterns among causative pathogens of UTI in hospitalized patients in two different ICUs in Loghman Hospital. Eur Urol Suppl. 2017;16 (3): e130. [DOI:10.1016/S1569-9056(17)30144-6]
6. Aldred KJ, Kerns RJ, Osheroff N. Mechanism of quinolone action and resistance. Biochemistry. 2014; 53 (10): 1565-74. [DOI:10.1021/bi5000564]
7. Organization WH. Report of the 3rd meeting of the WHO advisory group on integrated surveillance of antimicrobial resistance, 14-17 June 2011, Oslo, Norway: World Health Organization; 2012.
8. Lesher GY, Froelich EJ, Gruett MD, Bailey JH, Brundage RP. 1, 8-Naphthyridine derivatives. A new class of chemotherapeutic agents. J Med Chem. 1962; 5 (5): 1063-5. [DOI:10.1021/jm01240a021]
9. Yanat B, Rodríguez-Martínez J-M, Touati A. Plasmid-mediated quinolone resistance in Enterobacteriaceae: a systematic review with a focus on Mediterranean countries. Eur J Clin Microbiol Infect Dis. 2017; 36 (3): 421-35. [DOI:10.1007/s10096-016-2847-x]
10. Emmerson A, Jones A. The quinolones: decades of development and use. JAC. 2003; 51 (suppl_1):13-20. [DOI:10.1093/jac/dkg208]
11. Mitscher LA. Bacterial topoisomerase inhibitors: quinolone and pyridone antibacterial agents. Chem Rev. 2005; 105 (2): 559-92. [DOI:10.1021/cr030101q]
12. Andriole VT. The quinolones: past, present, and future. Clin Infect Dis. 2005; 41 (Supplement_2): S113-S9. [DOI:10.1086/428051]
13. Stein GE. The 4‐Quinolone Antibiotics: Past, Present, and Future. Pharmacotherapy. 1988; 8 (6): 301-14. [DOI:10.1002/j.1875-9114.1988.tb04088.x]
14. Boyd LB, Maynard MJ, Morgan-Linnell SK, Horton LB, Sucgang R, Hamill RJ, et al. Relationships among ciprofloxacin, gatifloxacin, levofloxacin, and norfloxacin MICs for fluoroquinolone-resistant Escherichia coli clinical isolates. Antimicrob Agents Chemother. 2009; 53 (1): 229-34. [DOI:10.1128/AAC.00722-08]
15. Mahdavi A, Nahaei M, Akhi M, Akhi M, Akbari DM. Antibiotic Resistance Pattern against Fluoroquinolones among Escherichia coli Isolated from ICU and Out- patient Clinic Admitted Patients with Urinary Tract Infection. Med J Tabriz Univ Med Sci Health Serv. 2009; 91-96.
16. Hadadi A, Rasoulinejad M, Maleki Z, Mojtahedzadeh M, Younesian M, Ahmadi S, et al. Antimicrobial resistance patterns among Gram-negative bacilli isolated from patients with nosocomial infections: Disk diffusion versus E-test. Tehran Univ Med J. 2007; 65 (4): 1-10.
17. Milani M, Nahaei M, Lotfipour F, Yousefee S. Antibiotic sensitivity of prevalent Bacteria isolated from urinary tract infection during 1998-2005. Pharmaceutical Sci. 2008; 4: 47-53.
18. Mokhtarian D, Ghahramani M, Nourzad H. A study of antibiotic resistance of Escherichia coli isolated from urinary tract infection. Horizon Med Sci. 2006; 12 (3): 5-10.
19. Kahlmeter G. An international survey of the antimicrobial susceptibility of pathogens from uncomplicated urinary tract infections: the ECO SENS Project. JAC. 2003; 51 (1): 69-76. [DOI:10.1093/jac/dkg028]
20. Shao H, Wang W, Zhang X, Li Z. Distribution and resistance trends of pathogens from urinary tract infections and impact on management. Zhonghua Nan Ke Xue. 2003; 9 (9): 690-2, 6.
21. Colodner R, Kometiani I, Chazan B, Raz R. Risk factors for community-acquired urinary tract infection due to quinolone-resistant E. coli. Infection. 2008; 36 (1): 41-5. [DOI:10.1007/s15010-007-7083-y]
22. Piéboji JG, Koulla-Shiro S, Ngassam P, Adiogo D, Njine T, Ndumbe P. Antimicrobial resistance of Gram-negative bacilli isolates from inpatients and outpatients at Yaounde Central Hospital, Cameroon. Int J Infect Dis. 2004; 8 (3): 147-54. [DOI:10.1016/j.ijid.2004.01.001]
23. Terlizzi ME, Gribaudo G, Maffei ME. UroPathogenic Escherichia coli (UPEC) infections: virulence factors, bladder responses, antibiotic, and non-antibiotic antimicrobial strategies. Frontiers in microbiology. 2017; 8: 1566. [DOI:10.3389/fmicb.2017.01566]
24. Foxman B, Manning SD, Tallman P, Bauer R, Zhang L, Koopman JS, et al. Uropathogenic Escherichia coli are more likely than commensal E. coli to be shared between heterosexual sex partners. Am J Epidemiol. 2002; 156 (12): 1133-40. [DOI:10.1093/aje/kwf159]
25. Nielubowicz GR, Mobley HL. Host-pathogen interactions in urinary tract infection. Nat Rev Urol. 2010; 7 (8): 430. [DOI:10.1038/nrurol.2010.101]
26. Chen Y-H, Ko W-C, Hsueh P-R. The role of fluoroquinolones in the management of urinary tract infections in areas with high rates of fluoroquinolone-resistant uropathogens. Eur J Clin Microbiol Infect Dis. 2012; 31 (8): 1699-704. [DOI:10.1007/s10096-011-1457-x]
27. Strahilevitz J, Jacoby GA, Hooper DC, Robicsek A. Plasmid-mediated quinolone resistance: a multifaceted threat. Clin Microbiol Rev. 2009; 22 (4): 664-89. [DOI:10.1128/CMR.00016-09]
28. Cao X, Cavaco LM, Lv Y, Li Y, Zheng B, Wang P, et al. Molecular characterization and antimicrobial susceptibility testing of Escherichia coli isolates from patients with urinary tract infections in 20 Chinese hospitals. J Clin Microbiol. 2011; 49 (7): 2496-501. [DOI:10.1128/JCM.02503-10]
29. Santiso R, Tamayo M, Fernández JL, del Carmen Fernández M, Molina F, Villanueva R, et al. Rapid and simple determination of ciprofloxacin resistance in clinical strains of Escherichia coli. J Clin Microbiol. 2009; 47 (8): 2593-5. [DOI:10.1128/JCM.00367-09]
30. Nakhjavani F, Mirsalehian A, Hamidian M, Kazemi B, Mirafshar M, Jabalameli F. Antimicrobial susceptibility testing for Escherichia coli strains to fluoroquinolones, in urinary tract infections. Iran J Public Health. 2007: 89-92.
31. Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011; 52 (5): e103-e20. [DOI:10.1093/cid/ciq257]
32. Soleimani-Asl Y, Zibaei M, Firoozeh F. Detection of qnrA gene among quinolone-resistant Escherichia coli isolated from urinary tract infections in Khorram Abad during 2011-2012. kaums. 2013; 17 (5).
33. Pouladfar G, Basiratnia M, Anvarinejad M, Abbasi P, Amirmoezi F, Zare S. The antibiotic susceptibility patterns of uropathogens among children with urinary tract infection in Shiraz. Medicine. 2017; 96 (37). [DOI:10.1097/MD.0000000000007834]
34. Sedighi I, Arabestani MR, Rahimbakhsh A, Karimitabar Z, Alikhani MY. Dissemination of extended-spectrum β-lactamases and quinolone resistance genes among clinical isolates of uropathogenic Escherichia coli in children. Jundishapur J Microbiol. 2015; 8 (7). [DOI:10.5812/jjm.19184v2]
35. Shenagari M, Bakhtiari M, Mojtahedi A, Roushan ZA. High frequency of mutations in gyrA gene associated with quinolones resistance in uropathogenic Escherichia coli isolates from the north of Iran. Iran J Basic Med Sci. 2018; 21 (12): 1226.
36. Mehri Habibi1 OA, Mohammad Reza Asadi Karam3*. The phenotypic and genotypic evaluation of resistance to quinolone antibiotics in clinical Escherichia coli isolated from urinary tract infection of hospitalized patients in Tehran, Iran in 2017. Journal of Torbat Heydariyeh University of Medical Sciences. 2018; 6 (1): 1-10.
37. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015; 13 (5): 269. [DOI:10.1038/nrmicro3432]
38. Damavandi M-S, Gholipour A, Pour ML. Prevalence of class D carbapenemases among extended-spectrum β-lactamases producing Escherichia coli isolates from educational hospitals in Shahrekord. J Clin Diagn Res. 2016; 10 (5): DC01. [DOI:10.7860/JCDR/2016/17722.7739]
39. Taheri M, Saleh M, Nemati AH, Ariana M, Shojaei E, Mardani M, et al. Antibiotic resistance pattern and phylogenetic groups of the Uropathogenic Escherichia coli isolates recovered from the urinary catheters of the hospitalized patients. J Med Microb Infect Dis. 2016; 4 (3): 76-82.
40. Rezazadeh M, Baghchesaraei H, Peymani A. Plasmid-Mediated Quinolone-Resistance (qnr) Genes in clinical isolates of Escherichia coli collected from several hospitals of Qazvin and Zanjan Provinces, Iran. Osong Public Health Res Perspect. 2016; 7 (5): 307-12. [DOI:10.1016/j.phrp.2016.08.003]
41. Blango MG, Mulvey MA. Persistence of uropathogenic Escherichia coli in the face of multiple antibiotics. Antimicrob Agents Chemother. 2010; 54 (5): 1855-63. [DOI:10.1128/AAC.00014-10]

Add your comments about this article : Your username or Email:

Send email to the article author

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.