Journal of Medical Microbiology and Infectious Diseases
Journal of Medical Microbiology and Infectious Diseases
JoMMID
Medical Sciences
http://jommid.pasteur.ac.ir
1
admin
2345-5349
2345-5330
8
10.61186/JoMMID
14
8888
13
en
jalali
1400
6
1
gregorian
2021
9
1
9
3
online
1
fulltext
en
Analysis of β-lactams and Carbapenem Heteroresistance in Extra-intestinal Pathogenic Escherichia coli from Blood Samples in Iran
Anti-microbial agents, resistance and treatment protocols
Anti-microbial agents, resistance and treatment protocols
Original article
Original article
<strong>Introduction:</strong> Heteroresistance is the phenomenon wherein subpopulations of microbes exhibit a range of resistance to an antibiotic and are prevalent in a broad range of microorganisms. Not much data on carbapenem and β-lactams heteroresistance among extra-intestinal pathogenic <em>Escherichia coli</em> (ExPEC) in blood infections is available. This study aimed to investigate the frequency of heteroresistance to β-lactams and carbapenems in ExPEC strains isolated from patients' blood in Tehran, Iran. <strong>Methods</strong>: Identification of <em>E. coli</em> isolates was performed using standard biochemical tests, and PFGE was employed to determine the <em>E. coli</em> isolates genotypes. Antibiotic resistance pattern to carbapenems (ertapenem, meropenem, and imipenem), cefotaxime, and cefepime was determined by measuring minimum inhibitory concentration (MIC). The results were used to assess β-lactam and carbapenem heteroresistance in <em>E. coli</em> isolates. <strong>Results:</strong> In this study, for the first time, heteroresistance to the antibiotics carbapenem (ertapenem, meropenem, and imipenem), cefotaxime, and cefepime was observed in <em>E. coli</em> isolates from blood samples. Sixteen samples had heteroresistance to antibiotics. Three and two isolates showed heteroresistance to imipenem and ertapenem, respectively. Simultaneous heteroresistance to two carbapenem family antibiotics in three isolates was detected. Also, three isolates showed heteroresistance to cefepime and five to cefotaxime. The imipenem-resistant isolates exhibited a higher level of heteroresistance than those resistant to other carbapenem antibiotics.<strong> Conclusions: </strong>The present study shows that heteroresistance is increasing in Iran. Furthermore, this study demonstrated increasing resistance to the carbapenem family.
Extraintestinal Pathogenic Escherichia coli, Heteroresistance, Broth microdilution, Agar dilution
170
177
http://jommid.pasteur.ac.ir/browse.php?a_code=A-10-249-9&slc_lang=en&sid=1
Mohammad Taha
Ebrahimi
mtebrahimi@ymail.com
10031947532846004697
10031947532846004697
Yes
Department of Microbiology, School of Medicine, Tehran University of Medical Sciences
Mohsen
Nazari
mohsennazari911@gmail.com
10031947532846004698
10031947532846004698
No
Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran
Niloofar
Mobarezpour
10031947532846004699
10031947532846004699
No
PPD Tuberculin Department, Razi Vaccine & Serum Research Institute, Karaj, Iran
Hamed
Afkhami
10031947532846004700
10031947532846004700
No
Department of Medical Microbiology, Faculty of Medicine, Shahed University of Medical Science, Tehran, Iran
Sepideh
Fereshteh
10031947532846004701
10031947532846004701
No
Department of Bacteriology, Pasteur Institute of Iran, Tehran, Iran