Prevalence of qnr, intI, and intII genes in extendedspectrum beta-lactamase (ESBL)-producing Escherichia coli isolated from clinical samples in Iran

Purpose: To investigate the prevalence of qnr, intI, and intII genes in extended spectrum betalactamase (ESBL)-producing Escherichia coli isolated from clinical samples in Kerman, Iran.Methods: A total of 127 E. coli were collected from clinical samples in Kerman hospitals. The antibiotic susceptibility test was performed using disc diffusion method, while the presence of ESBL-producing E. coli was determined by phenotypic confirmatory test. Furthermore, the presence of qnrA, qnrB, qnrS, intI, intII, and β-lactamase-encoding genes was detected by polymerase chain reaction (PCR). Finally, the data were analyzed and associations between different genes and antibiotic resistance were evaluated.Results: The highest and lowest rates of resistance were observed against ampicillin (72.4 %) and imipenem (2.3 %), respectively. Also, 41.7 % of the isolates produced ESBL-enzymes. The qnrS and genes were detected in 6.3 and 0.78 %, respectively, of the isolates, while qnrA gene was not detected in the current study. The results revealed that 64.5 and 10.2 % of isolates carried intI and intII genes, respectively. Data analysis showed a significant association between ESBL production and class I integrin gene in E. coli isolates.Conclusions: Due to the variation in the resistance patterns of E. coli against antibiotics in different geographical regions, antimicrobial treatments should be based on local experience. Also, the coexistence of ESBL and intI gene in the majority of E. coli isolates suggests that care should be taken in choosing antibiotic therapy.Keywords: Extended-spectrum β-lactamase, E. coli, Integrin, Imipenem, Bacterial genes, Antibiotic resistanc

The effect of endocervical and catheter bacterial colonisation during in vitro fertilisation and embryo transfer (IVF-ET) on IVF success rate among asymptomatic women: a longitudinal prospective study

The adverse effects of bacterial contamination during in vitro fertilisation and embryo transfer (IVF-ET) have been studied previously. However, data on asymptomatic women with positive bacterial culture and their IVF outcome are lacking. This prospective longitudinal study was conducted on 74 women undergoing IVF-ET, of whom specimens from the endocervix and ET catheter were taken and sent to a laboratory for microbiological assessment. Then, patients were followed up for evaluation of chemical pregnancy (β-HCG > 25 mIU/mL) and clinical pregnancy (detected foetal heartbeat). The findings revealed that there was no significant difference in terms of biochemical (35.4% vs. 19.2%, p= .116) and clinical pregnancy rate (25.0% vs. 15.4%, p= .257) among ET catheter culture positive and negative women. This finding allows us to conclude that the positive culture in the absence of clinical signs of infection may not increase the risk of implantation failure.Impact Statement What is already known on this subject? There is growing evidence indicating that endometritis may decrease the endometrial receptiveness in in vitro fertilisation (IVF) cycles; however, there is a paucity of knowledge regarding IVF outcomes when the bacterial culture of embryo transfer (ET) catheter is positive. What the results of this study add? The present study demonstrates that positive ET catheter culture in asymptomatic women does not increase the risk of IVF failure. What the implications are of these findings for clinical practice and/or further research? Positive-culture, per se, may not be associated with poor IVF outcomes and further studies should be undertaken on this topic in various clinical settings using different protocols