Virulence genotyping of Escherichia coli isolates from diarrheic and urinary tract infections in relation to phylogeny in southeast of Iran

The purpose of this study was to determine the prevalence of virulence genes and phylogenetic groups/subgroups of Escherichia coli (E. coli) isolates from diarrheic and urinary tract infections (UTI) cases in Rigan area, southeast of Iran. One hundred thirty five E. coli were isolated from diarrheic (90 isolates) and urinary tract infections (45 isolates) samples. The confirmed isolates were examined to detect the phylogenetic group/subgroups and a selection of virulence genes including iucD, sfa/focDE, afaIBC, papEF, hly, cnfI and cdtI by PCR. The examined isolates belonged to four phylogenetic groups A (42.2%), B1 (14.1%), B2 (10.4%), and D (33.3%). Among 135 tested bacteria, 62.22% of diarrheic and 30.37% of UTI isolates had at least one of the virulence genes. In the diarrheic isolates iucD (47.77%) was the most prevalent gene. The other genes including sfa/focDE, afaIBC, papEF and cnfI/cdtI genes were detected in 15, 13, 11 and one diarrheic isolates respectively. None of the diarrheic isolates were positive for hly gene. Out of 45 UTI isolates 28.88% were positive for iucD, 13.33% for cnfI, 11.11% for afaIBC, 11.11% for papEF, 6.66% for sfa/focDE and 4.44% for cdtI genes. Several combination patterns of the virulence genes were detected in diarrheic and UTI isolates. In conclusion, the prevalence of virulence genes in diarrheic and UTI isolates differ according to phylogenetic groups, although B2 and D phylotypes have an accumulation of virulence associated genes

Antibiotic resistance profile and virulence genes of uropathogenic Escherichia coli isolates in relation to phylogeny

Escherichia coli (E. coli) strains are the major cause of urinary tract infections (UTI) and belong to the large group of extra-intestinal pathogenic E. coli. The purposes of this study were to determine the antibiotic resistance profile, virulence genes and phylogenetic background of E. coli isolates from UTI cases. A total of 137 E. coli isolates were obtained from UTI samples. The antimicrobial susceptibility of confirmed isolates was determined by disk diffusion method against eight antibiotics. The isolates were examined to determine the presence and prevalence of selected virulence genes including iucD, sfa/focDE, papEF and hly. ECOR phylo-groups of isolates were determined by detection of yjaA and chuA genes and fragment TspE4.C2. The antibiogram results showed that 71% of the isolates were resistant to cefazolin, 60.42% to co-trimoxazole, 54.16% to nalidixic acid, 36.45% to gentamicin, 29.18% to ciprofloxacin, 14.58% to cefepime, 6.25% to nitrofurantoin and 0.00% to imipenem. Twentytwo antibiotic resistance patterns were observed among the isolates. Virulence genotyping of isolates revealed that 58.39% isolates had at least one of the four virulence genes. The iucD gene was the most prevalent gene (43.06%). The other genes including sfa/focDE, papEF and hly genes were detected in 35.76%, 18.97% and 2.18% isolates, respectively. Nine combination patterns of the virulence genes were detected in isolates. Phylotyping of 137 isolates revealed that the isolates fell into A (45.99%), B1 (13.14%), B2 (19.71%) and D (21.16%) groups. Phylotyping of multidrug resistant isolates indicated that these isolates are mostly in A (60.34%) and D (20.38%) groups. In conclusion, the isolates that possessed the iucD, sfa/focDE, papEF and hly virulence genes mostly belonged to A and B2 groups, whereas antibiotic resistant isolates were in groups A and D. Escherichia coli strains carrying virulence factors and antibiotic resistance are distributed in specific phylogenetic background

Assessment of renal damage in patients with multi-drug resistant strains of pneumonia treated with colistin

Background: Treatment of multi-drug-resistant strains of pneumonia with common antibiotics in renal patients is ine ective and physicians are compelled to use Colistin for such cases. Objectives: This study was conducted to assess the mortality, length of stay, and renal damages in the treatment of multi-drug-resistant pneumonia with Colistin among multiple trauma patients admitted to the emergency department and transferred to the ICU. Methods: This retrospective cohort study was conducted between 2011 and 2016. 102 multiple trauma (MT) patients with multidrug-resistant strains of hospital-acquired pneumonia (HAP) admitted to the emergency department then transferred to the ICU were assessed. All patients received Colistin according to their weight. Renal damage was evaluated according to the RIFLE criteria. The mortality and the length of stay were assessed. In order to statistically analyze the data, SPSS version 23 software was used to conduct t-test and chi-square test. Results: Out of 102 patients, 55 (54) died and 50 (49.1) developed acute renal failure; 64 cases had no hypertension. Patients according to the RIFLE index were assessed: Risk (11.01), Injury (14), Failure (18), Loss (6), and End-stage renal disease. The prevalence and prognosis of acute kidney injury in multiple trauma patients treated with Colistin were significantly correlated with drug dosage, body mass index, and use of corticosteroids (when assessed using relevant scoring systems, P < 0.05). Conclusions: The use of a scoring system in the intensive care unit, determining those patients requiring Colistin, and adjusting the dosage of this drug for treatment of MT patients with multi-drug resistant strains of HAP are vital. Creatinine levels must be carefully monitored. © 2018, Trauma Monthly

Molecular Evidences of Ehrlichiosis as an Emerging Zoonotic Disease in Kerman City

Abstract: Background and Aims: Ehrlichiosis is an emerging tick-borne zoonotic disease caused by the gram-negative coccid obligate intracellular bacteria of the family Anaplasmataceae. Since the only available evidence in regard to monocytic Ehrlichiosis in Iran is related to dogs, the present study was designed to use the polymerase chain reaction assay for confirming the presence of Ehrlichia spp. in tick infested client-owned dogs in Kerman. Methods: Blood samples were prepared randomly from 100 owned tick infested dogs regardless of clinical status. Complete blood count was done for each sample and in the next step, DNA extraction was done and PCR was carried out by a commercial kit. Results: Six of 100 (6%) examined dogs were positive for Ehrlichia spp. based on PCR. Conclusion: Results of the present study confirmed the presence of Ehrlichiosis as an emerging zoonotic disease in Iran and dogs could be considered as a main reservoir for the disease. It is recommended to determine the prevalence of Ehrlichiosis and the most prevalent Ehrlichia species in animal reservoirs, vectors, and human population in different geographical regions of Iran in further epidemiological studies. Keywords: Ehrlichiosis, Dogs, Polymerase chain Reaction, Tick-borne disease

High Frequency of Diarrheagenic Escherichia coli in HIV-Infected Patients and Patients with Thalassemia in Kerman, Iran

This study was conducted on patients with thalassemia and HIV-infected patients to determine the frequency of diarrheagenic Escherichia coli in Kerman, Iran. We analyzed 68 and 49 E coli isolates isolated from healthy fecal samples of patients with thalassemia and HIV-infected patients, respectively. The E coli isolates were studied using a multiplex polymerase chain reaction to identify the enterotoxigenic E coli (ETEC), enterohemorrhagic E coli (EHEC), and enteropathogenic E coli (EPEC) groups. Statistical analysis was carried out to determine the correlation of diarrheagenic E coli between HIV-infected patients and patients with thalassemia using Stata 11.2 software. The frequency of having at least 1 diarrheagenic E coli was more common in patients with thalassemia (67.64%) than in HIV-infected patients (57.14%; P = .25), including ETEC (67.64% versus 57.14%), EHEC (33.82% versus 26.53%), and EPEC (19.11% versus 16.32%). The results of this study indicate that ETEC, EHEC, and EPEC pathotypes are widespread among diarrheagenic E coli isolates in patients with thalassemia and HIV-infected patient

Antimicrobial resistance patterns and phylogenetic analysis of shiga toxin-producing escherichia coli strains from goats using both clermont phylogenetic schemes

Foodborne transmission of Shiga toxin-producing Escherichia coli (STEC) poses a threat to public health. The Clermont typing schemes (previous and revised) have been used widely to phylotype E. coli. The present study was conducted to compare the relationship of the Clermont phylogenetic schemes in STEC strains isolated from goats and antibiotic resistance patterns in the southeast of Iran. Overall 52 strains carrying the stx gene were used for subsequent analysis. All strains were deter-mined by analysing the genomic DNA with a PCR-based method using the two Clermont et al. (2000, 2013) schemes. Extended spectrum beta-lactamase (ESBL) producing strains were confirmed by the double disk-diffusion method. STEC strains were also tested for susceptibility to 20 antimicrobials agents. In the original Clermont method, the prevalent phylogroups were B1 (69.2) and A (28.8). The significant phylogenetic groups of strains according to the revised Clermont method were B1 (82.7), A (13.5) and unknown (3.8). However, STEC strains underwent changes as noted from A to B1 (17.3), B1 to unknown (3.8), B1 to A (1.9) and D to B1 (1.9) groupings. Of the 52 stx-positive strains, two ESBL producing strains were detected. Susceptibility data showed that the most frequent resistance phenotype was related to cefazolin (90.4), streptomycin (88.5), ampicillin (86.5) and oxytetracycline (82.7) respectively. Although the overall frequency of the reassigned phylotypes was not significant, most changes occurred within the A phylotype. Therefore, implementation of the new method on isolates belonging to the A phylotype in the old method seems to be necessary to obtain accurate results. © 2021, Trakia University. All rights reserved