Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
권호 표지
DOI QR코드

DOI QR Code

Antimicrobial Resistance Patterns and Integron Carriage of Escherichia coli Isolates Causing Community-Acquired Infections in Turkey

  • Copur-Cicek, Aysegul (Department of Medical Microbiology, Faculty of Medicine, Recep Tayyip Erdogan University) ;
  • Ozgumus, Osman Birol (Department of Medical Microbiology, Faculty of Medicine, Recep Tayyip Erdogan University) ;
  • Saral, Aysegul (Department of Biology, Faculty of Arts & Sciences, Artvin Coruh University) ;
  • Sandalli, Cemal (Department of Biology, Faculty of Arts & Sciences, Recep Tayyip Erdogan University)
  • Received : 2013.08.07
  • Accepted : 2013.11.20
  • Published : 2014.03.02
⟨ Previous Next ⟩

Abstract

We aimed to observe antimicrobial resistance patterns and integron carriage of Escherichia coli isolates causing community-acquired infections. Two hundred sixty-eight E. coli strains were obtained from outpatients with various infections at different polyclinics at the 82nd Year of State Hospital in Rize, Turkey. Susceptibility to antimicrobials was tested using a disk diffusion method. The presence of integrons was examined using PCR with specific primers. Positive PCR results were confirmed by sequencing. A broth mating method was used for conjugation assays. Extragenic palindromic-PCR was performed using the oligonucleotide primer BOXA1R. Resistance frequency for ampicillin, trimethoprim/sulfamethoxazole, and tetracycline was determined as 50.6%, 33.5%, and 36.8% respectively. No strains were resistant to amikacin. Seventy isolates were positive for the intI1 gene, of which 49 carried gene cassettes. Eleven isolates were positive for the intI2 gene, eight of which carried gene cassettes. Seven gene cassettes (dfrA1, dfrA5, dfrA7, dfrA17, aadA1, aadA5, and sat2) were predominantly harbored in integrons. We detected conjugative plasmids harboring integrons in two E. coli strains. Four strain clusters were yielded by BOX-PCR fingerprints showing that they were clonally related. No apparent relationship occurred among class 1 and 2 integron-carrying strains. We conclude that integrons are widespread in genetically variable E. coli strains and will continue to mediate dissemination of resistance genes in the community.

Keywords

References

  1. Jones RN, Kugler KC, Pfaller MA, Winokur PL. Characteristics of pathogens causing urinary tract infections in hospitals in North America: results from the SENTRY Antimicrobial Surveillance Program, 1997. Diagn Microbiol Infect Dis 1999;35:55-63. https://doi.org/10.1016/S0732-8893(98)00158-8
  2. Rice LB. The clinical consequences of antimicrobial resistance. Curr Opin Microbiol 2009;12:476-81. https://doi.org/10.1016/j.mib.2009.08.001
  3. Cocchi S, Grasselli E, Gutacker M, Benagli C, Convert M, Piffaretti JC. Distribution and characterization of integrons in Escherichia coli strains of animal and human origin. FEMS Immunol Med Microbiol 2007;50: 126-32. https://doi.org/10.1111/j.1574-695X.2007.00242.x
  4. Sandalli C, Buruk CK, Sancaktar M, Ozgumus OB. Prevalence of integrons and a new dfrA17 variant in Gram-negative bacilli that cause community-acquired infections. Microbiol Immun 2010;54:164-9. https://doi.org/10.1111/j.1348-0421.2010.00197.x
  5. National Committee for Clinical Laboratory Standards. Performance standards for antimicrobial susceptibility testing. Tenth Informational supplement, M100-S10 (M2). Wayne, PA: National Committee for Clinical Laboratory Standards, 2000.
  6. Lévesque C, Piché L, Larose C, Roy PH. PCR Mapping of integrons reveals several novel combinations of resistance genes. Antimicrob Agents Chemother 1995;39:185-91. https://doi.org/10.1128/AAC.39.1.185
  7. White PA, McIver CJ, Rawlinson WD. Integrons and gene cassettes in the enterobacteriaceae. Antimicrob Agents Chemother 2001;45:2658-61. https://doi.org/10.1128/AAC.45.9.2658-2661.2001
  8. http://www.ncbi.nlm.nih.gov/BLAST.
  9. Rice LB, Willey SH, Papanicolaou GA, Medeiros AA, Eliopoulos GM, Moellering RC Jr, et al. Outbreak of ceftazidime resistance caused by extended-spectrum ${\beta}$-lactamases at a Massachusetts chronic-care facility. Antimicrob Agents Chemother 1990;34:2193-9. https://doi.org/10.1128/AAC.34.11.2193
  10. Versalovic J, Schneider M, de Bruijn FJ, Lupski JR. Genomic fingerprinting of bacteria using repetitive sequence-based polymerase chain reaction. Methods Mol Cell Biol 1994;5:25-40.
  11. Seurinck S, Verstraete W, Siciliano SD. Use of 16S-23S rRNA intergenic spacer region PCR and repetitive extragenic palindromic PCR analyses of Escherichia coli isolates to identify nonpoint fecal sources. Appl Environ Microbiol 2003;69:4942-50. https://doi.org/10.1128/AEM.69.8.4942-4950.2003
  12. El-Najjar NG, Farah MJ, Hashwa FA, Tokajian ST. Antibiotic resistance patterns and sequencing of class I integron from uropathogenic Escherichia coli in Lebanon. Lett Appl Microbiol 2010;51:456-61. https://doi.org/10.1111/j.1472-765X.2010.02926.x
  13. Sawma-Aouad G, Hashwa F, Tokajian S. Antimicrobial resistance in relation to virulence determinants and phylogenetic background among uropathogenic Escherichia coli in Lebanon. J Chemother 2009;21:153-8. https://doi.org/10.1179/joc.2009.21.2.153
  14. Ozgumus OB, Celik-Sevim E, Alpay-Karaoglu S, Sandalli C, Sevim A. Molecular characterization of antibiotic resistant Escherichia coli strains isolated from tap and spring waters in a coastal region in Turkey. J Microbiol 2007;45:379-87.
  15. Ozgumus OB, Sandalli C, Sevim A, Celik-Sevim E, Sivri N. Class 1 and class 2 integrons and plasmid-mediated antibiotic resistance in coliforms isolated from ten rivers in northern Turkey. J Microbiol 2009;47: 19-27. https://doi.org/10.1007/s12275-008-0206-z
  16. Solberg OD, Ajiboye RM, Riley LW. Origin of class 1 and 2 integrons and gene cassettes in a population-based sample of uropathogenic Escherichia coli. J Clin Microbiol 2006;44:1347-51. https://doi.org/10.1128/JCM.44.4.1347-1351.2006
  17. Jones LA, McIver CJ, Rawlinson WD, White PA. Polymerase chain reaction screening for integrons can be used to complement resistance surveillance programs. Commun Dis Intell Q Rep 2003;27(S):S103-10.
  18. Leverstein-van Hall MA, Box AT, Blok HE, Paauw A, Fluit AC, Verhoef J. Evidence of extensive interspecies transfer of integron-mediated antimicrobial resistance genes among multidrug-resistant Enterobacteriaceae in a clinical setting. J Infect Dis 2002;186:49-56. https://doi.org/10.1086/341078

Cited by

  1. Automatisation en bactériologie vol.16, pp.3, 2014, https://doi.org/10.1016/j.antinf.2014.08.001
  2. Emerging Technologies for the Clinical Microbiology Laboratory vol.27, pp.4, 2014, https://doi.org/10.1128/cmr.00003-14
  3. Clinical Microbiology Informatics vol.27, pp.4, 2014, https://doi.org/10.1128/cmr.00049-14
  4. Liquid chromatography tandem mass spectrometry in the clinical laboratory vol.52, pp.1, 2014, https://doi.org/10.1177/0004563214557678
  5. A review of the current state of digital plate reading of cultures in clinical microbiology vol.6, pp.None, 2015, https://doi.org/10.4103/2153-3539.157789
  6. MALDI-TOF MS for the Diagnosis of Infectious Diseases vol.61, pp.1, 2014, https://doi.org/10.1373/clinchem.2014.221770
  7. Evaluation of the Impact of Automated Specimen Inoculation, Using Previ Isola, on the Quality of and Technical Time for Stool Cultures vol.35, pp.1, 2014, https://doi.org/10.3343/alm.2015.35.1.82
  8. PetriJet Platform Technology : An Automated Platform for Culture Dish Handling and Monitoring of the Contents vol.20, pp.4, 2014, https://doi.org/10.1177/2211068215576191
  9. Progress in proteomics for clinical microbiology: MALDI-TOF MS for microbial species identification and more vol.12, pp.6, 2014, https://doi.org/10.1586/14789450.2015.1091731
  10. Bacterial culture detection and identification in blood agar plates with an optoelectronic nose vol.141, pp.3, 2014, https://doi.org/10.1039/c5an01990g
  11. Does bacteriology laboratory automation reduce time to results and increase quality management? vol.22, pp.3, 2016, https://doi.org/10.1016/j.cmi.2015.10.037
  12. Performance of Copan WASP for Routine Urine Microbiology vol.54, pp.3, 2014, https://doi.org/10.1128/jcm.02577-15
  13. Integration of Diagnostic Microbiology in a Model of Total Laboratory Automation vol.47, pp.1, 2014, https://doi.org/10.1093/labmed/lmv007
  14. Automated High-Throughput Identification and Characterization of Clinically Important Bacteria and Fungi using Rapid Evaporative Ionization Mass Spectrometry vol.88, pp.19, 2016, https://doi.org/10.1021/acs.analchem.6b01016
  15. Proteomics progresses in microbial physiology and clinical antimicrobial therapy vol.36, pp.3, 2014, https://doi.org/10.1007/s10096-016-2816-4
  16. Towards automated detection, semi-quantification and identification of microbial growth in clinical bacteriology: A proof of concept vol.40, pp.6, 2014, https://doi.org/10.1016/j.bj.2017.09.001
  17. Multicenter Evaluation of an Image Analysis Device (APAS): Comparison Between Digital Image and Traditional Plate Reading Using Urine Cultures vol.37, pp.6, 2017, https://doi.org/10.3343/alm.2017.37.6.499
  18. Effect of Electrode Geometry on the Classification Performance of Rapid Evaporative Ionization Mass Spectrometric (REIMS) Bacterial Identification vol.29, pp.1, 2018, https://doi.org/10.1007/s13361-017-1818-5
  19. Total Laboratory Automation and Matrix-Assisted Laser Desorption Ionization–Time of Flight Mass Spectrometry Improve Turnaround Times in the Clinical Microbiology Laboratory: a Retrospective An vol.56, pp.1, 2014, https://doi.org/10.1128/jcm.01242-17
  20. Experimental fusion of different versions of the total laboratory automation system and improvement of laboratory turnaround time vol.32, pp.5, 2014, https://doi.org/10.1002/jcla.22400
  21. Significant increase in cultivation of Gardnerella vaginalis , Alloscardovia omnicolens , Actinotignum schaalii , and Actinomyces spp . in urine samples with total laboratory automation vol.37, pp.7, 2018, https://doi.org/10.1007/s10096-018-3250-6
  22. Laboratory automation reduces time to report of positive blood cultures and improves management of patients with bloodstream infection vol.37, pp.12, 2014, https://doi.org/10.1007/s10096-018-3377-5
  23. Automation and artificial intelligence in the clinical laboratory vol.56, pp.2, 2019, https://doi.org/10.1080/10408363.2018.1561640
  24. A Moldy Application of MALDI: MALDI-ToF Mass Spectrometry for Fungal Identification vol.5, pp.1, 2014, https://doi.org/10.3390/jof5010004
  25. Clinical Microbiology Is Growing Up: The Total Laboratory Automation Revolution vol.65, pp.5, 2014, https://doi.org/10.1373/clinchem.2017.274522
  26. Laboratory automation impact on antimicrobial resistance vol.40, pp.2, 2019, https://doi.org/10.1071/ma19019
  27. Culture of Rectal Swab Specimens for Enteric Bacterial Pathogens Decreases Time to Test Result While Preserving Assay Sensitivity Compared to Bulk Fecal Specimens vol.57, pp.6, 2014, https://doi.org/10.1128/jcm.02077-18
  28. Using artificial intelligence to reduce diagnostic workload without compromising detection of urinary tract infections vol.19, pp.1, 2014, https://doi.org/10.1186/s12911-019-0878-9
  29. Mini Review: Clinical Routine Microbiology in the Era of Automation and Digital Health vol.10, pp.None, 2014, https://doi.org/10.3389/fcimb.2020.582028
  30. Machine Learning Takes Laboratory Automation to the Next Level vol.58, pp.4, 2014, https://doi.org/10.1128/jcm.00012-20
  31. Mass spectrometry and total laboratory automation: opportunities and drawbacks vol.58, pp.6, 2020, https://doi.org/10.1515/cclm-2019-0723
  32. Total Laboratory Automation and Three Shifts Reduce Turnaround Time of Cerebrospinal Fluid Culture Results in the Chinese Clinical Microbiology Laboratory vol.11, pp.None, 2014, https://doi.org/10.3389/fcimb.2021.765504
  33. Benefits Derived from Full Laboratory Automation in Microbiology: a Tale of Four Laboratories vol.59, pp.3, 2014, https://doi.org/10.1128/jcm.01969-20
  34. Scanning Electron Microscope: A New Potential Tool to Replace Gram Staining for Microbe Identification in Blood Cultures vol.9, pp.6, 2014, https://doi.org/10.3390/microorganisms9061170
  35. Effects of Automation on Sustainability of Immunohistochemistry Laboratory vol.9, pp.7, 2014, https://doi.org/10.3390/healthcare9070866