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Prevalence of the fluoroquinolone resistance genes in the Escherichia coli sequence type 131 clone isolated from hospitalized patients with urinary tract infection
Mehdi Bozorgi Mazandarani1 , Mohammad Kargar2 , Farshid Kafilzadeh1
1- Department of Microbiology, Jahrom Branch, Islamic Azad University, Jahrom, Iran
2- Department of Microbiology, Zand Institute of Higher Education, Shiraz, Iran , microkargar@gmail.com
Abstract:   (1352 Views)
Background: The emergence of fluoroquinolones (FQ) resistance in the Escherichia coli (E. coli) sequence type 131 (ST131) has become a major challenge in the management of urinary tract infections (UTI). Chromosomal mutations and plasmid-mediated quinolone resistance (PMQR) determinants play an important role in the FQ resistance.
Methods: This cross-sectional study was conducted in 2020 on 300 urine samples. aimed to investigate the prevalence of the chromosomal mutations, the PMQR genes including qnr, aac (6′)-Ib-cr, and efflux pumps among the FQ-resistant ST131 and non-ST131 E. coli causing UTI.  Initially, the ST131 clone was detected using allele-specific PCR and confirmed by multilocus sequence typing.
Results:  Among 95 FQ-resistant E. coli isolates, 30%  (n=29/95) as belonging to the ST131 clone. The most frequently detected PMQR genes in FQ-resistant isolates were aac(6)’-lb-cr and qnrS. However, statistical analysis revealed a stronger association between aac(6ʹ)-Ib-cr and the ST131 clone (62%; p<0.03). The oqxA gene was the most prevalent efflux pump gene observed in both ST131 (n=11; 38%) and non-ST131 (n=16; 24%) isolates. Analysis of the gyrA and parC genes revealed significantly higher in ST131 compared to non-ST131. Double mutations, S80I+E84V, were significantly more prevalent in both gyrA (76% ST131 vs. 43% non-ST131; p=0.004) and parC (55% ST131 vs. 26% non-ST131; p=0.002). High-level resistance (MIC ≥32 μg/mL) observed in 96.6% (n=28/29) of ST131 isolates compared to 65% (n=43/66) of non-ST131 isolates.
Conclusion: The double mutations confer high level resistance to FQs in ST131 clone. These findings on resistance mechanisms can guide infection control strategies.
Keywords: mutation, plasmid, drug resistance, quinolones, fluoroquinolones
Full-Text [PDF 415 kb]   (368 Downloads)    
Research Article: Original Paper | Subject: bacteriology
Received: 2024/11/1 | Accepted: 2025/03/15
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