The emergence of plasmid-encoded oxacillinase and carbapenemase among uropathogenic Escherichia coli (UPEC) isolated from hospitalized patients in the North of Iran

Mahsa Sadeghi; Ali Mojtahedi; Iraj Nikokar; Zahra Atrkar Roushan

doi:10.1016/j.heliyon.2023.e15386

The emergence of plasmid-encoded oxacillinase and carbapenemase among uropathogenic Escherichia coli (UPEC) isolated from hospitalized patients in the North of Iran

Heliyon. 2023 Apr 10;9(4):e15386. doi: 10.1016/j.heliyon.2023.e15386. eCollection 2023 Apr.

Authors

Mahsa Sadeghi^{1

2}, Ali Mojtahedi², Iraj Nikokar³, Zahra Atrkar Roushan⁴

Affiliations

¹ Burn and Regenerative Medicine Research Center, Guilan University of Medical Sciences, Rasht, Iran.
² Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
³ Medical Biotechnology Research Center, Faculty of Paramedicine, Guilan University of Medical Sciences, Rasht, Iran.
⁴ Department of Biostatistics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

Abstract

Carbapenemase enzyme production is responsible for resistance to carbapenem among Gram-negative bacteria. This study aimed to detect common carbapenemase and oxacilinase genes among uropathogenic E. coli (UPEC) isolated from hospitalized patients in Rasht, north of Iran. In the present study, from 2000 urine samples, 263 UPEC strains were isolated from inpatients with urinary tract infections (UTI) in 2020. The Kirby-Bauer disk diffusion susceptibility test was used to determine the sensitivity or resistance of isolates to antimicrobial compounds. The double-disk test confirmed extended-spectrum β lactamase (ESBL) production phenotypically, and the presence and distribution of genes encoding carbapenemase and oxacilinase were investigated using polymerase chain reaction (PCR). Based on the findings, 13/263 isolates (8 ESBL and five non-ESBL) showed a non-susceptible phenotype to at least one of the studied carbapenem group antibiotics, and 121 (46%) isolates were ESBL-producers. PCR for oxacilinase and carbapenemase genes was done on all 126 isolates, including ESBL-positive and carbapenem-resistant strains, in which 10 (7.9%) and 25 (19.8%) isolates harbored OXA-1 and IMP genes, respectively. Also, OXA-2, OXA-10, OXA-48, VIM, and NDM genes were not found in any studied isolates. IMP and OXA-1 genes among carbapenemase-producing isolates indicate the possible spread of antibiotic-resistant strains. Hence, identification and control of ESBL and carbapenemase-producing strains, although with almost low frequency due to plasmid genes encoding carbapenemase, is essential for infection control.

Keywords: Carbapenemase; E. coli; Oxacillinase; Urinary tract infection.