Evaluation of the presence of integrons, sul and smqnr genes and the prevalence of antibiotic resistance in Stenotrophomonas maltophilia clinical isolates

Maryam Mokhtari Bibalan; Ali Mojtahedi; Nejat Mahdieh; Alireza Jafari; Zahra Atrkar Roushan; Mohammad Javad Arya

doi:10.1016/j.ijmmb.2024.100612

Evaluation of the presence of integrons, sul and smqnr genes and the prevalence of antibiotic resistance in Stenotrophomonas maltophilia clinical isolates

Indian J Med Microbiol. 2024 May 16:49:100612. doi: 10.1016/j.ijmmb.2024.100612. Online ahead of print.

Authors

Maryam Mokhtari Bibalan¹, Ali Mojtahedi², Nejat Mahdieh³, Alireza Jafari⁴, Zahra Atrkar Roushan⁵, Mohammad Javad Arya⁶

Affiliations

¹ Department of Microbiology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: maryam.mokhtari.b@gmail.com.
² Department of Microbiology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Electronic address: mojtahedi.a@iums.ac.ir.
³ Cardiogenetic Research Center, Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Electronic address: nmahdieh@gmail.com.
⁴ Urology Research Center, Razi Hospital, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: DR.ALIREZA.JAFARIII@gmail.com.
⁵ Department of Biostatistics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran. Electronic address: atrkar.roushan@gmail.com.
⁶ Fellowship of dermatopathology, Sina Pathobiology Lab, Yazd, Iran. Electronic address: Javad.Arya@gmail.com.

PMID: 38750966
DOI: 10.1016/j.ijmmb.2024.100612

Abstract

Objectives: The objective of this investigation was to examine the mechanisms associated with antibiotic resistance in Stenotrophomonas maltophilia clinical isolates retrieved from hospitalized patients undergoing open heart surgery in a Heart Center located in Tehran, Iran.

Materials and methods: This investigation encompassed a cross-sectional study of 60 S. maltophilia isolates, which were procured from diverse clinical specimens. Primary identification of the isolates was conducted through conventional microbiologic methods and subsequently verified by means of PCR primers. The E-test was utilized to establish the minimum inhibitory concentrations (MICs). PCR was then employed to ascertain the antibiotic resistance genes (sul1, sul2, Smqnr and intl1 - intl3).

Results: In this study, a total of sixty clinical isolates of S. maltophilia were collected, with the majority of them being obtained from Intensive Care Units (ICU) (n = 54; 90%). The disk diffusion method yielded results indicating that 55% of the isolates were sensitive to minocycline, whereas 30% were intermediate and 15% were found to be resistant. Additionally, the MIC results revealed that the resistant rates of the isolates towards ceftazidime, cotrimoxazole and levofloxacin were 46.7%, 1.7% and 5%, respectively. The PCR amplification of three classes of integrons genes indicated that fifteen (25%) of the isolates carried int1, while no detection for intl2 and intl3 was reported. Furthermore, the prevalence of antibiotic resistance genes (sul1, sul2, and Smqnr) was identified in 15 (25%), 6 (10%), and 28 (46.7%) isolates, respectively.

Conclusion: The reported increasing rate of antibiotic resistance and mobile genetic elements that could extend the resistance genes to other strains in the hospital, finally it could be an alarming issue for healthcare settings that need special attention to this strain and the epidemiological study on this issue.

Keywords: Clinical samples; Smqnr; Stenotrophomonas maltophilia; sul1; sul2.