High Frequency of Class 2 and 3 Integrons Related to Drug-Resistance in Clinical Isolates of Diarrheagenic E. coli in Iran
Background: Integrons are mobile genetic elements able to obtain the antibiotic resistance gene cassettes. The prevalence of integrons in the Enterobacteriaceae family has been varied and played an important role in the development of the drug resistant bacteria. The present study aimed to investigate the contribution of class 2 and 3 integrons in drug resistant Diarrheagenic Escherichia coli strains.
Materials and Methods: The 164 Diarrheagenic E. coli collected from feces samples of children in the Yasuj –Iran and all isolates were identified by standard biochemical tests. The antimicrobial susceptibility for 14 antibiotics, which are used conventionally was determined by disk diffusion. The presence of class 2 and 3 integrons in all isolates was investigated by PCR.
Results: Of 164 E. coli isolates from children, 80.49% carried class 2 integron and the length of the amplicons ranged from 800 bp to 2 kb. Class 3 integrons were identified among 24 E. coli isolates. All the E.coli isolates were susceptible to imipenem and the greatest resistance was correspondent to nalidixic acid. A significant correlation was revealed between Class 2 integron and resistance to kanamycin, amikacin, gentamicin, ceftazidime, chloramphenicol and cephalexin. The presence of class 3 integron was significantly associated with resistance to ampicillin, gentamicin, streptomycin, kanamycin, tetracycline and trimetoprime-sulfametoxazol.
Conclusion: The results indicated that integrons are widespread in Diarrheagenic E. coli and its carriage contributed significantly to the emergence of resistance among Diarrheagenic E. coli. However, factors leading to the wide spread of integrons are still to be determined.
Bakhshi B, Fallahzad S, Pourshafie M.R. The occurrence of atypical enteropathogenic escherichia coli strains among children with diarrhea in iran. Journal of Infection and Chemotherapy 2013; 19 (4), 615-620.
Barlow R.S, Pemberton J.M, Desmarchelier P.M, Gobius K.S. Isolation and characterization of integron-containing bacteria without antibiotic selection. Antimicrobial agents and chemotherapy 2004; 48 (3), 838-842
Bass L, Liebert CA, Lee MD, Summers AO, White DG, Thayer SG, Maurer JJ. Incidence and characterization of integrons, genetic elements mediating multiple-drug resistance, in avian Escherichia coli. Antimicrob Agents Chemother 1999; Dec;43(12):2925e9.
Dawes F.E. Antibiotic resistance genes located in integrons isolated from escherichia coli recovered from humans and animals. 2009
Dawes F.E, Kuzevski A, Bettelheim K.A, Hornitzky M.A, Djordjevic S.P, Walker M.J. Distribution of class 1 integrons with is26-mediated deletions in their 3′-conserved segments in escherichia coli of human and animal origin. PloS one 2010; 5 (9), e12754
Eslami G, Seyedjavadi S.S, Goudarzi H, Fallah F, Goudarzi M. Distribution of integrons among multidrug resistant e. Coli and klebsiella strains. Pejouhesh 2010; 34 (1), 61-65
Farshad S, Japoni A, Hosseini M. low distribution of integrons among Multidrug resistant E. coli strains isolated from children with Community-Acquired urinary tract infections in shiraz, Iran, polish journal of microbiology, 2008; Vol. 57, No. 3, 193-198
Frisca F, Lay B.W, Waturangi D.E. Identification of class 1 integron of escherichia coli from street foods in jakarta. Microbiology Indonesia 2010; 1 (1)
Hansson K, Sundström L, Pelletier A, Roy P.H. Inti2 integron integrase in tn7. Journal of bacteriology 2002; 184 (6), 1712-1721
Heir E, Lindstedt B, Leegaard T, Gjernes E, Kapperud G. Prevalence and characterization of integrons in blood culture Enterobacteriaceae and gastrointestinal Escherichia coli in Norway and reporting of a novel class 1 integron-located lincosamide resistance gene, Annals of Clinical Microbiology and Antimicrobials, 2004; 3:12 doi:10.1186/1476-0711-3-12
Hernandes R.T, Elias W.P, Vieira M.A, Gomes T.A. An overview of atypical enteropathogenic escherichia coli. FEMS microbiology letters 2009; 297 (2), 137-149.
Ibrahim N, Wajidi M.F, Yusef M.Y, Tay S.T. The integron prevalence of extended-spectrum betalactamase producing enterobacterial isolates in a Malaysian teaching hospital, Tropical Biomedicine, 2011; 28(3): 668-671
Iyer A, Barbour E, Azhar E, El Salabi A.A, Hassan H.M.A, Qadri I. et al. Transposable elements in escherichia coli antimicrobial resistance. Advances in Bioscience and Biotechnology 2013; 4, 415.
Japoni A, Gudarzi M, Farshad S, Basiri E, Ziyaeyan M, Alborzi A, et al. Assay for integrons and pattern of antibiotic resistance in clinical escherichia coli strains by pcr-rflp in southern iran. Japanese journal of infectious diseases 2008; 61 (1), 85.
Kargar M, Homayoon M. Outbreaks of infection sources and antibiotic resistance in EHEC strains among children under 5 years old in Marvdasht. Medical Sciences Journal of Islamic Azad University Tehran Medical Branch. 2010;19:268-73 [In Persian]
Machado E, Canton R, Baquero F, Galan J, Rollan A, Peixe L, et al. Integron Content of Extended-Spectrum-β-Lactamase-Producing Escherichia coli Strains over 12 Years in a Single Hospital in Madrid, Spain, Antimicrobial agents and Chemotherapy, 2005; Vol. 49, No. 5, p. 1823-1829
Normark B.H, Normark S. Evolution and spread of antibiotic resistance. Journal of internal medicine, 2002; 252 (2), 91-106.
Nweze E.I, Virulence Properties of Diarrheagenic E. coli and Etiology of Diarrhea in Infants, Young Children and Other Age Groups in Southeast, Nigeria, American-Eurasian Journal of Scientific Research, 2009; 4 (3): 173-179
Phongpaichit S, Wuttananupan K, Samasanti W. Class 1 integrons and multidrug resistance among escherichia coli isolates from human stools. Southeast Asian J Trop Med Public Health. 2008 Mar;39(2):279-87
Poirel L, Carattoli A, Bernabeu S, Brudere T, Frei R, Nordmann P. A novel IncQ plasmid type harbouring a class 3 integron from Escherichia coli, Antimicrob Chemother 2010; 65: 1594–1598
Razaghi M, Alebouyeh M, Rajabi Bazl M, Zali M.R. Frequency of β-lactamase producing isolates of escherichia coli and their diversity in enzyme activities among the resistance isolates from patients with diarrhea and nosocomial infections in tehran, iran. Koomesh 2014. 15 (2), 197-205.
Rezaee M.A, Langarizadeh N, Aghazadeh M. First report of class 1 and class 2 integrons in multidrug-resistant klebsiella pneumoniae isolates from northwest iran. Jpn J. Infect. Dis 2012. 65, 256-259.
Rowe‐Magnus D.A, Guerout A.M, Mazel D. Bacterial resistance evolution by recruitment of super‐integron gene cassettes. Molecular microbiology 2002. 43 (6), 1657-1669.
Rowe-Magnus D.A, Guerout A.-M, Ploncard P, Dychinco B, Davies J, Mazel D. The evolutionary history of chromosomal super-integrons provides an ancestry for multiresistant integrons. Proceedings of the National Academy of Sciences 2001. 98 (2), 652-657.
Skurnik D, Menac’h A, Zurakowski D, Mazal D, Courvalin P, Denamur E, et al. Integron-Associated Antibiotic Resistance and Phylogenetic Grouping of Escherichia coli Isolates from Healthy Subjects Free of Recent Antibiotic Exposure, Antimicrobial agents and Chemotherapy. 2005, Vol. 49, No. 7, p. 3062-3065
Su J, Shi L, Yang L, Xiao Z, Li X, Yamasaki S. Analysis of integrons in clinical isolates of Escherichia coli in China during the last six years, FEMS Microbiol Lett 254, 2006, 75-80
Su H.C, Ying G.G, Tao R, Zhang R.Q, Zhao J.L, Liu Y.S. Class 1 and 2 integrons, sul resistance genes and antibiotic resistance in Escherichia coli isolated from dongjiang river, south china. Environmental Pollution 2012. 169, 42-49.
Vinue L, Saenz Y, Somalo S, Escudero E, Moreno MA, Ruiz-Larrea F, Torres C. Prevalence and diversity of integrons and associated resistance genes in faecal Escherichia coli isolates of healthy humans in Spain, Journal of Antimicrobial Chemotherapy 2008; 62, 934–937
White P.A, Mciver C.J, Rawlinson W.D. Integrons and gene cassettes in theenterobacteriaceae. Antimicrobial agents and chemotherapy 2001; 45 (9), 2658-2661.
Yu G. Role of integrons in antimicrobial resistance: A review, African Journal of Microbiology Research, 2013,Vol. 7(15), pp. 1301-1310
Yu H.S, Lee J.C, Kang H.Y, Ro D.W, Chung J.Y, Jeong Y.S, et al. Changes in gene cassettes of class 1 integrons among escherichia coli isolates from urine specimens collected in korea during the last two decades. Journal of clinical microbiology 2003; 41 (12), 5429-5433.