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Genetic diversity and antibiotic susceptibility of uropathogenic Escherichia coli isolates from kidney transplant recipients

Authors Mohammadzadeh M, Tavakoli M, Yaslianifard S, Asadi E, Golmohammadi R, Mirnejad R

Received 9 January 2019

Accepted for publication 29 May 2019

Published 9 July 2019 Volume 2019:12 Pages 1795—1803

DOI https://doi.org/10.2147/IDR.S200811

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 2

Editor who approved publication: Professor Suresh Antony


Mohammad Mohammadzadeh,1 Mahnaz Tavakoli,2 Somayeh Yaslianifard,3 Ehsan Asadi,4 Reza Golmohammadi,1 Reza Mirnejad1

1Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; 2Department of Medical Microbiology, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Dietary Supplements and Probiotic Research Center, Alborz University of Medical Sciences, Alborz, Iran; 4Department of Microbiology, Faculty of Medical Sciences, Shahed University, Tehran, Iran

Purpose: Uropathogenic Escherichia coli (UPEC) strains are a common cause of transplant rejection, morbidity, and mortality among kidney transplant recipients. The virulence of UPEC strains differs based on their pathogenicity islands (PAIs) and susceptibility to antibiotics. The present study evaluates the clonal relationship and antibiotic susceptibility of UPEC PAI-genotypes among Escherichia coli (E. coli) isolates from kidney transplant patients.
Patients and methods: A total of 115 Escherichia coli (E. coli) isolates were collected from kidney transplant recipients with acute urinary tract infections (UTIs). Isolates were typed based on the presence of PAI-markers, and random amplified polymorphic DNA (RAPD). The disk diffusion method was performed for the antibiotic susceptibility pattern of isolates.
Results: According to the PAI-specific virulence markers, 69 (60%), 21 (18.3%), and 25 (21.7%) isolates were identified as genotypes related to UPEC 536, UPEC J96, and UPEC CFT073 strains, respectively. PAI III536 genotypes were the most prevalent genotype in this study. The findings showed a high-sensitivity to imipenem (93.9%) and nitrofurantoin (91.3%) and a low-sensitivity to trimethoprim/sulfamethoxazole (36.5%). Clonal association and similar antibiotic susceptibility pattern were seen in the PAI-related genotypes.
Conclusion: Due to a similar pattern of antibiotic susceptibility of these clonal groups and increased resistance to some important antibiotics such as trimethoprim/sulfamethoxazole in the treatment of urinary tract infections, especially in kidney transplant patients, the spread of these clones should be considered as a serious concern.

Keywords: uropathogenic Escherichia coli, kidney transplantation, pathogenicity islands, random amplified polymorphic DNA

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