Observational Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Biol Chem. Nov 27, 2020; 11(3): 112-118
Published online Nov 27, 2020. doi: 10.4331/wjbc.v11.i3.112
Prevalence, serotyping and drug susceptibility patterns of Escherichia coli isolates from kidney transplanted patients with urinary tract infections
Atefeh Najafi Khah, Mojdeh Hakemi-Vala, Shiva Samavat, Mohammad Javad Nasiri
Atefeh Najafi Khah, Mojdeh Hakemi-Vala, Mohammad Javad Nasiri, Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran 1985717443, Iran
Shiva Samavat, Department of Adult Nephrology, School of Medicine, Shahid Labbafinezhad Hospital, Shahid Beheshti University of Medical Sciences, Tehran 1666694516, Iran
Author contributions: Hakemi-Vala M proposed the subject of the project, supervised the proposal, practical steps, revised the draft, and submitted the article to this journal; Samavat S, as the urologist in Labafi Nejad Hospital, introduced the patients who were compatible with this subject; Najafi Khah A is an MSc student in medical microbiology and this paper is part of her thesis, she also carried out all practical processes such as sampling, cooperated with two private clinical laboratories and drafted the paper; Nasiri MJ, a consultant, contributed to statistical analysis, paper preparation, and revision, data collection and analysis.
Supported by Research Department of School of Medicine Shahid Beheshti University of Medical Sciences, No. 17920, and accepted by the ethic committee, Code. IR.SBMU. MSP.REC.1398.349.
Institutional review board statement: This paper is extracted from a project which was accepted by the research committee.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: This project has received a grant from the Research Department of School of Medicine Shahid Beheshti University of Medical Sciences, No. 17920, Tehran, Iran.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mojdeh Hakemi-Vala, PhD, Associate Professor, Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Kodakyar St, Daneshjo Blvd, Velenjak Tehran, Tehran 1985717443, Iran. m.hakemi@sbmu.ac.ir
Received: April 26, 2020
Peer-review started: April 26, 2020
First decision: June 7, 2020
Revised: August 24, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: November 27, 2020
ARTICLE HIGHLIGHTS
Research background

Escherichia coli (E. coli) isolates are the main pathogens in urinary tract infections (UTIs). Their effect is more important in kidney transplant patients (KTPs). Based on several studies and documents, the frequency of E. coli resistant to common drugs is increasing. Their resistance to antimicrobial drugs is mediated by different mechanisms such as producing extended-spectrum beta-lactamase (ESBLs). Therefore, UTIs caused by ESBL-producing E. coli in KTPs is an important challenge in healthcare settings.

Research motivation

However, different studies have reported the frequency of ESBLs E. coli isolates from different origins in Iran, but there are few studies on their frequency and role in KTPs and their antimicrobial susceptibility profile.

Research objectives

The aims of this study were: (1) To estimate the prevalence of ESBL-producing E. coli in KTPs; (2) To serotype the ESBL-producing E. coli; and (3) To identify the antibacterial susceptibility patterns of isolated bacteria in Tehran, Iran.

Research methods

Bacterial culture and isolation based on standard bacteriologic methods were carried out. Antimicrobial susceptibility testing based on the Clinical Laboratory and Standards Institute was performed. The minimum inhibitory concentration was determined using Epsilon strips during the E-test. The frequency of genes responsible for ESBLs coding was assessed after DNA extraction and polymerase chain reaction. Statistical analysis of the data was performed.

Research results

The most important findings were: (1) The frequency of ESBL-producing E. coli in KTPs was found to be 33.4%; (2) High resistance rates to ampicillin (86%) and cefotaxime (80%) were documented; (3) The most frequent serotype was serotype I (50%); (4) The most frequently found related gene was blaTEM (55%); and (5) All of the E. coli isolates were susceptible to doripenem and ertapenem.

Research conclusions

Further efforts to control ESBL-producing E. coli isolates should include the careful use of all antibiotics as well as barrier precautions to reduce their spread.

Research perspectives

More E. coli isolates from different parts of Iran should be obtained and their antimicrobial profiles evaluated. Also, the frequency of ESBLs production and the existence of other ESBLs genes such as KPC and metalo-betalactamases should be determined.