Ann Lab Med.  2014 Mar;34(2):139-144. 10.3343/alm.2014.34.2.139.

Antimicrobial Resistance Patterns and Integron Carriage of Escherichia coli Isolates Causing Community-Acquired Infections in Turkey

• Copur-Cicek A
• Ozgumus OB
• Saral A
• Sandalli C

• KMID: 1791907
• DOI: http://doi.org/10.3343/alm.2014.34.2.139

Abstract

We aimed to observe antimicrobial resistance patterns and integron carriage of Escherichia coli isolates causing community-acquired infections. Two hundred sixty-eight E. coli strains were obtained from outpatients with various infections at different polyclinics at the 82nd Year of State Hospital in Rize, Turkey. Susceptibility to antimicrobials was tested using a disk diffusion method. The presence of integrons was examined using PCR with specific primers. Positive PCR results were confirmed by sequencing. A broth mating method was used for conjugation assays. Extragenic palindromic-PCR was performed using the oligonucleotide primer BOXA1R. Resistance frequency for ampicillin, trimethoprim/sulfamethoxazole, and tetracycline was determined as 50.6%, 33.5%, and 36.8% respectively. No strains were resistant to amikacin. Seventy isolates were positive for the intI1 gene, of which 49 carried gene cassettes. Eleven isolates were positive for the intI2 gene, eight of which carried gene cassettes. Seven gene cassettes (dfrA1, dfrA5, dfrA7, dfrA17, aadA1, aadA5, and sat2) were predominantly harbored in integrons. We detected conjugative plasmids harboring integrons in two E. coli strains. Four strain clusters were yielded by BOX-PCR fingerprints showing that they were clonally related. No apparent relationship occurred among class 1 and 2 integron-carrying strains. We conclude that integrons are widespread in genetically variable E. coli strains and will continue to mediate dissemination of resistance genes in the community.

Keyword

Antimicrobial; Resistance; Integrons; Escherichia coli; Community-acquired infections

MeSH Terms

Anti-Bacterial Agents/*pharmacology
Community-Acquired Infections/*microbiology
Disk Diffusion Antimicrobial Tests
Drug Resistance, Bacterial
Escherichia coli/*drug effects/isolation & purification
Escherichia coli Proteins/*genetics
Humans
Integrases/genetics
Polymerase Chain Reaction
Turkey
Anti-Bacterial Agents
Escherichia coli Proteins
Integrases

Figure

• 

  Fig. 1 Total antimicrobial resistance frequencies of 268 clinical isolates of Escherichia coli.Abbreviations: AK, amikacin; AMP, ampicillin; ATM, aztreonam; CAZ, ceftazidime; CIP, ciprofloxacin; CN, gentamicin; CRO, ceftriaxone; CXM, cefuroxime; IPM, imipenem; NOR, norfloxacin; OFX, ofloxacin; S, streptomycin; SAM, ampicillin/sulbactam; SXT, trimethoprim/sulfamethoxazole; TE, tetracycline.

• 

  Fig. 2 Dendrogram analysis of E. coli strains harboring class 1 and 2 integrons using repetitive extragenic palindromic-PCR with the oligonucleotide primer BOXA1R. All strains clustered into four groups (A to D), as seen in Table 1. While 42 class 1 integron-carrying E. coli strains were collected in four different clusters, class 2 integron-carrying E. coli strains (13, 48, 172, 185, 283, 305, and 684) were collected only in the cluster A.

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