Infect Chemother.  2018 Mar;50(1):29-37. 10.3947/ic.2018.50.1.29.

Genotypic Diversity of Multidrug Resistant Shigella species from Iran

• Zamanlou S
• Rezaee MA
• Aghazadeh
• Ghotaslou
• Nave HH
• Khalili Y

• KMID: 2407965
• DOI: http://doi.org/10.3947/ic.2018.50.1.29

Abstract

BACKGROUND
In many developing countries, shigellosis is endemic and also occurs in epidemics and treatment of multidrug-resistant (MDR) isolates are important. The aims of this study were to determine the antimicrobial susceptibility, prevalence of class 1 and 2 integrons and the clonal relatedness of isolates.
MATERIALS AND METHODS
Antimicrobial susceptibility tests were performed by disc diffusion method. Polymerase chain reaction (PCR)-sequencing technique was employed for detection and characterization of integrons. The genetic relatedness was evaluated by using enterobacterial repetitive intergenic consensus (ERIC) PCR.
RESULTS
There was a high percentage of resistance to trimethoprim-sulfamethoxazole (TMP/SMX) (93.7%), ampicillin (AMP) (87.3%), streptomycin (STR) (84.5%) and tetracycline (TET) (78.9%). Multidrug resistant phenotype was seen in 95.1% of total isolates. Most common MDR profile was TMP/SMX/STR/AMP resistant pattern. Among the 142 Shigella spp. analyzed in this study, 28 isolates were positive for class 1 integron with two types of gene cassette arrays (dfrA17/aadA5 = 31.7% and dfrA7 = 3.8%). The class 2 integron was more frequently detected among the isolates (94.7%) with dfrA1/sat1/aadA1 (69.4%) and dfrA1/sat1 (30.6%) gene cassettes. ERIC-PCR results showed 6, 5, 4 and 3 main genotypes among S. flexneri, S. sonnei, S. boydii and S. dysenteriae isolates, respectively.
CONCLUSIONS
Our findings revealed that multidrug resistant Shigella species with high prevalence of class 2 integron were very common in Iran. In addition, ERIC-PCR patterns showed limited variety of clones are responsible for shigellosis in the region of the study.

Keyword

Shigella; Integron; Multidrug resistant; Enterobacterial repetitive intergenic consensus; Polymerase chain reaction

MeSH Terms

Ampicillin
Clone Cells
Consensus
Developing Countries
Diffusion
Dysentery, Bacillary
Genotype
Integrons
Iran*
Methods
Phenotype
Polymerase Chain Reaction
Prevalence
Shigella*
Streptomycin
Tetracycline
Trimethoprim, Sulfamethoxazole Drug Combination
Ampicillin
Streptomycin
Tetracycline
Trimethoprim, Sulfamethoxazole Drug Combination

Figure

• 

  Figure 1 Structures of class 1, 2 integrons variable regions found in this study.

• 

  Figure 2 Dendrogram based on ERIC-PCR of 73 Shigella flexneri in relation to the resistance profile and integron resistance gene content. ERIC, enterobacterial repetitive intergenic consensus; PCR, polymerase chain reaction; AMP, ampicillin; FOX, cefoxitin; CFZ, cefazolin; 3GC, 3-th generation of cephalosporins; FEP, cefepime; GEN, gentamicin; STR, streptomycin; NAL, nalidixic acid, OFX, ofloxacin; CIP; ciprofloxacin; LVX, levofloxacin; CHL, chloramphenicol; TMP/SMX, trimethoprim-sulfamethoxazole; TET, tetracycline; AZM, azithromycin; Int 1, integrase 1; Int 2, integrase 2.

• 

  Figure 3 Dendrogram based on ERIC-PCR of 47 Shigella sonnei in relation to the resistance profile and integron resistance gene content. ERIC, enterobacterial repetitive intergenic consensus; PCR, polymerase chain reaction; AMP, ampicillin; FOX, cefoxitin; CFZ, cefazolin; 3GC, 3rd generation of cephalosporins; FEP, cefepime; GEN, gentamicin; STR, streptomycin; NAL, nalidixic acid; OFX, ofloxacin; CIP, ciprofloxacin; LVX, levofloxacin; CHL, chloramphenicol; TMP/SMX, trimethoprim-sulfamethoxazole; TET, tetracycline; AZM, azithromycin; Int 1, integrase 1; Int 2, integrase 2.

• 

  Figure 4 Dendrogram based on ERIC-PCR of 16 Shigella boydii and 6 Shigella dysenteriae in relation to the resistance profile and integron resistance gene content. ERIC, enterobacterial repetitive intergenic consensus; PCR, polymerase chain reaction; AMP, ampicillin; FOX; cefoxitin; CFZ, cefazolin; 3GC, 3rd generation of cephalosporins; FEP, cefepime; GEN, gentamicin; STR, streptomycin; NAL, nalidixic acid; OFX, ofloxacin; CIP, ciprofloxacin; LVX, levofloxacin; CHL, chloramphenicol; TMP/SMX, trimethoprim-sulfamethoxazole; TET, tetracycline; AZM, azithromycin; Int 1, integrase 1; Int 2, integrase 2.

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