The Prevalence of Plasmid-mediated Quinolone Resistance Genes in Escherichia coli Isolated from Hospital Wastewater Sources in Tehran, Iran
Abstract
Background: Considering the importance of hospital wastewaters as potential reservoirs for the dissemination of bacterial pathogens such as Escherichia coli and antibiotic resistance genes in the environment, the need for such information becomes imperative.
Methods: E. coli strains were isolated from hospital wastewater sources in Tehran, Iran, over a 24-month sampling period (Jun 2014- Jun 2016) and identified using standard bacteriological methods. Quinolone resistance among the strains was determined using Kirby-Bauer method and the frequency of plasmid-mediated quinolone resistance genes (qnrA, qnrB, qnrS) was investigated by PCR.
Results: In total, 80 E. coli strains were isolated during the study period, of which 51 (63.8%) isolates were resistant to tested antibiotics. Of note, 13 isolates were resistant to all the antibiotics employed. The highest rates of antibiotic resistance were obtained for nalidixic acid (60%), followed by norfloxacin (30%), and ciprofloxacin (25%). Of the 51 quinolone-resistant strains, 24 (47.1%) isolates harbored qnr genes. None of the isolates harboured the qnrA gene, while 11 (45.8%) and 7 (29.2%) isolates contained qnrB and qnrS, respectively.
Conclusion: Our findings showed high rates of quinolone resistance (63.8%) and qnr genes, underlining the importance of hospital wastewaters as reservoirs for dissemination of potentially pathogenic E. coli and horizontal gene transfer between other waterborne bacterial species. Other possible mechanisms of resistance should also be investigated for better characterization of quinolone-resistant E. coli isolates.
Moges F, Endris M, Belyhun Y, Worku W (2014). Isolation and characterization of multiple drug resistance bacterial pathogens from waste water in hospital and non-hospital environments, Northwest Ethiopia. BMC Res Notes, 7:215.
Yang CM, Lin MF, Liao PC et al (2009). Compari-son of antimicrobial resistance patterns between clinical and wastewater strains in a regional hospital in Taiwan. Lett Appl Microbiol, 48:560-5.
Ranjbar R, Masoudimanesh M, Dehkordi FS, Jo-naidi-Jafari N, Rahimi E (2017). Shiga (Vero)-toxin producing Escherichia coli isolated from the hospital foods; virulence factors, o-serogroups and antimicrobial resistance properties. Antimicrob Resist Infect Control, 6:4.
Ranjbar R, Hosseini S, Zahraei-salehi T et al (2016). Investigation on prevalence of Escherichia coli strains carrying virulence genes ipaH, estA, eaeA and bfpA isolated from different water sources. Asian Pac J Trop Dis, 6(4): 278-283
Anvarinejad M, Farshad Sh, Ranjbar R, Giammanco GM, Alborzi A, Japoni A (2012). Genotypic Analysis of E. coli Strains Isolated from Patients with Cystitis and Pyelonephritis. Iran Red Crescent Med J, 14(7):408-16.
Ranjbar R, Haghi-Ashtiani MT, Jonaidi Jafari N, Abedini M (2009). The prevalence and antimi-crobial susceptibility of bacterial uropathogens isolated from pediatric patients . Iran J Public Health, 38(2): 134-138.
Hamelin K, Bruant G, El-Shaarawi A et al (2006). A virulence and antimicrobial resistance DNA microarray detects a high frequency of virulence genes in Escherichia coli isolates from Great Lakes recreational waters. Appl Environ Microbiol, 72(6):4200-6.
Ranjbar R, Karami A, Farshad S, Giammanco GM, Mammina C (2014). Typing methods used in the molecular epidemiology of microbial patho-gens: a how-to guide. New Microbiol, 37(1):1-15.
Adefioye MA, Okoh AI (2016). Identification and antimicrobial resistance prevalence of pathogenic Escherichia coli strains from treated wastewater effluents in Eastern Cape, South Africa. Microbi-ologyopen, 5(1):143-51.
Casarez EA, Pillai SD, Di Giovanni GD (2007). Genotype diversity of Escherichia coli isolates in natural waters determined by PFGE and ERIC-PCR. Water Res, 41(16):3643-8.
Anderson KL, Whitlock JE, Harwood VJ (2005). Persistence and differential survival of fecal indi-cator bacteria in subtropical waters and sediments. Appl Environ Microbiol, 71(6): 3041-8.
Abdi S, Ranjbar R, Vala MH, Jonaidi N, Bejestany OB, Bejestany FB (2014). Frequency of bla TEM, bla SHV, bla CTX-M, and qnrA among Escherichia coli isolated from urinary tract infection . Arch Clin Infect Dis, 9(1): e18690.
Momtaz H, Karimian A, Madani M, Safarpoor Dehkordi F, Ranjbar R, Sarshar M, Souod N (2013). Uropathogenic Escherichia coli in Iran: serogroup distributions, virulence factors and antimicrobial resistance properties. Ann Clin Mi-crobiol Antimicrob, 12:8.
Castillo FYR, González FJA, Garneau P, Díaz FM, Barrera ALG, Harel J (2013). Presence of multi-drug resistant pathogenic Escherichia coli in the San Pedro river located in the state of Aguascalientes, Mexico. Front Microbiol, 4:147.
Ranjbar R, Behnood V, Memariani H, Najafi A, Moghbeli M, Mammina C (2016). Molecular characterisation of quinolone-resistant Shigella strains isolated in Tehran, Iran. J Glob Antimicrob Resist, 5:26-30.
Anvarinejad M, Farshad S, Alborzi A, Ranjbar R, Giammanco GM, Japoni A (2011). Integron and genotype patterns of quinolones-resistant uropathogenic Escherichia coli. Afr J Microbiol Res, 5(22):3765-70.
Tajbakhsh E, Khamesipour F, Ranjbar R, Ugwu IC (2015). Prevalence of class 1 and 2 integrons in multi-drug resistant Escherichia coli isolated from aquaculture water in Chaharmahal Va Bakhtiari province, Iran. Ann Clin Microbiol Antimicrob, 14:37.
Farshad S, Ranjbar R, Japoni A, Hosseini M, Anva-rinejad M, Mohammadzadegan R (2012). Mi-crobial susceptibility, virulence factors, and plasmid profiles of uropathogenic Escherichia coli strains isolated from children in Jahrom, Iran. Arch Iran Med, 15(5):312-6.
Webber M, Piddock LJ (2001). Quinolone resistance in Escherichia coli. Vet Res, 32(3-4):275-84.
Cummings DE, Archer KF, Arriola DJ et al (2010). Broad dissemination of plasmid-mediated qui-nolone resistance genes in sediments of two ur-ban coastal wetlands. Environ Sci Technol, 45 (2), 447-54.
Kim KY, Park JH, Kwak HS, Woo GJ (2011). Characterization of the quinolone resistance mechanism in foodborne Salmonella isolates with high nalidixic acid resistance. Int J Food Microbiol, 146(1):52-6.
Li J, Wang T, Shao B, Shen J, Wang S, Wu Y (2012). Plasmid-mediated quinolone resistance genes and antibiotic residues in wastewater and soil adjacent to swine feedlots: potential transfer to agricultural lands. Environ Health Perspect, 120(8):1144-9.
APHA/AWWA/WEF. 2012 Standard methods for the examination of water and wastewater. 22nd edn. American public health Associa-tion/American water works Association/Water environment federation, Washington DC, USA.
Memariani M, Peerayeh SN, Salehi TZ, Mostafavi SKS (2015). Occurrence of SHV, TEM and CTX-M β-lactamase genes among enteropa-thogenic Escherichia coli strains isolated from children with diarrhea. Jundishapur J Microbiol, 8(4):e15620.
Wu JJ, Ko WC, Chiou CS, Chen HM, Wang LR, Yan JJ (2008). Emergence of qnr determinants in human Salmonella isolates in Taiwan. J Antimicrob Chemother, 62(6):1269-1272.
Garcia S, Wade B, Bauer C, Craig C, Nakaoka K, Lorowitz W (2007). The effect of wastewater treatment on antibiotic resistance in Escherichia coli and Enterococcus sp. Water Environ Res, 79(12):2387-95.
Xia R, Ren Y, Xu H (2013). Identification of plasmid-mediated quinolone resistance qnr genes in multidrug-resistant Gram-negative bacteria from hospital wastewaters and receiving waters in the Jinan area, China. Microb Drug Resist, 19(6):446-56.
Vaz-Moreira I, Varela AR, Pereira TV, Fochat RC, Manaia CM (2016). Multidrug resistance in qui-nolone-resistant gram-negative bacteria isolated from hospital effluent and the municipal waste-water treatment plant. Microb Drug Resist, 22(2):155-63.
Picão RC, Cardoso JP, Campana EH, Nicoletti AG, Petrolini FV, Assis DM, Juliano L, Gales AC (2013). The route of antimicrobial resistance from the hospital effluent to the environment: focus on the occurrence of KPC-producing Aeromonas spp. and Enterobacteriaceae in sewage. Diagn Microbiol Infect Dis, 76(1):80-5.
Hadi M, Shokoohi R, Ebrahimzadeh Namvar AM, Karimi M, Solaimany Aminabad M (2011). an-tibiotic resistance of isolated bacteria from urban and hospital wastewaters in Hamadan city. Iran J Health Environ, 4(1):105-14.
Chandran SP, Diwan V, Tamhankar AJ, Joseph BV, Rosales-Klintz S, Mundayoor S, Lundborg CS, Macaden R (2014). Detection of carbapenem resistance genes and cephalosporin, and quinolone resistance genes along with oqxAB gene in Escherichia coli in hospital wastewater: a matter of concern. J Appl Microbiol, 117(4):984-95.
Amaya E, Reyes D, Paniagua M, Calderón S, Rashid MU, Colque P, Kühn I, Möllby R, Weintraub A, Nord CE (2012). Antibiotic resistance patterns of Escherichia coli isolates from different aquatic environmental sources in León, Nicaragua. Clin Microbiol Infect, 18(9):E347-354.
Wang A, Yang Y, Lu Q et al (2008). Presence of qnr gene in Escherichia coli and Klebsiella pneumonia resistant to ciprofloxacin isolated from pediatric patients in China. BMC Infect Dis, 8:68.
Alam M, Imarn M (2014). Multiple antibiotic resis-tances in metal tolerant E. coli from hospital waste water. Bioinformation, 10(5):267-72.
Conte D, Palmeiro JK, da Silva Nogueira K, de Lima TM, Cardoso MA, Pontarolo R, Degaut Pontes FL, Dalla-Costa LM (2017). Characterization of CTX-M enzymes, quinolone resistance determinants, and antimicrobial residues from hospital sewage, wastewater treatment plant, and river water. Ecotoxicol Environ Saf, 136:62-9.
Anssour L, Messai Y, Estepa V, Torres C, Bakour R (2016). Characteristics of ciprofloxacin-resistant Enterobacteriaceae isolates recovered from wastewater of an Algerian hospital. J Infect Dev Ctries, 10(7):728-34.
Diwan V, Chandran SP, Tamhankar AJ, Stalsby Lundborg C, Macaden R (2012). Identification of extended-spectrum β-lactamase and quinolone resistance genes in Escherichia coli isolated from hospital wastewater from central India. J Antimicrob Chemother, 67(4):857-9.
Wen Y, Pu X, Zheng W, Hu G (2016). High preva-lence of plasmid-mediated quinolone resistance and IncQ plasmids carrying qnrS2 gene in bacteria from rivers near hospitals and aquaculture in China. PLoS One, 11(7):e0159418.
| Files | ||
| Issue | Vol 46 No 9 (2017) | |
| Section | Original Article(s) | |
| Keywords | ||
| Escherichia coli Quinolone Hospital wastewater Iran | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
