بررسی فراوانی اینتگرون 1 و 2 و ارتباط آنها با الگوی مقاومت دارویی در بیماران مبتلا به گاستروانتریت در سویه های سالمونلا در تهران، ایران

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه میکروب‌شناسی، دانشکده پزشکی، دانشگاه شاهد تهران. ایران

2 دانشگاه آزاد اسلامی، واحد علوم تحقیقات، گروه زیست‌شناسی، تهران، ایران

3 مرکز تحقیقات عفونی اطفال، پژوهشکده سلامت کودکان، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

10.22070/daneshmed.2020.3051

چکیده

مقدمه و هدف: سالمونلا یکی از باکتری های مهم ایجادکننده گاستروانتریت در انسان بوده و گسترش سویه های سالمونلا با مقاومت چند دارویی یک مشکل حاد جهانی است. اینتگرون ها از مهمترین عوامل مسئول انتقال ژنهای مقاومت به دارو در بین سروتیپ های سالمونلا هستند. در مطالعه حاضر، فراوانی اینتگرون های کلاس 1 و کلاس 2 و همچنین ارتباط آنها با الگوهای مقاومت دارویی بیماران با علائم گوارشی بررسی شد.
مواد و روش ها: در این مطالعه مقطعی، 400 نمونه مدفوع انسانی با علائم گوارشی از 4 بیمارستان در شهر تهران تهیه شد. تمامی نمونه ها توسط روش استاندارد از نظر کشت میکروبی بررسی و تائید نتایج توسط آزمایش های بیوشیمیایی و PCR انجام گرفت. آنتی بیوگرام توسط روش انتشار از دیسک صورت پذیرفت. پس از استخراج DNA حضور اینتگرون های کلاس 1 و 2 با PCR بررسی گردید. آنالیز آماری جهت سنجش ارتباط بین الگوهای مقاومت دارویی و حضور اینتگرون ها توسط نرم افزار SPSS و آزمون فیشر انجام گرفت.
نتایج: نتایج نشان داد که سالمونلا در 5.5٪ (400/22) از نمونه های مدفوع با علامت گوارشی وجود دارد. میزان شیوع اینتگرون کلاس 1 و 2 برای نمونه های مدفوع انسانی به ترتیب 9/40% (22/9) و 2/27% (22/6) بود. فنوتیپ MDR در 4.5٪ (1.22) جدایه های سالمونلا از نمونه های مدفوع انسانی شناسایی شد.
نتیجه‌گیری: در این مطالعه میزان بالایی از حضور اینتگرون های 1 و 2 در جدایه های مدفوع بیماران با علائم گاستروانتریت مشاهده شد. ارتباط مشاهده شده میان حضور اینتگرون ها و الگوهای مقاومت دارویی نشان دهنده احتمال افزایش ریسک انتقال ژنهای مقاومت دارویی در سویه های سالمونلای مسئول عفونت انسانی است.

کلیدواژه‌ها


عنوان مقاله [English]

Frequency of integrons 1 and 2 and their relationship with drug resistance patterns of Salmonella isolates in patients with gastroenteritis in Tehran, Iran

نویسندگان [English]

  • Saeid Besharati 1
  • Parviz Owlia 1
  • Atena Sadeghi 1
  • Fateme Ahmadi 2
  • Masoud Alebouyeh 3
1 Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
2 Department of Microbiology, Faculty of Basic Sciences, Science and Research Branch, Islamic Azad University, Tehran, Iran
3 Pediatric Infections Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]

Background and Objective: Salmonella is one of the most important bacteria that causes gastroenteritis in humans and the spread of Salmonella strains with multidrug resistance is an acute global problem. Integrons are one of the most important factors responsible for transfering of drug resistance genes among Salmonella serotypes. In the present study, the frequency of class 1 and class 2 integrons as well as their relationship with drug resistance patterns in patients with gastrointestinal symptoms were investigated.
Materials and Methods: In this cross-sectional study, 400 human fecal samples with gastrointestinal symptoms were collected from 4 hospitals in Tehran. All the samples were analyzed by standard method for microbial culture and the results were confirmed by biochemical and PCR tests. Antimicrobial susceptibility testing was performed by disk diffusion method. After DNA extraction, the presence of class 1 and 2 integrons was investigated by PCR. Statistical analysis for detection of correlation between the presence of integrons and resistance patterns was done using SPSS software and Fisherʼs exact test.
Results: The results showed that Salmonella was present in 5.5% (22.400) of the stool specimens. The prevalence rates of class 1 and 2 integrons for human stool specimens were 40.9% (9/22) and 27.2% (6/22), respectively. MDR phenotype was detected in 4.5% (1.22) of the Salmonella isolates from patients with gastroenteritis.
Conclusion: In this study, high levels of integrons 1 and 2 were observed in the patients' Salmonella isolates with gastroenteritis. The observed relationship between drug resistance patterns and the integrons indicated a possible increased risk of drug resistance genes in Salmonella isolates with human gastroenteritis.

کلیدواژه‌ها [English]

  • Salmonella
  • Integrons
  • Drug Resistance
  • Gastroenteritis
  1. Octavia S, Lan R. Multiple-locus variable-number tandem-repeat analysis of Salmonella enterica serovar Typhi. Journal of Clinical Microbiology 2009; 1;47(8):2369-76.
  2. Da Silva N, Taniwaki MH, Junqueira VC, Silveira N, Okazaki MM, Gomes RA, editors. Microbiological examination methods of food and water: a laboratory manual. Chemical Rubber Company Press 2018.
  3. Salimkhani E, Ranjbar R, Sadeghifard N, Morovvati S, Jonaidi N, Izadi M. An outbreak of gastroenteritis of unknown origin in Tehran. Pakistan Journal of Biological Science 2007; 10:1138-40.
  4. Eshraghi S, Dalall MM, Fardsanei F, Salehi TZ, Ranjbar R, Nikmanesh B, Aminharati F, Abdosamadi Z, Akbari A. Salmonella enteritidis and antibiotic resistance patterns.Tehran University Medical Journal 2010, 67(12): 876-882
  5. Besharati S, Owlia P, Sadeghi A, Ahmadi F, Fani F, Puladfar G, Alebouyeh M. Frequency, antibiotic resistance, and serogroups of Salmonella among chicken meat specimens in Tehran, Iran. Daneshvar Medicine 2019; 10;27(143):1-0.
  6. Rowe-Magnus DA, Mazel D. The role of integrons in antibiotic resistance gene capture. International Journal of Medical Microbiology 2002; 1;292(2):115-25.
  7. Manyi-Loh C, Mamphweli S, Meyer E, Okoh A. Antibiotic use in agriculture and its consequential resistance in environmental sources: Potential Public Health Implications. Molecules 2018; 23(4):795.
  8. Collis CM, Grammaticopoulos G, Briton J, Stokes HW, Hall RM. Site‐specific insertion of gene cassettes into integrons. Molecular Microbiology 1993; 9(1):41-52.
  9. Firoozeh F, Shahcheraghi FE, Salehi TZ, Karimi V, Aslani MM. Antimicrobial resistance profile and presence of class I integrongs among Salmonella entericaserovars isolated from human clinical specimens in Tehran, Iran. Iranian Journal of Microbiology 2011; 3(3):112.
  10. Hall, R. M.: Mobile gene cassettes and integrons: moving antibiotic resistance genes in gram-negative bacteria. Ciba Foundation symposium 1997;207:192-202; discussion 202-5.
  11. Hall RM, Collis CM, KIM MJ, Partridge SR, Recchia GD, Stokes HW. Mobile gene cassettes and integrons in evolution. Annals of the New York Academy of Sciences 1999; 870(1):68-80.
  12. WHO Global Foodborne Infections Network. Laboratory Protocol. Isolation of salmonella spp from food and animal faeces 5th Ed 2010.
  13. CLSI. Performance Standards for Antimicrobial Susceptibility Testing 2018.
  14. Lindstedt B-A, Heir E, Nygård I, Kapperud G. Characterization of class I integrons in clinical strains of Salmonella enterica subsp. Enterica serovars typhimurium and enteritidis from norwegian hospitals. Journal of Medical Microbiology 2003; 52:141–9.
  15. Machado E, Ferreira J, Novais Â, Peixe L, Cantón R, Baquero F, Coque TM. Preservation of integron types among Enterobacteriaceae producing extended-spectrum β-lactamases in a Spanish hospital over a 15-year period. Antimicrobial Agents and Chemotherapy 2007; 1;51(6):2201-4.
  16. Rodrigue DC, Tauxe RV, Rowe B. International increase in Salmonella enteritidis: a new pandemic. Epidemiology & Infection 1990; 105(1):21-7.
  17. Louis M. S. St, Morse D.L, Potter M.E, DeMelfi T, Guzewich J, et al. The emergence of grade A eggs as a major source of Salmonella enteritidis infections. JAMA 1988;259(14):2103-2107.
  18. Lahoorpour F, Jasemi N, Ashrafi S. Salmonella typhi holder inspection in foodstuff producers and distributors in Sanandaj. International Congress of Central Asia Infectious Diseases 2006.
  19. Mashouf R, Ranjbar M. Prevalence of Salmonella carriers among food handlers in Hamadan, western Iran. Clinical Microbiology & Infection Supplement 2005; 1(11):648.
  20. SoltanDallal MM, Moezardalan K. Aeromonas spp associated with children's diarrhoea in Tehran. Annals of Tropical Paediatrics 2004; 1;24(1):45-51.
  21. Amini K. Prevalence of antibiotic resistance genes in Salmonella enteritidis isolated from animal and human and determining their antibiotic resistance patterns. Journal of Comparative Pathobiology Iran 2016; 12;4(51):1733-1740.
  22. Ranjbar R, Sarshar M. Genetic diversity of clinical strains of Salmonella enterica serovar Typhimurium. Journal Military Medicine 2012; 15;14(2):143-7.
  23. Konaté A, Guessennd NK, Kouadio FK, Dembélé R, Kagambèga A. Epidemiology and Resistance Phenotypes of Salmonella spp. Strains Responsible for Gastroenteritis in Children Less Than Five Years of Age in Ouagadougou, Burkina Faso. Archives of Clinical Microbiology 2019; 10(2):90.
  24. Spiliopoulou I, Zografou S, Goula A, Dimitracopoulos G, Christofidou M. Molecular epidemiology and antibiotic resistance patterns of Salmonella enterica from southwestern Greece. Chemotherapy 2007; 53(6):392-6.
  25. Fallah SH, Asgharpour F, Naderian Z, Moulana Z. Isolation and determination of antibiotic resistance patterns in nontyphoid Salmonella spp isolated from chicken. International Journal of Enteric Pathogense 2013;1(1): e9416.
  26. Fallah F, Godarzi H, Lahoorpour F, Bandehpour M. Detection of asymptomatic carrier of salmonella entericaserovartyphi by phenotypic and molecular characteristics of organism. Medical Journal of Mashhad University of Medical Sciences 2015; 58(5):258-62
  27. Sadeghi V, Amini K. Study and identify integrons class Ι, II III, Salmonella typhimurium isolated from clinical samples of Tehran Medical Centers. Medical Science Journal of Islamic Azad Univesity Tehran Medical Branch 2018; 15;28(2):130-5.
  28. Randall LP, Cooles SW, Osborn MK, Piddock LJ, Woodward MJ. Antibiotic resistance genes, integrons and multiple antibiotic resistance in thirty-five serotypes of Salmonella enterica isolated from humans and animals in the UK. Journal of Antimicrobial Chemotherapy 2004; 1;53(2):208-16
  29. Chitnis V, Chitnis S, Vaidya K, Ravikant S, Patil S, Chitnis D. Bacterial population changes in hospital effluent treatment plant in central India. Water Research 2004; 38:441-77.