Clonal relation and antimicrobial resistance pattern of extended-spectrum β-lactamase- and AmpC β-lactamase-producing <i>Enterobacter</i> spp. isolated from different clinical samples in Tehran, Iran

Ghanavati, Roya; Emaneini, Mohammad; Kalantar-Neyestanaki, Davood; Maraji, Azin Sattari; Dalvand, Mosayyeb; Beigverdi, Reza; Jabalameli, Fereshteh

doi:10.1590/0037-8682-0227-2017

Short Communication • Rev. Soc. Bras. Med. Trop. 51 (01) • Jan-Feb 2018 • https://doi.org/10.1590/0037-8682-0227-2017 linkcopy

Clonal relation and antimicrobial resistance pattern of extended-spectrum β-lactamase- and AmpC β-lactamase-producing Enterobacter spp. isolated from different clinical samples in Tehran, Iran

Authorship SCIMAGO INSTITUTIONS RANKINGS

INTRODUCTION: Here, we determined the genes encoding antibiotic resistance enzymes and virulence factors and evaluated the genetic relationship between Enterobacter spp. isolated from different clinical samples.

METHODS: A total of 57 clinical isolates of Enterobacter spp. were tested for the production of extended-spectrum β-lactamases (ESBLs), carbapenemase, and AmpC using phenotypic and genotypic methods.

RESULTS: The most common ESBLs and AmpC β-lactamases were bla _TEM (63.3%) and bla _EBC (57.7%), respectively. The most prevalent virulence gene was rpos (87.7%). The random amplified polymorphic DNA (RAPD) patterns of strains were genetically unrelated.

CONCLUSIONS: RAPD polymerase chain reaction analysis revealed high genetic diversity among isolates.

Keywords:
Enterobacter; ESBL; AmpC; RAPD-PCR

Gene	Primer sequence (5′ to 3′)	Annealing temperature (°C)	Product size (bp)	Reference
csgA	F- TTCAAAGTGGCAGTTATTGCAG	56	276	[4]
	R- TTTTTGCAGCAGATCGATAGAA
csgD	F- GAAATTGCATAATATTCAACGTTC R- TTTGTTCAGGATCTCTTTTTCAC	54	385
csgB	F- TCCTGGGAAACGATGGACAA	54	193	this study
	R- TTACATTACTGGGAGCGCCT
fliI	F- ATACGGCGCAGTGCGTTAC	54	154	this study
	R- ACCAAAGAGAGGACACAATGC
rpoS	F- CACTTCACGCTGTTTGGCG	56	273	this study
	R- CGCGAGTTGTCCCATAAACTG
fepA	F- TCTTTT TTCACCGGCATGGA	57	572	this study
	R- CGTGCGGTGGTCAATATCT
iutA	F- TGAAACGTTCTCATCTTTGGGTT	56	1117	this study
	R- TCG AAGGTTTCATGGTCGGC

Isolate ID	Date	Source	Resistance pattern	MDR	ESBL gene	MIC of IMI	AmpC gene	RAPD type
1	11/11/2013	Burn	CTX, CAZ, CPM, CPD, FOX, AUG, IMI, MEM, ETP, AK, GM, CIP, LEV, GAT	+	bla_TEM, bla_CTX-M	1	bla _EBC	D
2	11/11/2013	Burn	CTX, CAZ, CPM, CPD, FOX, AUG, AK, GM	−	bla_TEM, bla_CTX-M	2	bla _EBC	E
3	11/25/2013	Burn	CTX, CAZ, CPM, CPD, FOX, AUG, AK, GM, CIP	+	bla_TEM, bla_SHV	2	bla _EBC	F
4	12/21/2013	Eye	CTX, CAZ, CPM, CPD, FOX, AUG, AK, GM	−	bla _TEM	4	bla_ACC, bla_EBC	G
5	12/29/2013	Respiratory	CTX, CAZ, CPM, CPD, FOX, AUG, AK	−	bla _TEM	4	bla_ACC, bla_DHA	H
6	12/28/2011	Urine	CTX, CAZ, CPM, CPD, FOX, AUG, GM, CIP	+	bla_TEM, bla_CTX-M, bla_SHV	0.25	bla_DHA, bla_EBC	B
7	12/28/2011	Wound	CTX, FOX, AUG	−	bla_TEM, bla_CTX-M	2	bla_ACC, bla_EBC	C
8	1/12/2011	Wound	CTX, FOX, AUG	−	bla _TEM	2	bla _EBC	I
9	6/1/2012	Wound	CTX, CAZ, CPM, CPD, FOX, AUG, GM	−	bla_TEM, bla_CTX-M	2	bla _EBC	C
10	12/13/2013	Wound	CTX, CAZ, CPM, CPD, FOX, AUG, AK, GM, CIP, LEV	+	bla_TEM, bla_CTX-M	4	bla_EBC, bla_CIT	J
11	12/13/2013	Urine	CTX, FOX, AUG	−	bla_TEM, bla_CTX-M	4	−	K
12	2/25/2014	Urine	CTX, CAZ, CPM, CPD, FOX, AUG, AK, GM	−	bla_TEM, bla_CTX-M	1	bla_ACC, bla_EBC	L
13	3/11/2014	Burn	CTX, CAZ, CPM, CPD, FOX, AUG, IMI, MEM, ETP, AK, GM, CIP, LEV, GAT	+	bla_TEM, bla_CTX-M	64	bla_EBC, bla_CIT	A
14	3/11/2014	Burn	CTX, CAZ, CPM, CPD, FOX, AUG, IMI, MEM, ETP, AK, GM, CIP, LEV, GAT	+	bla_TEM, bla_CTX-M	64	bla _EBC	A
15	4/22/2014	Urine	CTX, FOX, AUG	−	bla _CTX-M	4	bla _EBC	M
16	4/25/2014	Respiratory	CTX, CAZ, CPM, CPD, AUG, GM	−	−	4	bla _EBC	B
17	4/29/2014	Respiratory	CTX, CAZ, CPM, CPD, FOX, AUG, AK, GM	−	bla_TEM, bla_CTX-M	4	bla _EBC	N
18	5/5/2014	Blood	CTX, CAZ, CPM, CPD, FOX, AUG, IMI, MEM, ETP, AK, GM, CIP, GAT	+	−	16	−	O
19	5/6/2014	Blood	CTX, CAZ, CPM, CPD, FOX, AUG, IMI	−	bla_TEM, bla_CTX-M, bla_SHV	16	bla _EBC	P
20	5/7/2014	Urine	FOX, AUG	−	bla _TEM	2	−	Q
21	5/7/2014	Urine	FOX, AUG	−	−	8	bla _EBC	R
22	5/15/2014	Wound	CTX, CAZ, CPM, CPD, FOX, AUG, IMI, MEM, ETP, GM, CIP, LEV, GAT	+	bla _SHV	4		S

Isolate ID	Date	Source	Resistance pattern	MDR	ESBL gene	MIC of IMI	AmpC gene	RAPD type
1	2/19/2012	Wound	CTX, AUG	−	bla _TEM	2		B

2	2/6/2014	Blood	CTX, CAZ, CPM, CPD, FOX, AUG, IMI, MEM, ETP, AK, CIP	+	bla_TEM, bla_CTX-M	4		C
3	2/25/2014	Urine	CTX, CAZ, ETP, GM, CIP	−	bla_SHV, bla_CTX-M	2		D
4	3/3/2014	Urine	CTX, CAZ, CPM, CPD	−	bla _SHV, bla _CTX-M	0.625		A
5	3/11/2014	Burn	CTX, CAZ, CPD, FOX, GM	−	bla _CTX-M	0.5	bla _EBC	E
6	4/22/2014	Respiratory	-	−	bla _CTX-M	0.25	bla _ACC	F
7	5/15/2014	Wound	CTX, CAZ, CPM, CPD, FOX, AUG, IMI, MEM, ETP, GM, CIP, LEV, GAT	+	bla _SHV	0.625		A
8	5/25/2014	Urine	-	−	bla_SHV , bla _CTX-M	2		G

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[TFN1] CTX: cefotaxime; CAZ: ceftazidime; CPM: cefepime; CPD: cefpodoxime; FOX: cefoxitin; AUG: amoxicillin-clavulanate; IMI: imipenem; MEM: meropenem; ETP: ertapenem; AK: amikacin; GM: gentamicin; CIP: ciprofloxacin; LEV: levofloxacin; GAT: gatifloxacin; MDR: multi-drug resistant; ESBL: extended-spectrum β-lactamase; MIC: minimum inhibitory concentration; RAPD: random amplified polymorphic DNA.