High frequency of mutations in gyrA gene associated with quinolones resistance in uropathogenic Escherichia coli isolates from the north of Iran

Iran J Basic Med Sci. 2018 Dec;21(12):1226-1231. doi: 10.22038/ijbms.2018.31285.7539.

Abstract

Objectives: Regarding the global burden of uropathogenic Escherichia coli (UPEC) infections, prevention and treatment of such infections play a significant role in healthcare management. The inordinate use of fluoroquinolones led to a worldwide spread of quinolone-resistant strains. Therefore, this study aimed to investigate mutations in codons 83 and 106 of gyrA gene in UPEC isolates in the north of Iran.

Materials and methods: This cross-sectional study performed on a total of 223 UPEC isolates which were recovered within 6 months in 2017. Isolates were identified and confirmed by standard microbiologic tests, and antimicrobial susceptibility testing was carried out by disk diffusion and E-test methods. PCR reaction was performed to amplify gyrA gene, and PCR-RFLP was performed using BsiEI and BstUI restriction enzymes to investigate mutations in gyrA gene.

Results: The nalidixic acid, ciprofloxacin, ofloxacin, and norfloxacin resistance rates were 61.9%, 50.2%, 48.25, and 45.3%, respectively. Overall, 55.2% of E. coli isolates had a mutation in gyrA gene in codon 83, and 20.2% in codon 106. Also, 15.2% of isolates had simultaneously mutation. Moreover, a significant association was found between mutations in gyrA gene and quinolone and fluoroquinolones resistance pattern of UPEC isolates.

Conclusion: Our results revealed a high level of quinolone resistance associated with the mutations in gyrA among the clinical isolates of UPEC in our region. To the best of our knowledge, this study is the first investigation on the role of gyrA alteration in quinolone resistance among UPEC isolates from the north of Iran.

Keywords: Antibiotic resistance; PCR-RFLP; Quinolone; Uropathogenic Escherichia coli; gyrA.