Abstract
Background: Enterobacter infections are increasingly recognized as an important nosocomial infection. Here we describe the prevalence of three classes of integrons in clinical isolates of Enterobacter spp. and the prevalence of antibiotic resistance genes among isolates with integron. Objectives: Here we describe the prevalence of integrons genes among clinical isolates of Enterobacter spp. and antibiotic susceptibility pattern, ESBL production and the prevalence of resistance genes among clinical isolates of Enterobacter spp. Materials and Methods: A total of 110 Enterobacter isolates collected from four hospitals in Tehran during 2012-2013. Enterobacter species were identified by using API 20E system. The existence of integron classes was investigated by PCR assay through the amplification of integrase genes. Then, antibacterial susceptibility and confirmation of ESBL phenotype was determined. Then, the bla groups, blaTEM, blaSHV, blaCTX-M-1 and aminoglycoside modifying enzymes genes were identified by PCR with specific primers. Results: The prevalence of Enterobacter species were E. cloacae (78.2 %), E. aerogenes (13.6 %) and E. sakazakii (8.2%). They were from different clinical sources. Forty five of Enterobacter isolates have integron but there was not detected class 3 of integrons. All isolates with integron were susceptible to imipenem. Ten isolates of Enterobacter with integron showed ESBL phenotype. The frequency of blaTEM, blaSHV and blaCTX-M-1 genes are 20%, 0% and 15.6%, respectively. The frequency of genes encoding ANT (2˝)-Ia, APH (3΄)-Ia, AAC (6΄)-Ib and AAC (3)-IIa were 11.1%, 13.3%, 13.3 % and 20 %, respectively. Conclusions: The high prevalence of integron-positive isolates in our MDR Enterobacter isolates indicates that these mobile genetic elements are common among different Enterobacter spp. and associate with reduced susceptibility to the first-line antimicrobial drugs. This so highlight the continued monitoring of drug resistance in clinical settings.
Highlights
Enterobacter infections are increasingly recognized as an important nosocomial infection
The ability of integrons to integrate resistance gene cassettes makes them prime pools for the further dissemination of antibiotic resistance among clinical isolates of gram-negative bacteria, including Enterobacter isolates [13]
Our findings indicated that the 41 % of isolated Enterobacter were integron positive, this rate of integron positive in our isolates are similar with published reports that Enterobacter harbors high prevalence of integron class 1, lower class 2 and no class 3 [14,15,16]
Summary
Enterobacter infections are increasingly recognized as an important nosocomial infection. We describe the prevalence of three classes of integrons in clinical isolates of Enterobacter spp. and the prevalence of antibiotic resistance genes among isolates with integron. Results: The prevalence of Enterobacter species were E. cloacae (78.2 %), E. aerogenes (13.6 %) and E. sakazakii (8.2%) Conclusions: The high prevalence of integron-positive isolates in our MDR Enterobacter isolates indicates that these mobile genetic elements are common among different Enterobacter spp. and associate with reduced susceptibility to the first-line antimicrobial drugs. This so highlight the continued monitoring of drug resistance in clinical settings. The prevalence of multidrug resistance among isolates of the Enterobacter spp. in human infections is rising
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