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. 2018 Jan 31:13:Doc02.
doi: 10.3205/dgkh000308. eCollection 2018.

Molecular analysis of integrons and antimicrobial resistance profile in Shigella spp. isolated from acute pediatric diarrhea patients

Mohammad Mehdi Soltan Dallal  1   2 , Sajjad Omidi  3 , Masoumeh Douraghi  2   3 , Mohammad Taghi Haghi Ashtiani  4 , Mohammad Kazem Sharifi Yazdi  5   6 , Arash Okazi  7
Affiliations

Molecular analysis of integrons and antimicrobial resistance profile in Shigella spp. isolated from acute pediatric diarrhea patients

Mohammad Mehdi Soltan Dallal et al. GMS Hyg Infect Control. .

Abstract
in English, German

Introduction:Shigella spp. is a growing global health concern due to increasing multiple drug resistance, commonly resulting in therapeutic failure. Integrons are gene expression systems run by integrase genes. The aims of this study were detection of class I, II and III integrons and assessment of antimicrobial resistance in Shigella spp. isolated from acute pediatric diarrhea patients. Materials and methods: From January to December 2015, 16 Shigella spp. were isolated from 310 non-duplicative diarrheal stool samples in Children's Medical Center, Tehran, Iran. The isolates were analyzed for their antibiotic susceptibility using CLSI guidelines M100-S14. Multiplex PCR was used for amplification of I, II and III integron-associated integrase (intl) genes. Results: Of 310 stool samples, 16 (5.2%) were positive for Shigella spp., in 7 of them S. sonnei and in 9 of them S. flexneri were identified. Results of the antimicrobial susceptibility test showed that 6.2%, 50%, 31.2%, 6.2%, 81.2%, 56.2% and 31.2% of the isolates were resistant to gentamicin, chloramphenicol, nalidixic acid, ciprofloxacin, tetracycline, ampicillin and trimethoprim-sulfamethoxazole, respectively. Multiplex PCR results revealed that 6.2% (1/16), 31.2% (5/16), 50% (8/16) of Shigella isolates carried intlI, intlII and both intlI/intllI genes. No class 3 integrons were detected. Discussion: In this study, multidrug resistance was seen in Shigella isolates similar to that in isolates from other geographical areas. This is possible due to inappropriate use of antimicrobials. Furthermore, prevalence of multidrug resistance was significantly linked to the presence of integrin genes. Conclusion: A class 2 integron plays a role in presence of multidrug resistance in Shigella spp. It is vital to prevent the spread of antibiotic resistance through continuous monitoring.

Hintergrund: Die Zunahme multiresistenter Shigella spp. ist ein globales Gesundheitsproblem wachsender Bedeutung. Integrons sind Genexpressionssysteme, die von Integrase-Genen gesteuert werden. Zielsetzung der Studie war die Detektion von Klasse 1, 2 und 3 Integrons und die Bestimmung der antimikrobiellen Resistenz von Shigella spp., die von pädiatrischen Patienten mit Diarrhoe isoliert wurden. Material und Methoden: Von Januar bis Dezember 2015 wurden 16 Shigella spp. aus 310 nicht-duplikativen Durchfall-Stuhlproben im Children’s Medical Center, Tehran, gemäß Guideline des Clinical and Laboratory Standards Institute isoliert. Zur Amplifikation der I, II und III Integron-assoziierten Integrase(intl)-Gene wurde die Multiplex PCR eingesetzt.Ergebnisse: In 16 (5,2%) der 310 Stuhlproben wurden 7-mal S. sonnei und 9-mal S. flexneri isoliert. 6,2%, 50%, 31,2%, 6,2%, 81,2%, 56,2% bzw. 31,2% der Isolate waren resistent gegen Gentamicin, Chloramphenicol, Nalidixinsäure, Ciprofloxacin, Tetracycline, Ampicillin und Trimethoprim-Sulfamethoxazol. Mittels Multiplex PCR wurde nachgewiesen, dass 6,2% (1/16), 31,2% (5/16), 50% (8/16) der Shigella Isolate intlI, intlII bzw. beide Gene trugen. Klasse III Integrons wurden nicht detektiert.Diskussion: Bei Shigella-Isolaten wurde ähnlich zu anderen geographischen Regionen Multiresistenz nachgewiesen. Das wird begünstigt durch nicht Leitlinien gerechten Einsatz von Antibiotika. Die Prävalenz der Multiresistenz war signifikant mit dem Vorhandensein von Integrin-Genen assoziiert.Schlussfolgerung: Das Klasse 2 Integron ist von Bedeutung für die Multiresistenz von Shigella spp. Es ist wichtig, die Ausbreitung von Antibiotikaresistenzen durch kontinuierliche Überwachung zu verhindern.

Keywords: Shigella spp.; acute pediatric diarrhea; integrons; multiplex PCR.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Table 1
Table 1. PCR primers used in this study
Table 2
Table 2. Antimicrobial susceptibility of the Shigella isolates
Table 3
Table 3. Distribution of class I, II and III integrons in Shigella spp.
Table 4
Table 4. Integrons and multiresistance in the Shigella isolates
Figure 1
Figure 1. M-PCR products of intlI/II genes (280/789 bp).
M: 100-bp DNA ladder; C+, positive control (S. flexneri ATCC 12022/S. sonnei ATCC 9290), Lanes 1 & 2: S. flexneri; Lanes 3 & 4: S. sonnei strains; C–, negative control (E. coli ATCC 25922)
See this image and copyright information in PMC

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