Analysis of genetic determinants involved in antibiotic resistance in clinical strains Isolated from urine samples of renal transplantation Recipients

Background: Urinary Tract Infection (UTI) is one of the most important infections among renal transplant recipients; however, the threat caused by the acquisition of antibiotic resistance by pathogenic bacteria has been growing. Objectives: The aim of this study was to investigate the antibiotic sensitivity of 25 strains isolated from urine samples of renal transplant recipients and evaluate the presence and prevalence of resistance determinants such as Integron in them. Methods: The patients enrolled into the study had undergone renal transplantation in the Department of General and Transplantation Surgery of Labafinejad hospital, 70 to 90 days before urine samples were collected. Susceptibility of 25 bacterial strains [ 10 Enterococcus faecalis, 4 Coagulase-negative Staphylococcus 2 Streptococcus sp., 2 Klebsiella pneumoniae, 2 E.coli, 2 Acinetobacter baumannii, 1 Stenotrophomonas maltophilia, 1 Proteus mirabilis and 1 Citrobacter freundii ] to 13 antibiotics: Gentamycin, Tetracycline, Ceftazidime, Co-trimoxazole, Imipenem, Ciprofloxacin, Norfloxacin, Cefalotin, Amikacin, Chloramphenicol, Nalidixic Acid, Amoxicillin and Nitrofurantoin were determined by the Kirby-Bauer disk diffusion method. In addition, the existance of Integrons in resistant isolates was assessed by PCR. Results: It was demonstrated that TEM gene in gram-negative bacterial strains (100%) and Entrococcus (55.6%) and ctx gene in other gram-positive bacterial strains (72.3%) are responsible for antimicrobial resistance more than any other gene. Furthermore, it was revealed that class 1 and 2 Integrons exist in all resistant isolates while class 3 Integrons only exist in Entrococcus. Conclusion: The results indicate that Integrons may contribute significantly to the spread of antibiotic resistant bacteria among renal transplantation patients.