Potential plasmidic co-transfer, extended spectrum β--lactamase lineage and integron association in uropathogenic e. coli from an endemic region

Resistance to extended-spectrum β-lactams was mediated by plasmidic extended-spectrum β-lactamases (ESBLs) and/or AmpC β–lactamases in uropathogenic E. coli (UPEC) a primary etiologic agent of urinary tract infections (UTI). Often the isolates were multidrug resistant harboring integrons and cause great hindrance in treatment. This study aims to identify genetic relatedness between plasmids and their correlation with β-lactamase resistant genes and integrons in nosocomial UPEC isolates. 29 drug resistant patterns were observed in 82 E. coli isolates after urine culture and biochemical detection. 33(45.8%) isolates were ESBL producers and 39 (54.2%) resistant to ESBL production. The former showed lowest resistance (3%, 24.2%) than the latter (43.6%, 35.9%) group to meropenem and nitofurantoin respectively. Conjugal transfer of plasmids was successful for 52 isolates. blaTEM was present in all transconjugants, alone or in combination with other β-lactamases and integrons. Mantel test revealed significant correlation (Rxy=0.997, p <0.0001) between plasmids, β-lactamase genes and integrons. Therefore this study demonstrated that flow of genetic information was due to mobile genetic elements instead of genetic recombination between plasmid pairs. Furthermore awareness, detection and distribution of resistant determinants were an absolute necessary for designing therapeutics for optimal patient care.