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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Antibiotic Resistance and New Antimicrobial drugs
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1462742
This article is part of the Research Topic Insight into the Upsurge of Resistance in Infectious Microbes View all 3 articles

Distribution characteristics of integrons and correlation analysis of antibiotic resistance in urine isolated Enterobacter cloacae

Provisionally accepted
Xuedan Qiu Xuedan Qiu 1*Hui Zhang Hui Zhang 2*Min Jiang Min Jiang 1Qiaoping Wu Qiaoping Wu 1*Qingcao Li Qingcao Li 1*Guangliang Wu Guangliang Wu 3*
  • 1 Department of Clinical Laboratory, The Affiliated Li Huili Hospital, Ningbo University,, Ningbo, China
  • 2 Ninghai County Chengguan Hospital, Ningbo, Zhejiang Province, China
  • 3 The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang Province, China

The final, formatted version of the article will be published soon.

    Objective: This study aims to understand the distribution of integrons among Enterobacter cloacae isolated from clinical urine specimens in our hospital, as well as the molecular characteristics of the variable region resistance gene cassette of integron-positive strains and its relationship with drug resistance.We collected a total of 80 strains of Enterobacter cloacae isolated from urine specimens of hospitalized patients in our hospital between August 2019 and July 2023, and conducted drug sensitivity testing on them. Polymerase Chain Reaction (PCR) technology was employed to screen these strains for Class 1, 2, and 3 integrons. Following this, the promoter and variable regions of integron-positive strains were amplified and sequenced. Additionally, Enterobacterial Repetitive Intergenic Consensus PCR (ERIC-PCR) was utilized for homology analysis of integron-positive strains.Results: Among the 80 clinical strains, Class 1 integrons were detected in 31 (38.8%) strains, and the following resistance gene cassettes were identified: aadA2, aadA1, aadB, aac(6'), and catB8. Three types of variable region promoters were observed: PcS (4 strains), PcW (7 strains), and PcH1 (17 strains), with consistently inactive downstream P2 promoters. Additionally, Class 2 integrons were detected in 5 (6.3%) strains, carrying the variable region resistance gene cassette dfrA1-sat2-aadA1.The promoters for Class 2 integrons were uniformly of the Pc2D-Pc2A-Pc2B-Pc2C type. No Class integrons were detected. The strains containing integrons showed significantly higher resistance rates to ciprofloxacin, compound sulfamethoxazole, levofloxacin, gentamicin, amikacin, and tobramycin compared to those without integrons (P<0.05). 35 strains of Enterobacter cloacae carrying integrons are primarily classified into three genotypes: A, B, and C. These genotypes are mainly distributed in the urology department and Intensive Care Unit (ICU). The distribution of variable region gene boxes and promoter types is relatively concentrated in the same genotype.Our study confirmed that Enterobacter cloacae isolated from urine samples predominantly carries Class 1 integrons with an extended array of antibiotic-resistant genes. For future research, it is recommended to explore additional resistance mechanisms and evaluate the effectiveness of new therapeutic strategies. Clinicians should be vigilant about the possibility of clonal dissemination and implement enhanced infection control measures in hospital settings.

    Keywords: integron, Enterobacter cloacae, resistance gene, homology, antibiotic resistance

    Received: 10 Jul 2024; Accepted: 09 Sep 2024.

    Copyright: © 2024 Qiu, Zhang, Jiang, Wu, Li and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Xuedan Qiu, Department of Clinical Laboratory, The Affiliated Li Huili Hospital, Ningbo University,, Ningbo, China
    Hui Zhang, Ninghai County Chengguan Hospital, Ningbo, Zhejiang Province, China
    Qiaoping Wu, Department of Clinical Laboratory, The Affiliated Li Huili Hospital, Ningbo University,, Ningbo, China
    Qingcao Li, Department of Clinical Laboratory, The Affiliated Li Huili Hospital, Ningbo University,, Ningbo, China
    Guangliang Wu, The Affiliated Li Huili Hospital, Ningbo University, Ningbo, Zhejiang Province, China

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