Journal of Pediatric Research (Dec 2019)

Evaluation of Resistance to Ciprofloxacin and Identification of Mutations in Topoisomerase Genes in Escherichia coli and Klebsiella pneumonia Isolated from Pediatric Urinary Tract Infections

  • Keyghobad Ghadiri,
  • Alisha Akya,
  • Azam Elahi,
  • Somaye Jafari,
  • Roya Chegenelorestani

DOI
https://doi.org/10.4274/jpr.galenos.2019.16362
Journal volume & issue
Vol. 6, no. 4
pp. 322 – 328

Abstract

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Aim:Urinary tract infection (UTI) is one of the common infectious diseases of children. Due to the limited use of fluoroquinolones in children, they still have no resistance problems as seen in the adult population. However, recent reports suggested an increase in resistance to fluoroquinolones among bacteria causing UTI in children. Therefore, the aim of this study is to evaluate the prevalence of Escherichia coli and Klebsiella pneumoniae isolates resistant to ciprofloxacin and to detect mutations in their gyrA and parC genes.Materials and Methods:The present study is conducted on 78 bacterial strains isolated from children with UTI during 2016-2017 at İmam Reza Hospital in Kermanshah, Iran. The bacteria were identified based on microbiological methods and an antibiotic susceptibility test using disc diffusion and broth microdilution methods. Then, polymerase chain reaction and sequencing were performed to investigate mutations in the gyrA and parC genes.Results:Overall, 15.3% of isolates of E. coli and K. pneumonia were resistant to ciprofloxacin. Sequence analysis confirmed mutations in the gyrA and parC genes in all of the isolates resistant to ciprofloxacin. The results showed changes in amino acids (ser83leu, ser83phe and Asp87Asn) in codons 83 and 87 in the quinolone resistance-determining regions of the gyrA gene, three substitutions in both the 80 and 84 positions in the parC, ser80Ile, Glu84val and Glu84lys genes.Conclusion:The results of this study revealed resistance to ciprofloxacin in the pediatric population. Given that the use of ciprofloxacin in children is limited, this resistance cannot be due to antibiotic selective pressure. On the other hand, the mutations in the gyrA and parC genes in children was similar to that in adults which indicate that these resistant isolates can be transmitted from adults to children.

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