Significant association between genes encoding virulence factors with antibiotic resistance and phylogenetic groups in community acquired uropathogenic Escherichia coli isolates.

BACKGROUND: Antibiotic resistance is an increasing phenomenon in many bacterial pathogens including uropathogenic Escherichia coli. Hypothetical anti-virulent agents could be a solution, but first clear virulence associated gene-pool of antibiotic resistant isolates have to be determined. The aim of this study is to investigate the significant associations between genes encoding VFs with antibiotic resistance and phylogenetic groups in UPEC isolates. RESULTS: The majority of 248 UPEC isolates belonged to phylogenetic group B2 (67.3%). The maximum and minimum resistance was attributed to amoxicillin (90.3%) and both fosfomycin and imipenem (1.6%) respectively. 11.3% of isolates were resistant to all antibiotic agents except that of imipenem, nitrofurantoin and fosfomycin. These highly resistant isolates were placed only in group B2 and D. The most prevalent virulence gene was ompA (93.5%). The hlyA was the only virulence gene that was significantly more prevalent in the highly resistant isolates. The ompA, malX and hlyA genes were obviously more abundant in the antibiotic resistant isolates in comparison to susceptible isolates. The papC gene was associated with amoxicillin resistance (p-value = 0.006, odds ratio: 26.00). CONCLUSIONS: Increased resistance to first line drugs prescribed for UTIs were detected in CA-UPEC isolates in our study.. Minimal resistance was observed against nitrofurantoin, fosfomycin and imipenem. Therefore, they are introduced for application in empirical therapy of UTIs. Fosfomycin may be the most effective antibiotic agent against highly resistant UPEC isolates. The presence of the ompA, malX and hlyA genes were significantly associated with resistance to different antibiotic agents. We assume that the ability of UPEC isolates to upgrade their antibiotic resistance capacity may occurs in compliance with the preliminary existence of specific virulence associated genes. But, more investigation with higher number of bacterial isolates, further virulence associated genes and comparison of gene pools from CA-UPEC isolates with HA-UPEC are proposed to confirm these finding and discovering new aspects of this association.

Human bocavirus infections and co-infections with respiratory syncytial virus and Rotavirus in children with acute respiratory or gastrointestinal disease.

The objective of this study was to determine the frequency and seasonal distributions of HBoV detections among Iranian children presenting with acute respiratory or gastrointestinal symptoms and to compare infections among children with concomitant respiratory syncytial virus (RSV) and rotavirus (RV) infections. A cross-sectional study at Mofid Children's Hospital in Tehran, Iran, enrolled children < 3 years old presenting with either acute respiratory or gastrointestinal symptoms during the period of 2017-2018. Respiratory or stool specimens collected from each group were initially tested by RT-PCR assays for RSV and RV, respectively, and all specimens were tested for HBoV by PCR assay. Clinical and demographic data were collected and statistically compared. Five hundred respiratory and stool specimens each were tested and 67 (13.4%) and 72 (14.4%) were PCR positive for HBoV, respectively. Of 128 (25.6%) respiratory specimens positive for RSV, 65% were also positive for HBoV (p = 0.019); of 169 (33.8%) stool specimens positive for RV, 62.5% were also positive for HBoV (p = 0.023). Peak circulation of all viruses was during late winter and early spring months (Jan-Mar) in gastrointestinal infections and during winter (Feb-Jan) in respiratory infections. HBoV is commonly detected among Iranian children presenting with acute respiratory or gastrointestinal symptoms and is often present as co-infections with RSV and RV, respectively.