fa بررسی ژنتیکی سویه‌های بالینی اشریشیاکلی جدا‌شده از عفونت‌های ادراری و ارزیابی ژن مقاومت به کینولون‌ها (qnrA) با روش PCR بيماريهاي عفوني Infectious Diseases پژوهشي Original <span style="font-size:12pt"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.1pt">سابقه و هدف:</span></span></span></span></span></span></b>&nbsp;<span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">باکتری اشریشیاکلی</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">باعث 90-80 درصد عفونت‌های ادراری در بیماران سرپایی و 50-30</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">درصد عفونت‌های ادراری در بیماران بستری است. در درمان عفونت‌های مجاری ادراری ناشی </span></span><span lang="AR-SA" style="font-size:9.0pt"><span b="" nazanin="" style="font-family:">از</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">E. coli </span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">، درمان آنتی‌بیوتیکی نامناسب باعث افزایش میزان مقاومت آنتی‌بیوتیکی در سویه‌های</span></span> <span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">E. coli </span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">جداشده از عفونت ادراری طی چند دهه گذشته شده است. هدف از این مطالعه بررسی و تایید سویه‌های </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">E. coli </span></span>&nbsp;<span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">جداشده از بیماران بستری در بیمارستان سینای همدان و تعیین مقاومت آنتی‌بیوتیکی آن‌ها و </span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ارزیابی فراوانی ژن مقاومت آنتی‌بیوتیکی</span></span> <span dir="LTR" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">qnrA </span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">بوده است.</span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:BNazanin"></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">مواد و روش‌‌ها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">:</span></span></span></span></span></b><b>&nbsp;</b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">در این مطالعه</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">مقطعی</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">، 100 سویه از باکتری </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">E. coli</span></span> &nbsp;<span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">که از عفونت‌های دستگاه ادراری بیماران بستری در بیمارستان سینا در شهر همدان جمع‌آوری شده بودند، با استفاده از روش‌های فنوتیپی و مولکولی </span></span><span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">مطالعه</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> شده‌اند. الگوی مقاومت آنتی‌بیوتیکی با استفاده از روش دیسک دیفیوژن و ارزیابی پرایمرهای خاص ژن مقاومت آنتی‌بیوتیکی </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">qnrA</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">با</span></span><span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> روش</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">PCR</span></span> &nbsp;<span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">انجام شده است.</span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:BNazanin"></span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">یافته‌ها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">:</span></span></span></span></span></b>&nbsp;<span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">در مجموع از بین 100 سویه </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">E.coli</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">تاییدشده نهایی، 70 درصد سویه‌ها به نالیدیکسیک اسید،53</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">درصد به لووفلوکساسین و 59 درصد به سیپروفلوکساسین مقاوم بوده‌اند</span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:BNazanin">.</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"> فراوانی ژن مقاومت </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">qnrA</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">بین سویه‌ها 28 درصد بوده است</span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:BNazanin">.</span></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-autospace:none"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#274cc3"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">نتیجه‌گیری:</span></span></span></span></span></span></b><b>&nbsp;</b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">مطالعه حاضر مقاومت بالای </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">E.coli</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">به کینولون‌ها را نشان داده است؛ همچنین حضور ژن </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">qnrA</span></span> <span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">می‌تواند از عوامل این مقاومت باشد</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">. </span></span></span></span></span></span></span></span><br> &nbsp; <span style="font-size:12pt"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:.15pt">Background and Objective:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">Escherichia coli is responsible for </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">80-90% </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">of urinary infections in outpatients and 30-</span></span><span style="font-size:9.0pt"><span style="font-family:Optima">50% </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">of urinary infections in inpatients. The selection of inappropriate antibiotics for treatment has led to an increase in antibiotic resistance in E. coli isolates over the past few decades. The aim of this study was the phonotypical and molecular investigation of E. coli strains isolated from urinary tract infections and study the pattern of antibiotic resistance. We also evaluated the frequency of antibiotic resistance genes of qnrA in relation to quinolone resistance genes.</span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3">Materials and Methods:</span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">In<b> </b>this cross-sectional study, </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">100 </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">E. coli strains isolated from urinary tract infections of patients admitted to Sina Hospital in Hamadan City were collected and studied by phenotypically and molecular methods. An antibiotic resistance pattern was determined using the disk diffusion method, and specific primers for the qnrA antibiotic resistance gene were evaluated using the polymerase chain reaction method. </span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:.15pt">Results:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima">Finally, among 100 confirmed E. coli isolates,</span></span><span style="font-size:9.0pt"><span style="font-family:Optima"> 70% </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">of the strains were resistant to nalidixic acid, </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">53% </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">to levofloxacin, and </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">59% </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">to ciprofloxacin. The frequency of <a name="_Hlk171550415">the qnrA</a> resistance gene was </span></span><span style="font-size:9.0pt"><span style="font-family:Optima">28%</span></span><span style="font-size:9.0pt"><span style="font-family:Optima">.</span></span></span></span></span></span></span><br> <b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#274cc3"><span style="letter-spacing:-.1pt">Conclusion:</span></span></span></span></b> <span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:black">The present study showed the high resistance of E. coli to quinolones</span></span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times=""><span style="color:black">.</span></span></span><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:black"> The presence of the qnrA gene can be one of the factors contributing to this resistance</span></span></span> اشریشیا‌کلی, عفونت ادراری, کینولون‌ها, مقاومت آنتی بیوتیکی Antibiotic Resistance, Escherichia coli, Quinolones, Urinary Tract Infection 206 212 http://sjh.umsha.ac.ir/browse.php?a_code=A-12-2471-2&slc_lang=fa&sid=1 Maryam Adabi مریم آدابی 100319475328460023453 100319475328460023453 No Infection Disease Research Center, Hamadan University of Medical Sciences, Hamadan, Iran مرکز تحقیقات بیماری‌های عفونی، دانشگاه علوم پزشکی همدان، همدان، ایران Elham Abdoli الهام عبدلی eabdoli8387@yahoo.com 100319475328460023454 100319475328460023454 No Infection Disease Research Center, Hamadan University of Medical Sciences, Hamadan, Iran مرکز تحقیقات بیماری‌های عفونی، دانشگاه علوم پزشکی همدان، همدان، ایران Marzieh Varasteh Shams مرضیه وارسته شمس 100319475328460023455 100319475328460023455 Yes Comprehensive Research Laboratory, Hamadan University of Medical Sciences, Hamadan, Iran آزمایشگاه جامع تحقیقات، دانشگاه علوم پزشکی همدان، همدان، ایران Fatemeh Batmani فاطمه باتمانی 100319475328460023456 100319475328460023456 No School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran دانشکده پزشکی، دانشگاه علوم پزشکی همدان، همدان، ایران