Quinolone resistance mediated by mutations in gyrA and parC genes among E. coli isolates from patients with urinary tract infections

Mohammed, Luma Mohsin; Kuzukiran, Özgür; Al. Rubaye, Ilham Abdulhadi Khalaf

doi:10.21608/mid.2024.328193.2281

Quinolone resistance mediated by mutations in gyrA and parC genes among E. coli isolates from patients with urinary tract infections

Articles in Press

Document Type : Original Article

Authors

¹ Department of biology in graduate, Graduate School of Natural and Applied Sciences, Çankiri Karatekin University, Turkey.

² Veterinary department laboratory and veterinary health program, Eldivan health services vocational school, Cankiri karatekin university, Turkey

³ Scientific researcher in Al-Razi center for research and medical diagnostic kits production. Iraq

10.21608/mid.2024.328193.2281

Abstract

Background: Urinary tract infections are common, with Escherichia coli as the primary pathogen. Increasing resistance to fluoroquinolones is a global concern. Aim: The study aimed to evaluate fluoroquinolone resistance in Escherichia coli isolates obtained from urinary tract infection patients and to identify specific genetic mutations in the gyrA and parC genes associated with this resistance. Methods: In a cross-sectional study, 120 urine samples from UTI patients in Baghdad (March-April 2023) were analyzed. E. coli was cultured, identified, and tested for susceptibility to Norfloxacin, Levofloxacin, and Ciprofloxacin. PCR and sequencing were used to detect mutations in 20 resistant isolates. Results: The study revealed a higher prevalence of UTIs in females (70.0%) compared to males (30.0%). Age groups 21-40 years (37.5%) and 41-60 years (30.0%) had the highest infection rates, while the youngest (<1 year) and oldest (>80 years) groups had the lowest (3.3% each). E. coli exhibited high resistance to fluoroquinolones: 66.7% to Norfloxacin, 72.5% to Levofloxacin, and 64.2% to Ciprofloxacin. Sequencing identified mutations in the gyrA (466 bp) and parC (540 bp) genes of fluoroquinolone-resistant isolates. Conclusion: This study concludes that alternative therapies and stricter antibiotic policies are urgently needed to combat high fluoroquinolone resistance in E. coli, driven by gyrA and parC mutations. Routine genetic monitoring and cautious fluoroquinolone use are recommended to improve treatment outcomes and reduce resistance spread, underscoring the importance of coordinated public health strategies.

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