Phenotypic and Genotypic Efflux Pumps in Resistance to Fluoroquinolones in E.coli Isolated from Inpatients in Kermanshah Hospitals in 2013

Abstract Background: Antibiotic resistance rates in E. coli are rapidly rising, especially with regard to fluoroquinolones. One of the mechanisms that lead to antibiotic resistance is efflux pumps. The aim of this study was phonotypic and genotypic analysis of efflux pump role in fluoroquinolones resistance of E. coli strains isolated from hospitalized patients in Kermanshah 2013. Materials and Methods: In this cross-sectional study, 100 isolates of E. coli were collected from hospitalized patients from Kermanshah. All isolates were identified by standard biochemical tests. The antimicrobial susceptibility patterns were determined by disk diffusion method according to CLSI guidelines. The presence of Efflux pump genes was determined by a PCR method. Results: The rates of resistance to Ceftazidime, Nalidixic Acid, Ciprofloxacin, Norfloxacin, Ofloxacin, Gentamicin, and Tetracycline were 73%, 67%, 55%, 54%, 45%, 38%, and 24%, respectively. According to the results of PCR test, of 100 E. coli isolates, 99% of isolates were positive for acrA, 98% for acrB, 95% for acrE, 98% for acrF, 94% for mdfA, 96% for norE, and 96% for tolC. Conclusion: In Strains with positive gene acrA, acrB, acrA, acrB, tolC, mdfA, norE, the presence of efflux pump inhibitor reduced the amount of resistance to antibiotics. So, efflux pumps are important in antibiotic resistance