The dissemination of antibiotic resistance in Escherichia coli poses a significant threat to public health worldwide. This review provides a comprehensive update on the diverse mechanisms employed by E. coli in developing resistance to antibiotics. We primarily focus on pathotypes of E. coli (e.g., uropathogenic E. coli) and investigate the genetic determinants and molecular pathways that confer resistance, shedding light on both well-characterized and recently discovered mechanisms. The most prevalent mechanism continues to be the acquisition of resistance genes through horizontal gene transfer, facilitated by mobile genetic elements such as plasmids and transposons. We discuss the role of extended-spectrum β-lactamases (ESBLs) and carbapenemases in conferring resistance to β-lactam antibiotics, which remain vital in clinical practice. The review covers the key resistant mechanisms, including: 1) Efflux pumps and porin mutations that mediate resistance to a broad spectrum of antibiotics, including fluoroquinolones and aminoglycosides; 2) adaptive strategies employed by E. coli, including biofilm formation, persister cell formation, and the activation of stress response systems, to withstand antibiotic pressure; and 3) the role of regulatory systems in coordinating resistance mechanisms, providing insights into potential targets for therapeutic interventions. Understanding the intricate network of antibiotic resistance mechanisms in E. coli is crucial for the development of effective strategies to combat this growing public health crisis. By clarifying these mechanisms, we aim to pave the way for the design of innovative therapeutic approaches and the implementation of prudent antibiotic stewardship practices to preserve the efficacy of current antibiotics and ensure a sustainable future for healthcare.

Listeria monocytogenes as the main causative agent of human listeriosis is an intracellular bacterium that has the capability to infect a wide range of cell types. Human listeriosis is a sporadic foodborne disease, which is epidemiologically linked with consumption of contaminated food products. Listeriosis may range from mild and self-limiting diseases in healthy people to severe systemic infections in susceptible populations. This study aimed to investigate the prevalence of L. monocytogenes in food resources and human samples from Iran. A systematic search was performed by using electronic databases from papers that were published by Iranian authors Since January of 2000 to the end of April 2017. Then, 47 publications which met our inclusion criteria were selected for data extraction and analysis by Comprehensive Meta-Analysis Software. The pooled prevalence of L. monocytogenes in human origin was 10% (95% CI: 7–12%) ranging from 0 to 28%. The prevalence of L. monocytogenes in animals was estimated at 7% (95% CI: 4–10%) ranging from 1 to 18%. Moreover, the pooled prevalence of L. monocytogenes in Iranian food samples was estimated at 4% (95% CI: 3–5%) ranging from 0 to 50%. From those 12 studies which reported the distribution of L. monocytogenes serotypes, it was concluded that 4b, 1/2a, and 1/2b were the most prevalent serotypes. The prevalence of L. monocytogenes and prevalent serotypes in Iran are comparable with other parts of the world. Although the overall prevalence of human cross-contamination origin was low, awareness about the source of contamination is very important because of the higher incidence of infections in susceptible groups.

The role of integrons in the transfer of antibiotic resistance is one of the important issues, therefore, this study is aimed to investigate antibiotic resistance pattern and prevalence of class 1 and 2 integrons in P. aeruginosa isolated. Out of 72 confirmed P. aeruginosa isolates, 50% were from ICU patients. Antibacterial susceptibility pattern showed that isolates were most resistant to ceftazidime (76.4%) and colistin was the most effective antibiotic (100%) and molecular analysis of class I and II integrons showed 55.5% and 29.1% of isolates were positive, respectively and the proportions of MDR isolates were significantly higher among integron-positive isolates with 73.6% compared to negative isolates with 22.9%. Our results showed that there was a correlation among class 1 and 2 integrons with MDR P. aeruginosa isolates. According to the importance of integrons in acquisition and dissemination of antibiotics resistance genes, the performance of antibiotic surveillance programs and investigating the role of integrons is recommended to control the spreading of antibiotics resistance genes.

Introduction. Urinary tract infection (UTI) is one of the most frequent infections in kidney transplant patients (KTPs). This infection is mainly caused by uropathogenic Escherichia coli (UPEC). Plasmid‐mediated quinolone resistance (PMQR) was also increasingly identified in UPEC. This study proposed to investigate the frequency of quinolone‐resistance plasmid genes and the O‐antigen serogroup among UPEC isolated from KTPs and non‐KTP with UTI. Methods. Totally, 114 UPEC isolates from 49 KTPs and 65 non‐KTPs patients diagnosed with an UPEC‐associated UTI were obtained from June 2019 to December 2019 at three laboratory centers in Isfahan, Iran. The isolates were confirmed through phenotypic and genotypic methods. Moreover, the antimicrobial susceptibility test to nalidixic acid, ciprofloxacin, norfloxacin, and ofloxacin was performed using a disk diffusion method. The presence of the qnr gene as well as the serogroup distribution was identified using the PCR method. Result. According to data, the distribution of O1, O2, O4, O16, and O25 serogroups were 3.5%, 2.6, 3.5, 3.5, and 20.2%, respectively. Antibiotic susceptibility pattern revealed that the highest and lowest resistance rates were to nalidixic acid (69.3%) and norfloxacin (43.9%), respectively. Also, the frequency of qnrS and qnrB genes were 33.3% and 15.8%, respectively, while none of the isolates was found to be positive for the qnrA gene. There was no significant association between the presence of qnr genes and higher antibiotic resistance. Conclusion. This study recognized that the qnrS gene, O25 serotype, and resistance to nalidixic acid had the highest frequencies in UPEC strains isolated from UTI patients.

Objectives. To avoid worsening from mild, moderate, and severe diseases and to reduce mortality, it is necessary to identify the subpopulation that is more vulnerable to the development of COVID‐19 unfavorable consequences. This study aims to investigate the demographic information, prevalence rates of common comorbidities among negative and positive real‐time reverse‐transcriptase polymerase chain reaction (rRT‐PCR) patients, and the association between SARS‐CoV‐2 cycle threshold (Ct) at hospital admission, demographic data, and outcomes of the patients in a large population in Northern Iran. Methods. This large retrospective cross‐sectional study was performed from 7 March to 20 December 2020. Demographic data, including gender, age, underlying diseases, clinical outcomes, and Ct values, were obtained from 8,318 cases suspected of COVID‐19, who were admitted to four teaching hospitals affiliated to Babol University of Medical Sciences (MUBABOL), in the north of Iran. Results. Since 7 March 2020, the data were collected from 8,318 cases suspected of COVID‐19 (48.5% female and 51.5% male) with a mean age of 53 ± 25.3 years. Among 8,318 suspected COVID‐19 patients, 3,250 (39.1%) had a positive rRT‐PCR result; 1,632 (50.2%) patients were male and 335 (10.3%) patients died during their hospital stay. The distribution of positive rRT‐PCR revealed that most patients (464 (75.7%)) had a Ct between 21 and 30 (Group B). Conclusion. Elderly patients, lower Ct, patients having at least one comorbidity, and male cases were significantly associated with increased risk for COVID‐19‐related mortality. Moreover, mortality was significantly higher in patients with diabetes, kidney disease, and respiratory disease.