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Integrons and Efflux Pump-Mediated Antibiotic Resistance in Multidrug-Resistant (MDR) Uropathogenic Escherichia coli

Mohammad Amin Gonbadi1, Yasaman Dini1, Mohsen Mohammadi2

  • 1Student Research Committee, Babol University of Medical Sciences, Babol, Iran, mubabol.ac.ir.

Biomed Research International
|April 2, 2026
PubMed
Abstract

Insights

Class 1 and 2 integrons and the AcrAB-TolC efflux pump are prevalent in E. coli causing urinary tract infections. These genetic elements contribute to multidrug resistance, highlighting the need for better antibiotic stewardship.

Area of Science:

  • Microbiology
  • Genetics
  • Infectious Diseases

Background:

  • Integrons are genetic platforms that facilitate the acquisition and expression of antibiotic resistance genes.
  • Class 1 and 2 integrons are frequently identified in clinical isolates of Escherichia coli.
  • The AcrAB-TolC efflux pump is a major facilitator of antimicrobial resistance in bacteria.

Purpose of the Study:

  • To determine the prevalence of Class 1 and 2 integrons in Uropathogenic E. coli (UPEC) isolates from urinary tract infection (UTI) patients.
  • To investigate the presence of the AcrAB-TolC efflux pump in UPEC isolates.
  • To assess the association between integrons, efflux pumps, and antibiotic resistance patterns in UPEC.

Main Methods:

  • A cross-sectional study involving 155 UPEC isolates from UTI patients in Babol, Iran (2021-2023).
  • Isolate identification using biochemical and genotypic methods.
  • Antimicrobial susceptibility testing via disk diffusion.
  • Detection of integron and efflux pump genes using Polymerase Chain Reaction (PCR).

Main Results:

  • Class 1 integrons were detected in 85.2% of isolates, and Class 2 integrons in 23.2%.
  • Integron-positive isolates showed higher resistance to trimethoprim-sulfamethoxazole and nalidixic acid.
  • Over 88% of isolates harbored AcrAB-TolC efflux pump genes, with high multidrug resistance (MDR) rates observed in integron-positive isolates.

Conclusions:

  • Integrons play a significant role in the dissemination of antibiotic resistance among UPEC.
  • The AcrAB-TolC efflux pump contributes to the expulsion of antimicrobial agents.
  • Effective infection control and judicious antibiotic use are crucial to mitigate resistance spread.
Keywords:
antibiotic resistanceefflux pumpsintegronsmultidrug resistance (MDR)uropathogenic Escherichia coli (UPEC)

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