ArticleAnnals of clinical microbiology and antimicrobials2025
Nitrofurantoin resistance mechanisms in uropathogenic Escherichia coli isolates from Iran.
Article in Annals of clinical microbiology and antimicrobials, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Study of the Impact of Antibiotic Combinations Used in Urinary Tract Infections on the Effectiveness of Antimicrobial Therapy.Journal of clinical medicine · 2026Article
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Abstract
backgroundNitrofurantoin is an antibiotic that demonstrates good efficacy in the treatment of uncomplicated urinary tract infections (UTIs), especially those caused by uropathogenic Escherichia coli (UPEC). However, recent reports about the emergence of nitrofurantoin resistance in UPEC are concerning. This study aimed to investigate the genetic diversity of nitrofurantoin-resistant UPEC isolates and their characteristics.
methodsIn this cross-sectional study, 235 UPEC isolates collected from Ahvaz, Iran were investigated for resistance to nitrofurantoin. To evaluate the mechanism of this resistance, two groups of chromosomal genes (nfsA, nfsB, and ribE) and plasmid genes (oqxA and oqxB) were investigated by PCR. The nfsA, nfsB, and ribE genes were sequenced and variations of them were analyzed. The phenotypic and genotypic characteristics of the isolates were investigated.
resultsIn total, six (2.55%) nitrofurantoin-resistant UPEC isolates were identified. The oqxA and oqxB genes and mutations in ribE were not detected. Several deleterious mutations in NfsA (G130D, S39G, H11Y, and ΔW77-F79), and NfsB (N42H, W46R, and H80Y), as well as several neutral mutations in both genes were detected. To our knowledge, the NfsB mutations N42H and H80Y have not been previously reported, suggesting potential novelty. All these isolates were multidrug-resistant (MDR). Although all were non-motile and non-hemolytic, some showed biofilm and cellulose production. Three isolates belonged to the B2 group, while the others belonged to the B1, A, and F groups. Pathogenicity islands (PAIs) IV
conclusionWe concluded that in our studied isolates, deleterious mutation in chromosomal genes nfsA, nfsB, or both is likely drivers of resistance to nitrofurantoin and the changes caused by gene ribE and the presence of plasmid genes oqxAB are at the next levels of importance. Examination of the phenotypic and genetic characteristics of the isolates demonstrates that these mutations may occur in some isolates with high antimicrobial resistance and virulence, highlighting the need for broader studies to assess their epidemiological significance.
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