Our objectives were to investigate the extended-spectrum beta-lactamases (ESBLs) and carbapenemases (CR) genetic determinants and to assess the association between ESBL production and quinolone resistance in bacterial strains isolated from renal transplant recipients with urinary tract infections. Material and methods: A number of 30 isolates were recovered from urine specimens of patients with renal transplant from October 2015 to March 2016. The isolates were analyzed for ESBL production using double disc synergy test and for CR production by the Hodge test. Phenotypically confirmed isolates were screened by PCR for the identification of ESBL, CR and fluoroquinolone resistance genes. Results: The 30 clinical bacterial strains isolated from urinary tract infections in renal transplant recipients were identified as Klebsiella pneumoniae (17), Pseudomonas aeruginosa (7), Morganella morganii (2), Escherichia coli (2), Edwardsiella tarda (1) and Enterobacter cloacae (1). Out of them, 22 isolates were ESBL producers and 20 multi-drug resistant (MDR) (i.e., 13 K. pneumoniae and 7 P. aeruginosa strains). More than half of the ESBL clinical strains (14/22, 63.63%) revealed at least one ESBL gene, the most frequent being blaCTX-M type (18/22, 81.81%), either alone (4/22, 18.18%) or in combination with another ESBL gene (17/22, 77.27%), followed by blaTEM (13/22, 59.09%). The blaOXA-48 was present in 10 isolates (33.33%). The most frequent association of ESBLs and CR genes (5/14, 35.71%) was revealed by blaCTX-M- blaTEM - blaOXA-48, encountered particularly among K. pneumoniae isolates (4/17, 23.52%). The qnrB gene was identified in five strains, i.e. one P. aeruginosa ESBL isolate (expressing the blaCTX-M gene) and four K. pneumoniae ESBL isolates (harboring the blaCTX-M - blaTEM genes combination). Conclusions: The uropathogenic strains isolated from renal transplant recipients exhibited high rates of MDR and beta-lactam resistance. The selective pressure exerted by quinolones could enable uropathogenic bacteria to acquire resistance to this class of antibiotics.
In recent years, a significant number of epidemiological variations have been observed for fungal infections. In immunocompromised patients, Candida albicans is crucially involved in invasive infections, mostly originating in respiratory tract colonization. The global rise in candidiasis has led researchers to investigate possible correlations between fungal strains virulence profiles and their pathogenic potential, among the most investigated genes being those involved in adherence and biofilm development. In this study, we established the adherence gene profiles of C. albicans strains isolated from respiratory tract secretions in patients hospitalized for cardiovascular diseases and correlated them with the ability of the respective strains to colonize the epithelial cells and form biofilms on the inert substratum. The strains isolated from the lower respiratory tract exhibited the highest adherence capacity and were intensive biofilm producers. The SAP9, ALS3, ALS5, and ALS6 genes were the most frequently detected. There was a significant association between the presence of ALS 3 gene and the cellular substrate colonizing potential of the harboring strains. We also found that the strains expressing SAP9 were more virulent in the phenotypic assays. Detecting the presence of adherence genes from different clinical isolates is a cost-effective tool that would allow researchers to predict the virulence of a certain strain and estimate its potential to adhere to host cells and develop biofilms.