Evaluation of Efflux pump activity among Uropathogenic Escherichia coli and Klebsiella pneumonia multiple- Drug Resistance isolates

Antibiotic resistance is a phenomenon in which antibiotic used to treat bacteria becomes useless due to resistance mechanism. Increased drug resistance and occurrence of Multiple Drug Resistance in bacteria specificity nosocomial and Urinary Tract Infection bacteria has reduced the possibilities of treating these infectious diseases. Efflux pumps are one of the major mechanism of MDR in bacteria which effluxes out the drugs accumulated . Various MDR phenotypes that confer active protection against environmental toxic compounds by efflux mechanisms have been described in Enterobacteriaceae. The aim of this study was evaluation of efflux pumps in Uropathogenic Escherichia coli and Klebsiella pneumonia MDR isolates. 41 UPEC and 37 Klebsiella MDR strains that were isolated from urine samples and identified by biochemical tests were determined by disc diffusion method according to CLSI. The ETBr-agar cartwheel method with different concentrations of Ethidium bromide was used to assess the presence of efflux activity. Our results showed that among UPEC isolates 39%, 9.8% and 51.2% had High, moderate and no efflux activity. Among klebsiella pneumonia isolates 27%, 24.32% and 48.64 % had High , moderate and no activity, respectively. Also the frequency of UPEC bacteria with over expression of efflux pumps was 80% but for Klebsiella pneumonia isolates 52% was reported. UPEC isolates had more actively efflux pumps than Klebsiella isolates.Both bacterial isolates had ability to use efflux antibiotics out. The Et-Br cartwheel method could be used as a simple method for determining the phenotypic activity of efflux pump in UPEC and K. pneumoniae MDR isolates.