OBJECTIVES: Uropathogenic Escherichia coli (UPEC) are the major cause of urinary tract infections (UTIs). Here, we determined whether sensitivity to antibiotics was related to the prevalence of iron scavenging genes, or to biofilm and hemolysis formation. METHODS: A total of 110 UPEC and 30 E coli isolates were collected from the urine of UTI patients and feces of healthy individuals without UTI, respectively. The presence of iron receptor genes and phenotypic properties were evaluated by polymerase chain reaction and phenotypic methods, respectively. Susceptibility to routine antibiotics was evaluated using the disc diffusion method. RESULTS: The prevalence of iron scavenging genes ranged from 21.8% (ireA) to 84.5% (chuA) in the UPEC. Resistance to ceftazidime and cefotaxime was significantly correlated with the presence of fyuA and iutA iron genes. Biofilm production was significantly associated with the prevalence of fyuA and hma iron genes. A higher degree of antibiotic resistance was exhibited by isolates that produced biofilms than by their non-biofilm producing counterparts. CONCLUSION: Our study clearly indicates that biofilm production is associated with antibiotic resistance, and that iron receptors and hemolysin production also contribute to reduced antibiotic sensitivity. These results further our understanding of the role that these virulence factors play during UPEC pathogenesis, which in turn may be valuable for the development of novel treatment strategies against UTIs.
Anti-Bacterial Agents ; Biofilms ; Cefotaxime ; Ceftazidime ; Diffusion ; Drug Resistance, Microbial ; Escherichia coli* ; Escherichia* ; Feces ; Hemolysis ; Humans ; Iran* ; Iron ; Methods ; Polymerase Chain Reaction ; Prevalence ; Urinary Tract Infections* ; Urinary Tract* ; Uropathogenic Escherichia coli ; Virulence Factors* ; Virulence*

Objective: To examine the effect of acupuncture-like transcutaneous electrical nerve stimulation (ACUTENS) on labor pain in nulliparous women. Methods: This randomized clinical trial was conducted at Razi Hospital in Qazvin, Iran between January and July 2018. After the screening process, 144 out of 184 pregnant women were selected by convenience sampling and assigned to an intervention group or a control group by the block randomization method. The intervention group received ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) during various stages of delivery in addition to routine labor care at the delivery room. For the control group, the same routine labor care was performed alone. The severity of pain was assessed in the two groups using the visual analog scale (VAS). The data were analyzed using R software (ver. 4.0.2) and repeated measurement analysis of variance. Results: ACUTENS reduced the mean score of pain intensity in the first stage of labor in the intervention group more than that in the control group (P<0.001). Also, the mean scores of pain intensity in the second stage of labor, episiotomy, and one hour after delivery in the intervention group were significantly lower than those in the control group (P<0.001). Conclusion: ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) can decrease the intensity of labor pain in nulliparous women. It can be used as a non-pharmacological method for reducing pain in and after labor.