{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T19:41:14Z","timestamp":1767987674315,"version":"3.49.0"},"reference-count":98,"publisher":"Akademiai Kiado Zrt.","issue":"3","funder":[{"name":"School of Medicine, Shahid Beheshti University of Medical Sciences","award":["6965"],"award-info":[{"award-number":["6965"]}]}],"content-domain":{"domain":["akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMicr"],"published-print":{"date-parts":[[2020,10,21]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Antibiotic resistance and especially multiresistance in Enterococci, is a serious public health issue especially in infections of immunocompromised patients. EfrAB is a heterodimeric multidrug ATP-binding cassette (ABC) transporter that causes endogenous resistance to antimicrobials including fluoroquinolones in<jats:italic>Enterococcus<\/jats:italic>spp. The aim of this study was to seek the gene expression rate and role of<jats:italic>efrAB<\/jats:italic>efflux pump in ciprofloxacin resistant<jats:italic>Enterococcus faecalis<\/jats:italic>and Multilocus Sequence Typing (MLST) of multiresistant isolates. Phenotypic and genotyping identification of 80<jats:italic>E. faecalis<\/jats:italic>isolates were performed. Minimum inhibitory concentrations (MICs) to ciprofloxacin (CIP) were measured with and without carbonylcyanide 3-chlorophenylhydrazone (CCCP) by broth microdilution. After DNA extraction and sequencing for detection of<jats:italic>efrA<\/jats:italic>and<jats:italic>efrB<\/jats:italic>genes, the e<jats:italic>frAB<\/jats:italic>efflux positive isolates that were resistant to ciprofloxacin and showed decrease of ciprofloxacin MIC range were identified. Isolates that exhibited decrease in ciprofloxacin MIC range from two to ten folds were assessed for biofilm formation and finally, the expression levels of<jats:italic>efrB, efrA<\/jats:italic>genes were measured by quantitative Real-Time PCR (qRT-PCR). High rates of resistance to tetracycline and minocycline and low rates of resistance to the most antibiotics used in this study were detected. The results in this study indicated that the incidence of Multiple drug resistance (MDR) was 23.7% and all isolates that were resistant to ciprofloxacin revealed several degrees of overexpression in<jats:italic>efrA<\/jats:italic>and<jats:italic>efrB<\/jats:italic>genes. Our study found two ST480 and one ST847 in<jats:italic>E. faecalis<\/jats:italic>isolates. In conclusion, despite of low frequency of resistance to the most antibiotics and MDRs in our region, we found one ST480 isolate with resistance to eight antibiotics that also exists in other parts of the world.<\/jats:p>","DOI":"10.1556\/030.2020.01173","type":"journal-article","created":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T03:04:09Z","timestamp":1601694249000},"page":"187-192","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.1","source":"Crossref","is-referenced-by-count":7,"title":["Upregulation of efrAB efflux pump among Enterococcus faecalis ST480, ST847 in Iran"],"prefix":"10.1556","volume":"67","author":[{"given":"Seyedeh Marzieh Jabbari","family":"Shiadeh","sequence":"first","affiliation":[{"name":"1Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leila","family":"Azimi","sequence":"additional","affiliation":[{"name":"2Pediatric Infections Research Center, Mofid Children's Hospital, Shahid Beheshti, University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taher","family":"Azimi","sequence":"additional","affiliation":[{"name":"3Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Pourmohammad","sequence":"additional","affiliation":[{"name":"1Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehdi","family":"Goudarzi","sequence":"additional","affiliation":[{"name":"1Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bahare Gholami","family":"Chaboki","sequence":"additional","affiliation":[{"name":"4Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7258-5541","authenticated-orcid":true,"given":"Ali","family":"Hashemi","sequence":"additional","affiliation":[{"name":"1Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"425","reference":[{"key":"ref841","first-page":"179","article-title":"Enterococcus faecalis multi-drug resistance transporters: application for antibiotic discovery","volume":"3","author":"Pazoles","year":"2001","journal-title":"J Mol Microbiol Biotechnol"},{"key":"ref351","first-page":"179","article-title":"Enterococcus faecalis multi-drug resistance transporters: application for antibiotic discovery","volume":"3","author":"Pazoles","year":"2001","journal-title":"J Mol Microbiol Biotechnol"},{"key":"ref761","doi-asserted-by":"crossref","first-page":"e23349","DOI":"10.5812\/jjm.23349","article-title":"Antibiotic resistance and biofilm formation of Enterococcus faecalis in patient and environmental samples","volume":"8","author":"Talebi","year":"2015","journal-title":"Jundishapur J Microbiol"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"388","DOI":"10.4111\/kju.2013.54.6.388","article-title":"Ciprofloxacin resistance in Enterococcus faecalis strains isolated from male patients with complicated urinary tract infection","volume":"54","author":"Lee","year":"2013","journal-title":"Korean J Urol"},{"key":"ref341","volume-title":"Vancomycin-Resistant Enterococci (Vre). 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Dis"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1016\/j.fm.2009.03.005","article-title":"Antibiotic susceptibility of enterococci isolated from traditional fermented meat products","volume":"26","author":"Barbosa","year":"2009","journal-title":"Food Microbiol"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1093\/jac\/dkm071","article-title":"Reversal of resistance in microorganisms by help of non-antibiotics","volume":"59","author":"Kristiansen","year":"2007","journal-title":"J Antimicrob Chemother"},{"key":"ref581","first-page":"1768","article-title":"Impact of enterococcal urinary tract infections in immuno-compromised\u2013neoplastic patients","volume":"24","author":"Giannakopoulos","year":"2019","journal-title":"J BUON"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.fm.2014.01.008","article-title":"Prevalence and antibiotic resistance of Enterococcus spp. isolated from retail cheese, ready-to-eat salads, ham, and raw meat","volume":"41","author":"Pesavento","year":"2014","journal-title":"Food Microbiol"},{"key":"ref511","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.mib.2011.03.004","article-title":"Alternatives to antibiotics for the control of bacterial disease in aquaculture","volume":"14","author":"Defoirdt","year":"2011","journal-title":"Curr Opin Microbiol"},{"key":"ref171","first-page":"247","article-title":"In search of natural substrates and inhibitors of MDR pumps","volume":"3","author":"Lewis","year":"2001","journal-title":"J Mol Microbiol Biotechnol"},{"key":"ref361","first-page":"15","article-title":"Prevalence of multidrug resistant enterococci in nosocomial infection in Gaza strip","volume":"12","author":"Al-Jarousha","year":"2008","journal-title":"J Al-Aqsa Unv"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"2220","DOI":"10.1128\/JCM.02596-05","article-title":"Multilocus sequence typing scheme for Enterococcus 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Dis"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.fm.2014.06.009","article-title":"Role of EfrAB efflux pump in biocide tolerance and antibiotic resistance of Enterococcus faecalis and Enterococcus faecium isolated from traditional fermented foods and the effect of EDTA as EfrAB inhibitor","volume":"44","author":"Lerma","year":"2014","journal-title":"Food Microbiol"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"995","DOI":"10.1128\/mr.57.4.995-1017.1993","article-title":"ABC transporters: bacterial exporters","volume":"57","author":"Fath","year":"1993","journal-title":"Microbiol Rev"},{"key":"ref541","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.fm.2014.01.008","article-title":"Prevalence and antibiotic resistance of Enterococcus spp. isolated from retail cheese, ready-to-eat salads, ham, and raw meat","volume":"41","author":"Pesavento","year":"2014","journal-title":"Food Microbiol"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.fm.2014.06.009","article-title":"Role of EfrAB efflux pump in biocide tolerance and antibiotic resistance of Enterococcus faecalis and Enterococcus faecium isolated from traditional fermented foods and the effect of EDTA as EfrAB inhibitor","volume":"44","author":"Lerma","year":"2014","journal-title":"Food Microbiol"},{"key":"ref751","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1016\/j.ijantimicag.2010.10.032","article-title":"Nationwide survey of antibacterial activity against clinical isolates from urinary tract infections in Japan (2008)","volume":"37","author":"Matsumoto","year":"2011","journal-title":"Int J Antimicrob Agents"},{"key":"ref731","doi-asserted-by":"crossref","first-page":"239","DOI":"10.3201\/eid0402.980211","article-title":"Multiple-drug resistant enterococci: the nature of the problem and an agenda for the future","volume":"4","author":"Huycke","year":"1998","journal-title":"Emerg Infect Dis"},{"key":"ref711","first-page":"210","article-title":"Efficacy and safety of ciprofloxacin treatment in urinary tract infections (UTIs) in adults: a systematic review with meta-analysis","volume":"151","author":"Guti\u00e9rrez-Castrell\u00f3n","year":"2015","journal-title":"Gac Med Mexico"},{"key":"ref821","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1017\/ice.2018.165","article-title":"Enhanced disinfection leads to reduction of microbial contamination and a decrease in patient colonization and infection","volume":"39","author":"Rutala","year":"2018","journal-title":"Infect Cont Hosp Ep"},{"key":"ref11","first-page":"e5752","article-title":"Emerging antibiotic resistance to bacterial isolates from human urinary tract infections in Grenada","volume":"11","author":"Sharma","year":"2019","journal-title":"Cureus"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1128\/AAC.36.4.695","article-title":"Active efflux mechanisms for antimicrobial resistance","volume":"36","author":"Levy","year":"1992","journal-title":"Antimicrob Agents Chemother"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1476-0711-3-14","article-title":"Emerging resistance among bacterial pathogens in the intensive care unit \u2013 a European and North American Surveillance study (2000\u20132002)","volume":"3","author":"Jones","year":"2004","journal-title":"Ann Clin Microbiol Antimicrob"},{"key":"ref921","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1089\/fpd.2012.1279","article-title":"Phenotypic and molecular antibiotic resistance profile of Enterococcus faecalis and Enterococcus faecium isolated from different traditional fermented foods","volume":"10","author":"Sanchez Valenzuela","year":"2013","journal-title":"Foodborne Pathog Dis"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.mib.2011.03.004","article-title":"Alternatives to antibiotics for the control of bacterial disease in aquaculture","volume":"14","author":"Defoirdt","year":"2011","journal-title":"Curr Opin Microbiol"},{"key":"ref681","doi-asserted-by":"crossref","first-page":"5400","DOI":"10.1128\/AAC.00661-16","article-title":"The heterodimeric ABC transporter EfrCD mediates multidrug efflux in Enterococcus faecalis","volume":"60","author":"H\u00fcrlimann","year":"2016","journal-title":"Antimicrob Agents Chemother"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1179\/1973947814Y.0000000192","article-title":"Urinary tract infection caused by Enterococcus isolates: aetiology and antimicrobial resistance patterns","volume":"27","author":"Wang","year":"2015","journal-title":"J Chemother"},{"key":"ref281","volume-title":"CLSI. 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