Antibiotic Resistance and Virulence Phenotypes of Recent Bacterial Strains Isolated from Urinary Tract Infections in Elderly Patients with Prostatic Disease

Abstract

Acute bacterial prostatitis is one of the frequent complications of urinary tract infection (UTI). From the approximately 10% of men having prostatitis, 7% experience a bacterial prostatitis. The purpose of this study was to investigate the prevalence of uropathogens associated with UTIs in older patients with benign prostatic hyperplasia and to assess their susceptibility to commonly prescribed antibiotics as well as the relationships between microbial virulence and resistance features. Uropathogenic Escherichia coli was found to be the most frequent bacterial strain isolated from patients with benign prostatic hyperplasia, followed by Enterococcus spp., Enterobacter spp., Klebsiella spp., Proteus spp., Pseudomonas aeruginosa, and Serratia marcescens. Increased resistance rates to tetracyclines, quinolones, and sulfonamides were registered. Besides their resistance profiles, the uropathogenic isolates produced various virulence factors with possible implications in the pathogenesis process. The great majority of the uropathogenic isolates revealed a high capacity to adhere to HEp-2 cell monolayer in vitro, mostly exhibiting a localized adherence pattern. Differences in the repertoire of soluble virulence factors that can affect bacterial growth and persistence within the urinary tract were detected. The Gram-negative strains produced pore-forming toxins—such as hemolysins, lecithinases, and lipases—proteases, siderophore-like molecules resulted from the esculin hydrolysis and amylases, while Enterococcus sp. strains were positive only for caseinase and esculin hydrolase. Our study demonstrates that necessity of investigating the etiology and local resistance patterns of uropathogenic organisms, which is crucial for determining appropriate empirical antibiotic treatment in elderly patients with UTI, while establishing correlations between resistance and virulence profiles could provide valuable input about the clinical evolution and recurrence rates of UTI.

Antimicrobial Resistance of Uropathogenic Escherichia coli from Elderly Patients at a General Hospital, Argentina

“…In Italy and Romania, ciprofloxacin resistance presented a similar prevalence than the one in this study, 41.4% and over 50%, respectively. In Brazil, 33/49 nalidixic-resistant E.coli isolates also expressed resistance to ciprofloxacin, showing that nalidic acid is still a marker for quinolones susceptibility [19,25,27] Resistance to TMS was osberved by E.coli isolates in this investigation (37.6%). In Argentina, on recent years, resistance to this antimicrobial showed a preavalence range between 28.1% and 45.7% in eldery patients with UTI.…”

“…In a previous research carried out in Romania, 20% of the elderly patients studied expressed resistance to ceftazidime. A different epidemiological situation was seen in community-onset UTI patientsf rom Uruguay, where E .coli showed no resistance to third-generation cephalosporins [16,25].…”

Phylogenetic relationships, biofilm formation, motility, antibiotic resistance and extended virulence genotypes among Escherichia coli strains from women with community-onset primitive acute pyelonephritis

“…Although different studies analyzing the prevalence of many virulence factors in different UTIs have been performed in the past, pyelonephritis-associated virulence factors have not yet been clearly defined [ 11 – 21 ].…”

Screening for chronic prostatitis pathogens using high‐throughput next‐generation sequencing

“…Delcaru et al 13 found that uropathogenic E. coli was the most frequent bacterial strain isolated from patients with benign prostatic hyperplasia (BPH), followed by Enterococcus spp., Enterobacter spp., Klebsiella spp., Proteus spp., P. aeruginosa , and Serratia marcescens . Mishra et al 14 isolated 66 strains of pathogenic bacteria from urine cultures of patients with BPH and CP, and the eight most frequently detected were E. coli (31.8%), Klebsiella spp.…”

“…2 Jang et al 12 infected the prostates of mice with T. vaginalis and observed pathological changes, mast cell infiltration, and C-C motif chemokine ligand 2 elevation, providing evidence that T. vaginalis causes prostatitis. The detection rates of the above microorganisms were very low in the patients with CP III enrolled in our study.In fact, most of the pathogens were not even detected, confirming that they are not the true pathogens of prostatitis.Delcaru et al13 found that uropathogenic E. coli was the most frequent bacterial strain isolated from patients with benign prostatic hyperplasia (BPH), followed by Enterococcus spp., Enterobacter spp.…”