Characterisation of uropathogenic E.coli by detecting the virulence factors and its drug resistance pattern in a tertiary care hospital in India

Abstract

Urinary tract infections (UTIs) are among the most prevalent nosocomial and community-acquired bacterial diseases in humans, with E.coli being the most typical pathogen isolated. To detect the prevalence of virulence factors like haemolysin, haemagglutination of human erythrocytes with its effect of D-mannose, and cell surface hydrophobicity, the antibiotic sensitivity pattern and ESBL production in urinary isolates of E.coli obtained from clinical samples. We included the E.coli isolates obtained from a midstream urine sample for the study. Virulence factors like haemolysin, hemagglutination and salt aggregation were detected as per standard protocols. Antibiotic sensitivity testing was performed by the Kirby Bauer disc diffusion method. Extended-spectrum beta-lactamase (ESBL) production was seen by the combined disc diffusion method on Muller Hinton agar as per CLSI guidelines. A total of 103 E.coli isolates were tested, and among them, 24(23.30%) produced haemolysin, 65(63.10%) produced hemagglutination and 38(36.89%) had salt aggregation properties. Most isolates obtained were resistant to beta-lactam antibiotics but showed high sensitivity towards antibiotics like chloramphenicol, meropenem, amikacin, imipenem and nitrofurantoin. Around 48% of them were ESBL producers. The common virulence factors associated with UTI were P-fimbriae (MRHA), haemolysin production, cell surface hydrophobicity and type-1 fimbriae. Because of the emerging drug resistance among UPEC, therapy should be advocated as far as possible after obtaining the culture and sensitivity results to determine exact aetiology and susceptibility patterns. The sensitivity to nitrofurantoin is very high, suggesting that antibiotic recycling will help clinicians treat UPEC.