Escherichia coli bacteriuria in pregnant women in Ghana: antibiotic resistance patterns and virulence factors

Abstract

ObjectivesThe relevance of Escherichia coli associated bacteriuria infection in pregnant women is poorly understood, despite these strains sharing a similar virulence profile with other pathogenic E. coli causing severe obstetric and neonatal infections. We characterized and determined the antimicrobial susceptibility, resistance genes and virulence profiles of 82 E. coli isolates associated with asymptomatic bacteriuria in some pregnant in Ghana from February to August 2016 using Kirby–Bauer disc diffusion and polymerase chain reaction.ResultsHigh levels of antimicrobial resistance were observed to ampicillin (79.3%), tetracycline (70.7%) and cotrimoxazole (59.8%), except for cefuroxime (32.9%). Resistance genes analyses revealed 58.5% were positive for BlaTEM and 7.3% for aph(3)-Ia(aphA2). Virulence factors (VFs) was more widespread in pregnant women in the 2nd and 3rd trimesters than 1st trimester. VFs relating to adhesion (papC and iha), Protectins (traT), aerobactin acquisition (iutA) and iron acquisition systems (fyuA and irp2) were more prevalent in the resistant E. coli isolates. This study provides evidence for a link in bacteriuria and transmission of extra-intestinal E. coli in pregnant women to cause multi-resistant obstetric or neonatal infections. Considering the involvement of extra-intestinal E. coli in infections, results are helpful to develop strategies to prevent maternal and/ neonatal infections.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3989-y) contains supplementary material, which is available to authorized users.

Pathogenic features of urinary Escherichia coli strains causing Asymptomatic Bacteriuria during Pregnancy

“…papC, papGII and ecp (A and RB) _ the other genes related to the ability to colonize the urinary tract epithelium were detected in 88.5% , 14.2% and 58.1% of the isolates, respectively. Our results are in agreement with those found by other studies [17,[18][19][20][21][22][23].…”

“…This finding is in agreement with previous studies [24]. This study showed a considerable number of bacteria to harbor the kpsMTII, fimH, papC, iutA, fyuA, traT and sfa/focDE, respectively, which was in contrast to Sáez-López et al, but in line with Forson et al study on pregnant women in Barcelona [23] and Ghana [18].…”

“…In this study, E. coli isolates were highly resistant to nalidixic acid, trimethoprim/sulfamethoxazole and ampicillin by more than 70%, and sensitivity values above 80% were found to imipenem, aztreonam and nitrofurantoin. Findings are in line with the earlier studies in Iran [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. The findings of previous studies as well our current findings indicate that ESBL and AmpC-β-lactamase-producing isolates are typically resistant to others antibiotics such as trimethoprim/sulfamethoxazole and fluoroquinolones [13].…”

“…In this study, the prevalence of asymptomatic bacteriuria in pregnant women (with recurrent UTIs before pregnancy) was 42%, which was similar to what was observed by a study in Nigeria(47.5%) [17] and a study in Ghana (42.8%) [18]. In contrast, some other studies found lower prevalence than ours, a study in Chitwan, Nepal, conducted by Neupane et al (26%) [19] a study in Cameroon conducted by Mokube M.N.…”

“…iutA and fyuA play an important role in iron acquisition systems by up-taking the hydroxamate siderophore aerobactin [25]. The prevalence of the iutA (83.8%) and fyuA (76.1%) genes found in our E. coli isolates correlates with the results published by Forson et al [18]. Significant associations were 8 observed between SXT resistance and the presence of the siderophores fyuA and iutA.…”