Molecular Characterisation of Uropathogenic Escherichia coli Isolates at a Tertiary Care Hospital in South India

Chakraborty, Arindam; Adhikari, Prabha; Shenoy, Shalini; Saralaya, Vishwas

doi:10.4103/ijmm.ijmm_14_291

Cited by 12 publications

(13 citation statements)

References 25 publications

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“…In addition, in some other studies, iutA gene positivity has been detected at the rates of 67.5 to 80.2% in E. coli urinary and blood isolates. 27 38 In our study, the iutA gene was found in 92% of urine, and 90% of blood, isolates. In line with the results, it can be stated that the iucD and iutA genes actually demonstrate the importance of iron retrieval systems during pathogenesis.…”

Section: Discussionsupporting

confidence: 48%

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Investigation of Antibiotic Susceptibility and Virulence Genes in Escherichia coli Strains Isolated from Blood and Urine Samples

Hasanli

Dağı

Arslan

2022

J Pediatr Infect Dis

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Objective Extraintestinal Escherichia coli isolates are the most common gram-negative pathogens in humans and cause urinary tract infections, sepsis, neonatal meningitis, and others. The aim of this study was to investigate the rates of antibiotic resistance and virulence factors (kpsM II, neuc K1, hlyF, fyuA, afa/draBC, sat, chuA, fimH, tsh, yfcv, ibeA, traT, iucD, usp, iutA, cnf1, hlyA, papC, sfa/focDE, and ompT) of E. coli strains isolated from blood and urine samples. Methods A total of 150 E. coli strains isolated from blood and urine samples sent to the Microbiology Laboratory, Faculty of Medicine Hospital, Selcuk University were included in the study. The identification and antibiotic susceptibility tests were performed with the VITEK 2 automated system. Multiplex polymerase chain reaction was used to detect the virulence genes. Results Although the highest antibiotic resistance rate found was against ampicillin (73.3%), the lowest rates were against ertapenem and meropenem (0.7%). Extended-spectrum β-lactamase positivity was 38% in E. coli blood isolates and 29% in urine. The highest rates of virulence genes were detected in fimH gene (92%). iutA gene was 91.3%, traT 76%, fyuA 50%, chuA 54.7%, iucD 46.7%, ompT 32.7%, yfcv 31.3%, hlyF 28.7%, sat 22%, papC and sfa/focDE 20%, kpsM II 19.3%, neuc K1 14.7%, tsh 13.3%, cnf1 6.7%, afa/draBC 6%, ibeA 5.3%, usp 4.7%, and hlyA 3.3%. kpsM II, tsh, hlyA, papC, sfa/focDE, and ompT genes were higher in blood isolates. Conclusion High antibiotic resistance rates and virulence genes were detected in E. coli strains in Konya, Turkey. This is the first study in Turkey where both a large number and a variety of virulence factors were investigated and compared. Multicenter studies are needed to better understand E. coli virulence.

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Section: Discussionsupporting

confidence: 48%

“…These results suggest that the kpsM II gene affects the virulence of ExPEC. Furthermore, Chakraborty et al 27 reported a 5% neuc K1 gene positivity rate in E. coli . In our study, neuc K1 gene was found in 17% of urine, and 10% of blood, isolates.…”

Section: Discussionmentioning

confidence: 99%

Investigation of Antibiotic Susceptibility and Virulence Genes in Escherichia coli Strains Isolated from Blood and Urine Samples

Hasanli

Dağı

Arslan

2022

J Pediatr Infect Dis

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“…They cause a variety of clinical signs from asymptomatic bacteriuria to pyelonephritis, cystitis, and septic shock with multi-organ systems failure [4]. The most common pathogen causing UTI is a heterogeneous group of ExPEC, named uropathogenic E. coli (UPEC) [5]. UPEC strains cause 75-95% of uncomplicated and 40-50% of complicated UTIs [3].…”

Section: Introductionmentioning

confidence: 99%

Virulence genes and phylogenetic groups of uropathogenic Escherichia coli isolates from patients with urinary tract infection and uninfected control subjects: a case-control study

2021

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Background Urinary Tract Infection (UTI) is one of the most common bacterial infectious diseases which causes considerable morbidity and costly health problems. Uropathogenic Escherichia coli (UPEC), the most common pathogen causing UTI, is a highly heterogeneous group of extraintestinal pathogenic E. coli (ExPEC) which may carry a variety of virulence factors and belonging to different phylogenetic backgrounds. The current study aimed to investigate the frequency and association between various virulence factors (VFs) and phylogenetic groups of UPEC and commensal isolates. Methods UPEC and commensal E. coli strains isolated from UTI and feces of healthy humans were compared for the presence of VFs and phylogenetic groups. Association between virulence genes was investigated and cluster analysis was employed. Results According to the results, among a 30 virulence markers tested, the pathogenicity-associated island (PAI), papAH, papEF, fimH, fyuA, and traT genes prevalence were statistically significant in UPEC isolates. A strong association was found between the B2 and D phylogenetic groups and clinical isolates of UPEC; while, commensal isolates were mostly associated with phylogenetic group A. The aggregated VFs scores were more than twice higher in the UPEC isolates in comparison with the commensal isolates. Interestingly, the B2 group in both UPEC and commensal isolates had the highest VF scores. A strong positive association was found between several virulence genes. The clustering results demonstrated that UPEC or commensal E. coli isolates were highly heterogeneous due to different composition of their virulence gene pool and pathogenicity islands. Conclusion Genetic structure and VFs of UPEC strains vary from region to region; therefore, to control the UTI, the epidemiological aspects and characterization of the UPEC isolates need to be investigated in different regions. Since UPEC isolates are generally originate from the commensal strains, it may be feasible to reduce the UTI burden by interfering the intestinal colonization, particularly in the highly pathogenic clonal lineages such as B2.

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“…2 The term uropathogenic E. coli (UPEC) refers to the extraintestinal strains of E. coli that express a variety of virulence factors, contributing to their pathogenicity in comparison to commensal E. coli. 3,4 The specific virulence genes present in strains of UPEC isolates are the genes that encode adhesins (e.g. Type I fimbriae and P fimbriae), mechanisms for acquisition of nutrients (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…lipopolysaccharide, capsule) and toxins (e.g., cytotoxic necrotising factor 1, hemolysin). 3 The factors mentioned above equip the bacteria with the ability to colonize the periurethral region, ascend the urinary tract to reach the urinary bladder resulting in infections like cystitis, urethritis, pyelonephritis, and urosepsis. 5 UPEC strains have acquired the virulence genes (chromosomal or plasmid mediated by horizontal transfer of DNA).…”

Section: Introductionmentioning

confidence: 99%

Characterization of virulence factors and antibiotic resistance pattern of uropathogenic Escherichia coli strains in a tertiary care center

Bhat²,

K³

et al. 2022

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Background: Urinary tract infections (UTI) are the most prevalent bacterial infection in humans. The uropathogenic E. coli (UPEC) expresses a range of virulence factors that contribute to their pathogenicity. The emergence of multidrug resistance (MDR)-associated UTI is increasing. This study monitors the distribution of virulence factors among UPEC strains to note the antibiogram, outcome and type of associated UTI. Methods: A prospective cross-sectional time-bound study of six months was done on clinically significant urinary isolates of Escherichia coli. Detection of haemolysin production and serum resistance was done by phenotypic methods. Genotypic characterization of the virulence genes (papC, iutA, hlyA, cnf1) was done by multiplex PCR. Demographic data, clinical history, antibiogram and type of UTI was collected from clinical case records. Results:75 E.coli isolates from patients with suspected UTIs were included. Females had a higher preponderance of UTI (66.7%). 93% of patients were adults and the remaining 7% were from paediatrics. 24 (32%) isolates showed haemolysis by plate haemolysis and all isolates were serum-resistant. Out of 75 isolates, 65 were positive for at least one of four targeted genes, while remaining ten isolates were negative for all four genes. Multidrug resistance was found in 40 (53.3%) isolates. 97.4% of the UTI cases had a favourable clinical outcome at discharge. Mortality due to urosepsis was 2.6%. Conclusion: Association of hemolysin production with resistance to imipenem and norfloxacin in UPEC strains was significant. Presence of hlyA gene is positively associated with ceftazidime resistance. Nitrofurantoin, piperacillin, tazobactam, and cefaperazone sulbactam are possible candidates for empirical therapy of UTIs. Drugs like aminoglycosides, carbapenems and fosfomycin may be used as reserve drugs in the treatment of MDR-UTI. However, inappropriate usage can increase antibiotic resistance. Hence proper selection of antibiotics in hospitals taking into account the local antibiogram is needed to reduce the emergence of antibiotic resistance.

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Molecular Characterisation of Uropathogenic Escherichia coli Isolates at a Tertiary Care Hospital in South India

Cited by 12 publications

References 25 publications

Investigation of Antibiotic Susceptibility and Virulence Genes in Escherichia coli Strains Isolated from Blood and Urine Samples

Investigation of Antibiotic Susceptibility and Virulence Genes in Escherichia coli Strains Isolated from Blood and Urine Samples

Virulence genes and phylogenetic groups of uropathogenic Escherichia coli isolates from patients with urinary tract infection and uninfected control subjects: a case-control study

Characterization of virulence factors and antibiotic resistance pattern of uropathogenic Escherichia coli strains in a tertiary care center

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