Phenotypic and Genotypic Characteristics of Uropathogenic Escherichia coli Isolates from Kenya

Abstract

Introduction: Uropathogenic Escherichia coli (UPECs) are a significant cause of urinary tract infections (UTIs). In Kenya, UTIs are typically treated with b-lactam antibiotics without antibiotic susceptibility testing, which could accelerate antibiotic resistance among UPEC strains. Aim: This study determined the occurrence of UPEC producing extended-spectrum b-lactamases (ESBLs), the genes conferring resistance to b-lactams, and the phylogenetic groups associated with ESBLs in Kenyan UPECs. Methodology: Ninety-five UPEC isolates from six Kenyan hospitals were tested for ESBL and plasmidmediated AmpC b-lactamase (pAmpC) production by combined disk diffusion and disk approximation tests, respectively. Real-time and conventional polymerase chain reactions (PCRs) were used to detect three ESBL and six pAmpC genes, respectively, and phylogenetic groups were assigned by a quadruplex PCR method. Results: Twenty-four percent UPEC isolates were ESBL producers with bla CTX-M (95.6%), bla TEM (95.6%), and bla SHV (21.7%) genes detected. Sixteen isolates had bla CTX-M/TEM , whereas five had bla TEM/CTX-M/SHV . A total of 5/23 ESBLs were cefoxitin resistant, but no AmpC genes were detected. The UPECs belonged predominantly to phylogenetic groups B2 (31/95; 32.6%) and D (30/95; 31.6%), while groups B2 and A had the most ESBL producers. Conclusions: b-Lactam antibiotics have reduced utility for treating UTIs as a quarter of UPECs were ESBL producing. Single or multiple ESBL genes were present in UPECs, belonging primarily to phylogenetic groups B2 and A.

Prevalence of colonization with multidrug-resistant bacteria in communities and hospitals in Kenya

“…Estimates of prevalence in these studies vary widely. One study of E. coli isolated from urine cultures of symptomatic patients identified ESBL-producers in 25% of the 94 samples tested 35 . Other studies have reported estimates ≥ 50% of Enterobacterales isolates classified as ESBL-producers among hospitalized patients, which mirror the high prevalence of colonized inpatients found in this study 36 , 37 .…”

Susceptibility and Virulence of Enterobacteriaceae Isolated from Urinary Tract Infections in Benin

“…In Europe, the resistance of Enterobacteriaceae to third-generation cephalosporins ranged from 6.2 to 30.8% among bacterial isolates in 2019 [ 52 ]. Muriuki et al [ 53 ] reports a similar finding for uropathogenic E. coli in Kenya between 2015 and 2018. The production of ESBL is probably due to the often-empirical prescriptions of ß-lactams, particularly in ambulatory medicine, while awaiting the results of ECBU.…”

Association between biofilm-production and antibiotic resistance in Escherichia coli isolates: A laboratory-based case study and a literature review

“…Irrespective of the disease-presentation, the first key step in the pathogenesis of E. coli infections is the adherence to mucosal surfaces; subsequently, aggregation of bacteria inside the biofilm protects them from sheer forces and the onslaught of immune cells [52,69,70]. The relevant virulence-determinants of E. coli include adhesins (representative genes e.g., afa, CSH, fimH, fimP, pap, sfa, traT), toxins (cytotoxic necrotizing factor: Cnf1, haemolysin: hlyA, others: saT, vaT), suppressors of the immune system (shiA, sisA, sisB, sivH) and siderophores (aerobactin: aer, salmochelin: iro, enterobactin: ent, yersiniabactin: irp, others: iuD, iutA, yfcv), which all contribute to their survival and invasiveness in the infected host [71][72][73][74]. Surface factors, such as various adhesins have a pivotal role in mediating the adhesion of E. coli to biotic and abiotic surfaces, and the subsequent production of EPS.…”