Phenotypic Identification and Phylogenetic Characterization of Uropathogenic Escherichia coli in Symptomatic Pregnant Women With Urinary Tract Infections in South-Western Nigeria

Abstract

The study reports the characterization of uropathogenic E. coli (UPEC) in urine samples of pregnant women with confirmed urinary tract infections (UTIs) in Ondo and Ekiti States, Nigeria.Voided mid-stream urine samples were cultured on eosin methylene blue agar plates at 37 o C and identified by conventional biochemical tests. Antibiotic susceptibility testing of isolates was by Kirby-Bauer's disc diffusion technique. Phylogenetic typing of the isolates was by multiplex polymerase chain reaction (PCR).The occurrence of UPEC in pregnant women in age group 25-35 years (66.0%) was high. Two hundred and sixty four uropathogenic E. coli comprising 133 (50.38%) in Ondo and 131 (49.62%) in Ekiti States were recovered from 400 samlpes analyzed. In all, prevalence of UTIs with positive cultures was 66.0%. Escherichia coli only was 56.5%, mixed-infection (9.5%), non-E. coli infection (12.5%) and no growth (21.5%). Resistance to antibiotics was high with diverse multiple antibiotic resistance patterns. Greater percentage of the screened representative UPEC isolates belonged to phylogenetic group D (65.0%), group A (28.0%), group B1 (6.7%) and none to group B2.Escherichia coli belonging to phylogenetic group D appears to be a predominant uropathogen in this study area. Presence of chuA gene in most of the isolates shows the significance of iron acquisition in the pathogenesis and urovirulence of UPEC.

Distribution of virulence genes and phylogenetics of uropathogenic Escherichia coli among urinary tract infection patients in Addis Ababa, Ethiopia

“…Resistance to ceftriaxone was observed in 80.5% of UPEC isolates, which is comparable to studies conducted in Nigeria 86% [13], India 81.8% [53] and China 84.8% [30], but higher than studies conducted in Nigeria 23.3% [54] and Mexico 10.2% [21]. Resistance to cefotaxime was observed in 66% of UPEC isolates, which is in agreement with studies conducted in Nigeria 68% [13], India 66.66% [55] and Iraq 78% [37], but higher than studies conducted in Ethiopia 18.7% [56], Nigeria 4.4% [9] and South Korea 7.8% [43]. Ceftriaxone is recommended for treatment of severe pyelonephritis in Ethiopia by national standard treatment guidelines [57].…”

“…After 45 min 240 μl 1 M Tris-Cl was added to neutralize NaOH and centrifuged at 13,000 rpm for 3 min. One thousand microliters of the supernatant were stored at -20°C as a template DNA stock [12,13].…”

<p>Virulence and Resistance Determinants of Uropathogenic <em>Escherichia coli</em> Strains Isolated from Pregnant and Non-Pregnant Women from Two States in Mexico</p>

“…It has been previously reported that the predominant phylogenetic groups in pathogenic strains for humans are B2 and D, while A corresponds to commensal strains which are a reservoir of the resistance genes. 37,66 Previous research conducted in Mexico, Nigeria, Uganda, Sweden, Vietnam, India and Mongolia, 12,16,44,45 have reported the prevalence of the phylogenetic group B2 (ranges from 33.8% −58%), followed by A (5% −28%) and D (5% −28%). When analyzing these studies, we noticed a variation in the prevalence of these phylogenetic groups according to the geographical area.…”

“…The susceptibility profiles indicated that strains isolated from women in both states have a high resistance to β-lactam antibiotics, aminoglycosides, nitrofurans and amoxicillin-clavulanic acid, these results were similar to those reported in Mexico (Guerrero and Mexico city) and in Nigeria. 12,44 It becomes of relevant importance for pregnant woman since these antibiotics are in the short list of antibiotics available for the treatment of lower and upper UTI in this group. Our results showed a considerable reduction in the number of antibiotics available for UTIs treatment, showing the necessity of searching for other therapeutic alternatives as well as continuous monitoring of the empirical treatments implemented in Mexico.…”

Distribution of virulence genes and phylogenetics of uropathogenic Escherichia coli among urinary tract infection patients in Addis Ababa, Ethiopia

“…After 45 minutes 240 µl 1 M Tris-Cl was added to neutralize NaOH and centrifuged at 13,000rpm for 3 minutes. One thousand microliters of the supernatant were stored at -20 o C as a template DNA stock (11,12).…”