Virulence factors of uropathogenic Escherichia coli (UPEC) and correlation with antimicrobial resistance

Abstract

Background Escherichia coli has found to be the predominant uropathogen (50–90%) in uncomplicated, community acquired urinary tract infection (UTI). Uropathogenic Escherichia coli (UPEC) express a multitude of virulence factors, which enable the bacteria to establish UTI. The objective of this study was to evaluate the presence of different phenotypic virulence markers in UPEC isolates and determine their correlation with antibiotic resistance pattern. Results Out of 105 patients, 56 (53%) were females and 49 (47%) were males. The age of the patients in the study ranged from 18 years to 87 years and majority of the patients belonged to the age group 20–29 years. Virulence factor was observed in 65% (n = 69) of UPEC and 20% (n = 22) of control isolates (P = 0.0001). Haemolysin production was observed in 34(32.3%) of uroisolates and 12 (11.4%) of control strain. Similarly, 62% of UPEC and 1% of control produced biofilm (P = 0.0001). The expression of Mannose-resistant hemagglutinin (MRHA) and mannose-sensitive hemagglutinin (MSHA) in uroisolates were 52.3% (n = 55) and 5.7% (n = 6) respectively, whereas in faecal isolates, 8.5% (n = 9) expressed MRHA and none produced MSHA. Antimicrobial resistance showed a high degree of resistance towards ampicillin, cotrimoxazole and norfloxacin. The resistance was observed in significant higher degree in biofilm formers as compared to non-formers. MDR and ESBL was observed in 51 and 46% of test strains and 9 and 7.6% of control strains (P = 0.0001). Conclusion A significant association between virulence factors of UPEC and antimicrobial resistance in UPEC was present. Routine testing of these factors and co-relation with AMR is recommended. These findings will certainly help understand the pathogenicity and proper management of UTI patients, thus decreasing the improper use of antibiotics.

Significant association between genes encoding virulence factors with antibiotic resistance and phylogenetic groups in community acquired uropathogenic Escherichia coli isolates

“…The highest resistance were detected against amoxicillin and trimethoprim-sulfamethoxazole in our assessments. High rate of resistance to first line antibiotics that are prescribed to treat uncomplicated UTIs such as amoxicillin and trimethoprimsulfamethoxazole were also reported in other studies from Iran and other countries [14,[18][19][20][21]. This condition is conducive to uncontrolled application of empirical therapy with fluoroquinolones, third generation cephalosporins and even new macrolides like azithromycin.…”

Virulence factors analysis and antibiotic resistance of uropathogenic Escherichia coli isolated from patients in northeast of Iran

“…Likewise, Ghazvini et al isolated 86% of E. coli from female patients and 14% from male patients. The reason for women to hold a higher percentage of UTIs might be ascribed to the fact that their urethra is not only shorter but also its orifice opening is closer to anus compared to men ( 18 – 21 ).…”

“…The highest antibiotic resistance was to cefepime (100%) and the lowest resistance was to cefoxitin (7.6%). Most of the studies reported resistance rates to cephalosporins to be between 50% and 70% ( 8 , 9 , 17 , 21 , 25 , 37 – 39 , 42 , 43 ).…”

An Update on the Management of Urinary Tract Infections in the Era of Antimicrobial Resistance

“…(17) UTI infections may be done to certain virulence factors like hemolysin production and presence of fimbriae the most organism caused UTI. (18) In this study were belong gram negative bacteria which were isolated from74. Patients these results were almost similar to those of Baghdad teaching hospital samples that are collected in previous studies (19,20) In addition, our findings demonstrate that bacterial involvement in UTI is E-coli followed by staph aureus then entry bacteria and pseudomonas with a smaller number of cases there was klebsiellaspp as show in figure 1.…”