Phylogenetic group distributions, virulence factors and antimicrobial resistance properties of uropathogenic Escherichia coli strains isolated from patients with urinary tract infections in South Korea.

UNLABELLED: Urinary tract infections (UTIs) are one of the most common diseases by which humans seek medical help and are caused mainly by uropathogenic Escherichia coli (UPEC). Studying the virulence and antibiotic resistance of UPEC with respect to various phylogenetic groups is of utmost importance in developing new therapeutic agents. Thus, in this study, we analysed the virulence factors, antibiotic resistance and phylogenetic groups among various UPEC isolates from children with UTIs. The phylogenetic analysis revealed that majority of the strains responsible for UTIs belonged to the phylogenetic groups B2 and D. Of the 58 E. coli isolates, 79·31% belonged to group B2, 15·51% to group D, 3·44% to group A and 1·72% to B1. Simultaneously, the number of virulence factors and antibiotic resistance exhibited were also significantly high in groups B2 and D compared to other groups. Among the isolates, 44·8% were multidrug resistant and of that 73% belonged to the phylogenetic group B2, indicating the compatibility of antibiotic resistance and certain strains carrying virulence factor genes. The antibiotic resistance profiling of UPEC strains elucidates that the antimicrobial agents such as chloramphenicol, cefoxitin, cefepime, ceftazidime might still be used in the therapy for treating UTIs. SIGNIFICANCE AND IMPACT OF THE STUDY: As the antibiotic resistance pattern of uropathogenic Escherichia coli varies depending on different geographical regions, the antibiotic resistance pattern from this study will help the physicians to effectively administer antibiotic therapy for urinary tract infections. In addition, the frequency of virulence factors and antibiotic resistance genes among various phylogenic groups could be effectively used to draw new targets for uropathogenic Escherichia coli antibiotic-independent therapies. The study emphasizes need of public awareness on multidrug resistance and for more prudent use of antimicrobials.

Infección del tracto urinario y resistencia antimicrobiana en la comunidad / Urinary tract infection and antimicrobial resistance in the community

Introducción: las infecciones del tracto urinario constituyen un problema frecuente en la atención primaria de salud. Objetivo: actualizar la prevalencia y susceptibilidad a los antibióticos disponibles en nuestro medio. Métodos: se realizó un estudio retrospectivo sobre el aislamiento de gérmenes uropatógenos y la susceptibilidad antibiótica del microorganismo más frecuente en 2 912 pacientes ambulatorios que presentaron clínica sugerente de infección urinaria. Se tomó como muestra 484 pacientes con urocultivos positivos que tenían antibiograma realizado, en el municipio Banes, Holguín, desde noviembre del 2012 a octubre del 2013. Se utilizó el método de difusión de Kirby y Bauer. Resultados: la Escherichia coli resultó el germen más frecuente, afectando de igual manera al sexo femenino y mostró mayor resistencia al Ampicillín (83,7 %), Cefazolina (74,5 %), Ácido nalidíxixco (72,1 %), Co-trimoxazol (57,3 %), alrededor del (50,0 %) de resistencia a la Ciprofloxacina, Kanamicina y Ceftaxidima; mejor sensibilidad ante la Gentamicina, Cefotaxima y Ceftriaxona. Conclusiones: la Gentamicina, Cefotaxima y Ceftriaxona las opciones terapéuticas de primera línea en el tratamiento empírico de las infecciones del tracto urinario constituyen en nuestro medio.

Introduction: urinary tract infections are a common problem in primary health care. Objective: update the prevalence and susceptibility to available antibiotics in our environment. Method: a retrospective study was carried out on the isolation of uropathogenic bacteria and antibiotic susceptibility of the most common organism in 2912 ambulatory patients with symptoms suggesting urinary tract infection. The sample was 484 patients with positive urine cultures and susceptibility study performed in Banes municipality, Holguin, from November 2012 to October 2013. Kirby and Bauer diffusion method was used. Results: escherichia coli were the most common pathogen, affecting females. This pathogen showed higher resistance to Ampicillin (83.7%), Cefazolin (74.5%), nalidixic acid (72.1%), Co- trimoxazole (57.3%), about (50.0%) of ciprofloxacin resistance, kanamycin and Ceftaxidima; and better sensitivity to gentamicin, cefotaxime, and ceftriaxone. Conclusions: treatment options for first-line empiric treatment of urinary tract infections are gentamicin, cefotaxime, and ceftriaxone.