Antibiotic resistance, phylogenetic typing, and virulence genes profile analysis of uropathogenic Escherichia coli isolated from patients in southern Iraq

Molecular study on virulence and resistance genes of ST131 clone (uropathogenic/enteropathogenic Escherichia coli) hybrids in children

Aim: To analyze ST131 clones and other characteristics in uropathogenic and atypical enteropathogenic Escherichia coli hybrids. Methods: Samples were collected from children with urinary tract infections and underwent testing for antimicrobial susceptibility, multidrug resistance and extended-spectrum β-lactamases, in vitro biofilm formation and virulence, resistance genes, hybrid pathotypes and ST131 clones. Results: E. coli isolates showed high levels of antibiotic resistance, extended-spectrum β-lactamase production, virulence genes, multidrug resistance and biofilm formation. Four (5.0%) isolates were identified as uropathogenic/atypical enteropathogenic E. coli hybrids, all of which belonged to the high-risk ST131 clone. Conclusion: Our results provide promising insights about hybrid isolates and should be addressed to improve prevention measures for hybrid pathotypes.

Pathogenic E. coli in the Food Chain across the Arab Countries: A Descriptive Review

Foodborne bacterial infections caused by pathogens are a widespread problem in the Middle East, leading to significant economic losses and negative impacts on public health. This review aims to offer insights into the recent literature regarding the occurrence of harmful E. coli bacteria in the food supply of Arab countries. Additionally, it aims to summarize existing information on health issues and the state of resistance to antibiotics. The reviewed evidence highlights a lack of a comprehensive understanding of the extent to which harmful E. coli genes are present in the food supply of Arab countries. Efforts to identify the source of harmful E. coli in the Arab world through molecular characterization are limited. The Gulf Cooperation Council (GCC) countries have conducted few surveys specifically targeting harmful E. coli in the food supply. Despite having qualitative data that indicate the presence or absence of harmful E. coli, there is a noticeable absence of quantitative data regarding the actual numbers of harmful E. coli in chicken meat supplies across all Arab countries. While reports about harmful E. coli in animal-derived foods are common, especially in North African Arab countries, the literature emphasized in this review underscores the ongoing challenge that harmful E. coli pose to food safety and public health in Arab countries.

Characterization of uropathogenic Escherichia coli phylogroups associated with antimicrobial resistance, virulence factor distribution, and virulence-related phenotypes

In this study, we compared the characteristics of different uropathogenic Escherichia coli phylogroups. A total of 844 E. coli isolated from urine were enrolled and the antimicrobial susceptibility of E. coli to 22 antibiotics was determined by disk diffusion test. The distribution of phylogroups and 20 virulence factor genes was determined by PCR. Phenotypes associated with bacterial virulence, including motility, biofilm formation, and the production of curli and siderophore, were examined. Phylogroup B2 was dominant in our isolates (64.8%), followed by phylogroups D (8.6%), B1 (7.8%), F (6.0%), C (4.5%), A (3.1%), untypable (2.8%), E (1.8%), and clade I (0.5%). The prevalence of multidrug-resistant strains was highest in phylogroup C (86.8%), followed by E (80.0%), F (75.0%), and D (71.2%). Moreover, 23.5% of the phylogroup F E. coli were extensively drug-resistant. Phylogroup B2 E. coli had an average of the highest virulence factor genes (10.1 genes/isolate). Compared to phylogroup B2 E. coli, phylogroups F and clade I E. coli had higher motility while phylogroup C E. coli had lower motility. >60% of phylogroups A and C E. coli showed very low curli production. In contrast, 14%, 10%, and 7%, of E. coli in phylogroups F, B2, and E, produced a very high amount of curli, respectively. Surprisingly, phylogroup A E. coli showed the highest virulence to larvae, followed by phylogroups B2 and C. In summary, we first characterized and revealed that the antimicrobial resistance, virulence gene distribution, motility, and curli production, were associated with in E. coli phylogroups.

Incidence of biofilms among the multidrug resistant E. coli, isolated from urinary tract infections in the Nilgiris district, South India

Multidrug resistant uropathogenic Escherichia coli (MDRUPEC) significantly correlates with recurrent, complicated, and persistent urinary tract infection (UTI). The leading cause of multidrug resistance is the ability of E. coli to form biofilms. The physiological heterogeneity, genetic incontinency, and putative events in gene expression of biofilms render them resistant to antimicrobials and the host immune system. Understanding the determinants of antimicrobial resistance and its correlation with biofilm formations will, therefore, help the development of a better strategy for treating biofilm-associated UTIs. The present study reports on the in vitro detection of biofilm formation among multidrug resistant E. coli strains isolated from urine, the major cause of communal, nosocomial, and food-borne uropathogenic UTI. This is a cross-sectional study conducted in and around Ooty, Nilgiris, India. From the 869 urine samples analyzed for UTI, 29.34% were found to be caused by E. coli. Among this about 23.92% were found to be multidrug resistant. Among the multidrug resistant E. coli isolates, 36.06% of them were potent biofilm producers. E. coli biofilms (n = 22) were resistant to the antibiotics used to treat UTI, namely, amikacin, amoxicillin, ampicillin, cefepime, cefoperazone, cefotaxime, ceftriaxone, cefuroxime, cephalotin, ciprofloxacin, co-trimoxazole, gentamicin, levofloxacin, and nalidixic acid, but sensitive to imipenem and meropenem. All the biofilm producers exhibited motility and hemaggultination but none were positive for hemolysin production. The isolated E. coli biofilms were confirmed by VITEK R2 Compact (bioMerieux, France) and 16S rRNA gene sequencing.

Detection of Extended-spectrum β-lactamase-producing Escherichia coli isolates by isothermal amplification and association of their virulence genes and phylogroups with extraintestinal infection

Extraintestinal pathogenic Escherichia coli (ExPEC) producing extended-spectrum β-lactamases (ESBL) cause serious human infections due to their virulence and multidrug resistance (MDR) profiles. We characterized 144 ExPEC strains (collected from a tertiary cancer institute) in terms of antimicrobial susceptibility spectrum, ESBL variants, virulence factors (VF) patterns, and Clermont's phylogroup classification. The developed multiplex recombinase polymerase amplification and thermophilic helicase-dependent amplification (tHDA) assays for bla_CTX-M, bla_OXA, bla_SHV, and bla_TEM detection, respectively, were validated using PCR-sequencing results. All ESBL-ExPEC isolates carried bla_CTX-M genes with following prevalence frequency of variants: bla_CTX-M-15 (50.5%) > bla_CTX-M-55 (17.9%) > bla_CTX-M-27 (16.8%) > bla_CTX-M-14 (14.7%). The multiplex recombinase polymerase amplification assay had 100% sensitivity, and specificity for bla_CTX-M, bla_OXA, bla_SHV, while tHDA had 86.89% sensitivity, and 100% specificity for bla_TEM. The VF genes showed the following prevalence frequency: traT (67.4%) > ompT (52.6%) > iutA (50.5%) > fimH (47.4%) > iha (33.7%) > hlyA (26.3%) > papC (12.6%) > cvaC (3.2%), in ESBL-ExPEC isolates which belonged to phylogroups A (28.4%), B2 (28.4%), and F (22.1%). The distribution of traT, ompT, and hlyA and phylogroup B2 were significantly different (P < 0.05) between ESBL-ExPEC and non-ESBL-ExPEC isolates. Thus, these equipment-free isothermal resistance gene amplification assays contribute to effective treatment and control of virulent ExPEC, especially antimicrobial resistance strains.

Association Between Uropathogenic Escherichia coli Virulence Genes and Severity of Infection and Resistance to Antibiotics

Purpose

Urinary tract infection (UTI) is the most frequent bacterial infection. Some uropathogenic Escherichia coli (UPEC) genes have been associated with disease severity and antibiotic resistance. The aim was to determine the association of nine UPEC virulence genes with UTI severity and antibiotic resistance of strains collected from adults with community-acquired UTI.

Patients and Methods

A case-control study (1:3) (38 urosepsis/pyelonephritis and 114 cystitis/urethritis) was conducted. The fimH, sfa/foc, cvaC, hlyA, iroN, fyuA, ireA, iutA, and aer (the last five are siderophore genes) virulence genes were determined by PCR. The information of antibiotic susceptibility pattern of the strains was collected from medical records. This pattern was determined using an automated system for antimicrobial susceptibility testing. Multidrug-resistant (MDR) was defined as resistance to three or more antibiotic families.

Results

fimH was the most frequently detected virulence gene (94.7%), and sfa/foc was the least frequently detected (9.2%); 55.3% (83/150) of the strains were MDR. The evaluated genes were not associated with UTI severity. Associations were found between the presence of hlyA and carbapenem resistance (Odds ratio [OR] = 7.58, 95% confidence interval [CI], 1.50-35.42), iutA and fluoroquinolone resistance (OR = 2.35, 95% CI, 1.15-4.84, and aer (OR = 2.8, 95% CI, 1.20-6.48) and iutA (OR = 2.95, 95% CI, 1.33-6.69) with penicillin resistance. In addition, iutA was the only gene associated with MDR (OR = 2.09, 95% CI,1.03-4.26).

Conclusion

There was no association among virulence genes and UTI severity. Three of the five iron uptake genes were associated with resistance to at least one antibiotic family. Regarding the other four non-siderophore genes, only hlyA was associated with antibiotic resistance to carbapenems. It is essential to continue studying bacterial genetic characteristics that cause the generation of pathogenic and multidrug-resistant phenotypes of UPEC strains.

Antibiotic Resistance of Uropathogenic <i>Escherichia coli</i> Isolated from Patients with Urinary Tract Infections at the Urological Inpatient Facility of the Saratov Clinical Hospital

The aim of the work was to study the profile of antibiotic resistance of uropathogenic Escherichia coli strains isolated from patients with urinary tract infections in the urological inpatient facility of the clinical hospital in the Saratov city, depending on appurtenance to phylogenetic groups and subgroups, as well as O-serogroups.

Materials and methods. We assessed sensitivity/resistance to 25 different antibacterial drugs in 102 strains of uropathogenic E. coli. The studies were carried out using the disk diffusion method. The production of extended spectrum beta-lactamases was evaluated by the double disk method. Carbapenemase output was determined using the CIM test. The PCR method was applied to determine appurtenance to phylogenetic groups and subgroups, O-serogroups, as well as the frequency of occurrence of the mcr‑1, mcr‑2, mcr‑3, mcr‑4, mcr‑5 genes encoding the proteins that mediate the development of resistance to colistin.

Results and discussion. It has been established that all strains of uropathogenic E. coli are more or less resistant to antibacterial drugs. All studied 102 strains showed resistance to 23 antibacterial drugs from 8 functional groups. The resistance of uropathogenic E. coli had certain differences depending on belonging to phylogenetic groups and subgroups, O-serogroups. Strains of uropathogenic E. coli with high resistance (up to 100 %) belonged to the B23 phylogenetic group, the main representatives of which are cultures of the most common O-25 serogroup. The production of extended-spectrum beta-lactamases has been phenotypically confirmed for 69 (67.6 %) strains. No carbapenemaseproducing cultures were found in the study. The mcr‑1 and mcr‑2 genes encoding resistance to colistin have been identified in 3 uropathogenic E. coli strains (2.9 %).

Relationship Between Antibiotic Resistance, Biofilm Formation, and Biofilm-Specific Resistance in Escherichia coli Isolates from Ningbo, China

Purpose

Methods

Results

Conclusion

Prevalence of Extended-Spectrum β-Lactamase Genes and Antibiotic Resistance Pattern in Clinical Isolates of Acinetobacter baumannii from Patients Hospitalized in Mashhad, Iran

Background: Carbapenem-resistant Acinetobacter baumannii strains are one of the most severe factors in hospital infection worldwide, in which the beta-lactamase enzyme is one of the main resistance mechanisms. Objectives: This study aimed to evaluate the presence of carbapenem-resistant beta-lactamase genes and determine antibiotic resistance patterns in the clinical isolates of A. baumannii from patients hospitalized in the Shahid Kamyab Hospital, Mashhad, Iran. Methods: Out of 286 collected isolates from patients hospitalized in Shahid Kamyab Hospital (from March 2017 to June 2017), 31 isolates were confirmed to be A. baumannii using biochemical tests. Antibiotic susceptibility testing was conducted using the disc diffusion method according to the CLSI standard protocols. The presence of beta-lactamase genes, namely blaVEB, blaPER, blaAmpC, blaVIM, blaIMP, blaSHV, and blaTEM, was detected using polymerase chain reaction. Results: In this study, 31 isolates were identified as Acinetobacter baumannii, all of which revealed high resistance to ceftazidime, cefixime, ceftriaxone, meropenem, imipenem, cefotaxime and cephalexin. In this case, the lowest resistance (19.35%) was observed against polymixin B. Moreover, blaAmpC, blaTEM, blaSHV, blaPER, and blaVIM were observed in 93.54% (29), 51.61% (16), 48.38% (15), 41.93% (13), and 77% (24) of the isolates, respectively. However, blaVEB and blaIMP were observed in none of the isolates. Conclusions: The results showed high carbapenem resistance and high frequency of beta-lactamase resistance genes among the clinical isolates of A. baumannii.