Uropathogenic Escherichia coli virulence characteristics and antimicrobial resistance amongst pediatric urinary tract infections

Uropathogenic Escherichia coli (UPEC) harbors virulence factors responsible for bacterial adhesion and invasion. In addition, the bacterium is accountable for the occurrence of pediatric urinary tract infections globally and is becoming problematic due to the emergence of antimicrobial resistance. The current research investigated UPEC prevalence, virulence characteristics, and antimicrobial resistance in pediatric urinary tract infection (UTI). 200 urine specimens were taken from hospitalized pediatric patients who suffered from UTIs. E. coli was recovered from urine specimens using the microbial culture. Disc diffusion method was used to assess antimicrobial resistance and polymerase chain reaction (PCR) to assess the virulence factors distribution amongst the UPEC bacteria. Seventy-five out of 250 (30.00%) urine samples were positive for the UPEC bacteria. The UPEC prevalence amongst pediatric patients was 25.83% and 33.84%, respectively. UPEC bacteria harbored the maximum resistance toward gentamicin (45.33%), ampicillin (44.00%), and ciprofloxacin (40.00%). Cytotoxic necrotizing factor 1 (Cnf1) (53.33%) and pyelonephritis-associated pil (pap) (42.66%) were the most frequently identified virulence factors amongst the UPEC bacteria. The high prevalence of UPEC isolates harboring antimicrobial resistance and virulence factors suggest that diseases caused by them need more expansive healthcare monitoring with essential demand for novel antimicrobials.

Epidemiology and Antimicrobial Susceptibility Pattern of Uropathogens in Patients with the Community- and Hospital-Acquired Urinary Tract Infections at a Tertiary Hospital in Somalia

Background: Urinary tract infections (UTIs) are the most common infections in the community and in hospitalized patients. Objectives: To investigate the epidemiology and antimicrobial susceptibility pattern of uropathogens and determine the appropriate empirical antibiotics to treat UTIs in the community and hospitalized patients. Methods: A total of 2,485 urine cultures were performed at Mogadishu Somali Turkish Training and Research Hospital. Through the standard Kirby-Bauer disk diffusion method and commercial disks, antimicrobial sensitivity and resistance were studied based on the Clinical and Laboratory Standards Institute (CLSI) system using Mueller-Hinton agar. The identification of the microorganisms was done using eosin methylene blue agar and blood agar. Results: Escherichia coli was the most predominant pathogen (63.4%) in all age groups, both genders, and in the community and hospital-acquired UTIs, followed by Klebsiella pneumonia (13.3%). Ceftriaxone, trimethoprim/sulfamethoxazole, ampicillin, cefuroxime, and cefixime revealed the highest resistance level (82-100%) against uropathogens. Ciprofloxacin (67.7%) and levofloxacin (54.2%) showed increasing resistance rates against uropathogens. Tigecycline, colimycin, vancomycin, and teicoplanin exhibited the most powerful sensitivity rate (100%). Moreover, fosfomycin, nitrofurantoin, and amikacin manifested a significant sensitivity rate ranging from 86% - 95%. Acinetobacter baumannii was the most prevalent pathogen that belonged to multidrug- and extensively drug-resistant patterns in 69.1% of the samples. Escherichia coli and K. pneumonia showed similar multidrug-resistant patterns in 35.2% of the cases. Conclusions: The results indicated increased trends of antimicrobial resistance rate in trimethoprim/sulfamethoxazole (85.1%) and fluoroquinolones (61%) against E. coli that was higher than the recommended local resistance rate for empirical therapy (< 20% and < 10%, respectively). According to the results, using fosfomycin and nitrofurantoin are suggested for UTI empiric treatment, and other antibiotics should be prescribed carefully.

Molecular Serotyping and Antibiotic Resistance Patterns of Escherichia coli Isolated in Hospital Catering Service in Morocco

Escherichia coli is related to foodborne disease and outbreaks worldwide. It mainly affects persons at high risk as newborns, infants, and individuals with impaired immune system in hospitals. Multidrug-resistant E. coli is currently spreading both in community and hospital settings. Our study aims to evaluate the presence of E. coli and the incidence of its antibiotic resistance in samples obtained from various cooked and raw foods (N = 300), food contact surfaces (N = 238), and food handlers (N = 40) in Moroccan hospital catering service. E. coli was identified using API 20E, and the antibiotic resistance patterns were obtained using the agar disk diffusion methods. However, PCR method was used for O157 and H7 typing. The samples analysis showed that 14.33%, 24.16%, and 45% of food, surfaces, and food handlers harbored E. coli, respectively, with the highest rates obtained in raw meats (34.88%) and salads (34.88%). Molecular amplification shows that 14 E. coli isolates carried the flagellar antigen H7, while there are no isolates showing amplification for O157. The high rate of resistance was noted against ampicillin (100%), amoxicillin-clavulanate acid (100%), nalidixic acid (61.62%), and cefotaxime (59.49%), and isolates obtained from food handler's hands showed the highest rates of resistance. None of the isolates are extended-spectrum beta-lactamases producing, while 27.7% of the isolates were metallo-beta-lactams producing. This first study conducted on Moroccan hospital catering services may draw the authorities' attention to the necessity of setting up a surveillance system to monitor the food preparation process and the safety of prepared food in healthcare settings.