Distinct Characteristics of Escherichia coli Isolated from Patients with Urinary Tract Infections in a Medical Center at a Ten-Year Interval

Escherichia coli causing urinary tract infections (UTIs) are one of the most common outpatient bacterial infections. This study aimed to compare the characteristics of E. coli isolated from UTI patients in a single medical center in 2009–2010 (n = 504) and 2020 (n = 340). The antimicrobial susceptibility of E. coli was determined by the disk diffusion method. PCRs were conducted to detect phylogenetic groups, ST131, K1 capsule antigen, and 15 virulence factors. Phylogenetic group B2 dominated in our 2009–2010 and 2020 isolates. Moreover, no phylogenetic group E strains were isolated in 2020. E. coli isolates in 2020 were more susceptible to amoxicillin, ampicillin/sulbactam, cefuroxime, cefmetazole, ceftazidime, cefoxitin, tetracycline, and sulfamethoxazole/trimethoprim, compared to the isolates in 2009–2010. Extensively drug-resistant (XDR)-E. coli in 2009–2010 were detected in groups B1 (5 isolates), B2 (12 isolates), F (8 isolates), and unknown (1 isolate). In 2020, XDR-E. coli were only detected in groups A (2 isolates), B2 (5 isolates), D (1 isolate), and F (4 isolates). The prevalence of virulence factor genes aer and fimH were higher in E. coli in 2009–2010 compared to those in 2020. In contrast, afa and sat showed higher frequencies in E. coli isolates in 2020 compared to E. coli in 2009–2010.

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Detection of plasmid-mediated qnr genes among the quinolone-resistant Escherichia coli isolates in Iran

The Journal of Infection in Developing Countries ◽

10.3855/jidc.3746 ◽

2014 ◽

Vol 8 (07) ◽

pp. 818-822 ◽

Cited By ~ 12

Author(s):

Farzaneh Firoozeh ◽

Mohammad Zibaei ◽

Younes Soleimani-Asl

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Quinolone Resistance ◽

Diffusion Method ◽

Chain Reaction ◽

Disk Diffusion Method ◽

E Coli ◽

Polymerase Chain ◽

Tract Infections

Introduction: Plasmid-mediated quinolone resistance, which complicates treatment, has been increasingly identified in Escherichia coli isolates worldwide. The purpose of this study was to identify the plasmid-mediated qnrA and qnrB genes among the quinolone-resistant Escherichia coli isolated from urinary tract infections in Iran. Methodology: A total of 140 Escherichia coli isolates were collected between March and October 2012 from urinary tract infections in Khorram Abad, Iran. All isolates were tested for quinoloe resistance using the disk diffusion method. Also, all quinolone-resistant isolates were screened for the presence of the qnrA and qnrB genes by polymerase chain reaction. Minimum inhibitory concentrations (MICs) of ciprofloxacin for the qnr-positive isolates were determined. Results: One hundred sixteen (82.8%) of 140 Escherichia coli isolates were nalidixic acid-resistant; among them, 14 (12.1%) and 9 (7.8%) were qnrA and qnrB-positive, respectively. Two quinolone-resistant isolates harbored both qnrA and qnrB. Among 63 ciprofloxacin-resistant isolates, 14 (22.2%) and 9 (14.3%) were found to carry qnrA and qnrB genes, respectively. The ciprofloxacin MIC range was 0.25–512 μg/mL for 23 qnr-positive Escherichia coli isolates, 18 of which had MICs values of 4–512 μg/mL. Conclusion: Our study shows that the frequency of plasmid-mediated quinolone resistance genes among E. coli isolates in Iran is high.

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Escherichia coli Isolated from Urinary Tract Infections of Lebanese Patients between 2000 and 2009: Epidemiology and Profiles of Resistance

Chemotherapy Research and Practice ◽

10.1155/2011/218431 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 10

Author(s):

Ziad Daoud ◽

Claude Afif

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Diffusion Method ◽

Disk Diffusion Method ◽

E Coli ◽

Standard Culture ◽

Tract Infections ◽

Susceptibility Profiles ◽

Third Generation Cephalosporins

The purpose of this study was to investigate the bacterial etiology of urinary tract infections in one of the busiest hospitals of Lebanon and to examine the epidemiologic and microbiologic properties of Escherichia coli isolated from urinary tract infections of Lebanese patients over a 10-year period. Methods. This retrospective study analyzed the data generated between 2000 and 2009 (10,013 Gram-positive and Gram-negative bacteria). Bacterial identification was based on standard culture and biochemical characteristics of isolates. Antimicrobial susceptibility was tested by the disk diffusion method, and ESBL production was detected by synergy with third-generation cephalosporins and amoxiclav. Results. E. coli was the most frequent isolate throughout the ten years (60.64% of the total isolates). It was followed by Klebsiella pneumoniae and Proteus sp., Pseudomonas aeruginosa, Enterococcus sp., and Streptococcus agalactiae. E. coli occurred more frequently in women (69.8%) than in men (61.4%). The lowest percentage of susceptibility of E. coli was manifested against piperacillin and ampicillin. An increase in the production of ESBL was observed (2.3% in 2000 to 16.8% in 2009). Conclusions. The etiology of urinary tract infections and their susceptibility profiles are important to be evaluated in countries like Lebanon where a severe misuse of antibiotics at all levels is observed.

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Prevalence of Urinary Tract Infections in Children and Changes in Sensitivity to Antibiotics of E. coli Strains

Revista de Chimie ◽

10.37358/rc.70.19.11.7648 ◽

2019 ◽

Vol 70 (11) ◽

pp. 3788-3792

Author(s):

Adrian Hasegan ◽

Maria Totan ◽

Elisabeta Antonescu ◽

Adrian Gheorghe Bumbu ◽

Carmen Pantis ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Urine Culture ◽

Disk Diffusion ◽

Diffusion Method ◽

Sensitivity Testing ◽

Disk Diffusion Method ◽

E Coli ◽

Positive Urine ◽

Tract Infections

Urinary tract infections (UTIs) are the most common bacterial pathologies in children, but they are difficult to spot. The diagnosis relies on urine culture in order to measure the prevalence of the infection, to identify the etiology and the sensitivity of the germs to different antibiotics. Escherichia coli (E. coli) strains are the most common uro-pathogen germs. The change in sensitivity to antibiotic of these uro-pathogen bacteria should be closely monitored because the physicians should be informed about the evolution of the antibiotic resistance of E coli, for a more effective treatment in their fight against diseases. The study aimed to determine the prevalence of UTIs and the evolution of antimicrobial sensitivity for E. coli. This retrospective study was performed over a period of 4 years, 2013-2016, and included all the patients admitted in the Children�s Hospital, aged 0-18 years, with the suspicion of UTIs; also, the standard culture techniques for urine samples, the modified Kirby-Bauer disk diffusion method for the antibiotic sensitivity testing, and the disk diffusion method to confirm the ESBL production by the clinical isolates of E. coli in urine were used. The statistical analysis was performed using the proportions of sensitive, resistant and intermediates. Descriptive statistics like the total, mean and percentage were performed using the Statistical Package for the Social Sciences (SPSS), version 15.0 and Microsoft Excel. From 15389 urine cultures processed in 4 years, 1530 were positive (9.9 %). Among these positive urine cultures, 1056 (69 %) were positive for E. coli. Testing the E. coli to a range of antibiotics, according to CLSI standard, a high resistance to Ampicillin (69-96%), Amoxicillin/Clavulanic acid (32-70%), Trimethoprim/Sulfamethoxazole (36-42%) was observed and low levels of resistance to Ceftazidime, Cefuroxime, Cefpodoxime, Gentamycin, Nalidixic acid. Among E. Coli strains, 9-9.6 % were ESBL positive. Despite the low number of positive urine cultures in a paediatric population, it is very important to perform the urine culture in order to correctly identify the etiology of UTIs, recommend the right antibiotic, and avoid the wrong use of the antibiotics in children.

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Frequency and susceptibility pattern of uropathogenic Enterobacteriaceae isolated from patients in Algiers, Algeria

The Journal of Infection in Developing Countries ◽

10.3855/jidc.10017 ◽

2018 ◽

Vol 12 (04) ◽

pp. 244-249

Author(s):

Abdelhakim Aouf ◽

Taha Gueddi ◽

Bilal Djeghout ◽

Houria Ammari

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Acquired Resistance ◽

Urine Samples ◽

University Hospital ◽

Diffusion Method ◽

Disk Diffusion Method ◽

Tract Infections ◽

A Prospective Study

Introduction: The frequency of Enterobacteriaceae involved in urinary tract infections (UTI) has increased significantly since the early 1990s, particularly in at-risk facilities such as resuscitation, surgery, urology and nephrology. The objective of this study was to evaluate the antimicrobial susceptibility of Enterobacteriaceae causing urinary tract infections (UTIs)at the University Hospital Centre of Benimessous in Algiers. Methodology: The study was designed as a retrospective study (between January 1st 2010 and December 31st 2012) and a prospective study (between January 1standApril 30th 2013) on 13,611 urine samples. Antimicrobial resistance phenotyping was conducted on the bacterial isolates using disk-diffusion method. Results: On 13,611 urine samples analysed, 1,790 (13.15%) fulfilled the criteria for urinary tract infection. Enterobacteriaceae were identified in 1,561 analysed samples (87%). Escherichia coli was the dominant uropathogen (66,15%) in both hospitalized and non-hospitalized patients. The other main detected Enterobacteriaceae members were Klebsiella pneumoniae (11,96%) and Proteus mirabilis (5,42%). Analysis of results showed also that women were more prone to UTI than men with sex ratio of 3.76(W/M). The susceptibilities of isolated Enterobacteriaceae to antibiotics revealed that they had acquired resistance to several classes, particularly toward β-lactams. Resistance frequencies were relatively high to ampicillin and sulfomethoxasole, while being very low to aminoglycosides and furans. Results obtained revealed also that 7% of isolates where resistant to third generation cephalosporins by production of extended spectrum β-lactamases (ESBL). Conclusions: The continuous monitoring of antibiotic resistance of uropathogenic Escherichia coli is crucial to guide the clinician to choose the best empiric treatment.

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Antibiotic Susceptibility and Molecular Characterization of Uropathogenic Escherichia coli Associated with Community-Acquired Urinary Tract Infections in Urban and Rural Settings in South Africa

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed5040176 ◽

2020 ◽

Vol 5 (4) ◽

pp. 176

Author(s):

Purity Z. Kubone ◽

Koleka P. Mlisana ◽

Usha Govinden ◽

Akebe Luther King Abia ◽

Sabiha Y. Essack

Keyword(s):

Escherichia Coli ◽

South Africa ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Resistance Genes ◽

Multidrug Resistant ◽

Uropathogenic Escherichia Coli ◽

Diffusion Method ◽

E Coli ◽

Tract Infections

We investigated the phenotypic and genotypic antibiotic resistance, and clonality of uropathogenic Escherichia coli (UPEC) implicated in community-acquired urinary tract infections (CA-UTIs) in KwaZulu-Natal, South Africa. Mid-stream urine samples (n = 143) were cultured on selective media. Isolates were identified using the API 20E kit and their susceptibility to 17 antibiotics tested using the disk diffusion method. Extended-spectrum β-lactamases (ESBLs) were detected using ROSCO kits. Polymerase chain reaction (PCR) was used to detect uropathogenic E. coli (targeting the papC gene), and β-lactam (blaTEM/blaSHV-like and blaCTX-M) and fluoroquinolone (qnrA, qnrB, qnrS, gyrA, parC, aac(6’)-Ib-cr, and qepA) resistance genes. Clonality was ascertained using ERIC-PCR. The prevalence of UTIs of Gram-negative etiology among adults 18–60 years of age in the uMgungundlovu District was 19.6%. Twenty-six E. coli isolates were obtained from 28 positive UTI samples. All E. coli isolates were papC-positive. The highest resistance was to ampicillin (76.9%) and the lowest (7.7%) to amoxicillin/clavulanic acid and gentamycin. Four isolates were multidrug-resistant and three were ESBL-positive, all being CTX-M-positive but SHV-negative. The aac(6’)-Ib-cr and gyrA were the most detected fluoroquinolone resistance genes (75%). Isolates were clonally distinct, suggesting the spread of genetically diverse UPEC clones within the three communities. This study highlights the spread of genetically diverse antibiotic-resistant CA-UTI aetiologic agents, including multidrug-resistant ones, and suggests a revision of current treatment options for CA-UTIs in rural and urban settings.

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Mecillinam: Old Molecule, New Option

Journal of Pediatric Infectious Diseases ◽

10.1055/s-0038-1657790 ◽

2018 ◽

Vol 13 (03) ◽

pp. 229-233

Author(s):

Mevliye Yetik ◽

Fulya Bayındır Bilman

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Susceptibility Testing ◽

Diffusion Method ◽

First Line ◽

Disk Diffusion Method ◽

In Vitro Susceptibility ◽

E Coli ◽

Tract Infections

Background Mecillinam is a β-lactam antibiotic that is increasingly being used for the treatment of uncomplicated urinary tract infections. Nevertheless, the international guidelines still recommend nitrofurantoin, fosfomycin trometamol, and pivmecillinam as first-line agents in the treatment of such infections. Aim The objective of this study was to determine the in vitro efficacy of mecillinam against Escherichia coli and Klebsiella pneumoniae strains isolated from children with urinary tract infections. Materials Methods We investigated E. coli and K. pneumoniae isolates, obtained within the period from January 2016 to October 2017, from urine samples of patients aged 0 to 16 years. Antibiotics susceptibility testing was conducted through the disk diffusion method based on the guidelines provided by EUCAST (European Committee on Antimicrobial Susceptibility Testing). Extended-spectrum β-lactamase (ESBL)-positivity was detected by the double-disk synergy test. Isolates with mecillinam inhibition-zone diameter breakpoints lower than < 15 mm were considered to be resistant according to EUCAST criteria. Results A total of 450 isolates were assessed in the study, 135 of which were ESBL-producing E.coli, 230 were non-ESBL-producing E. coli, 35 were ESBL-producing K. pneumoniae, and 50 were non-ESBL-producing K. pneumoniae isolates. Mecillinam susceptibility was observed in most of the non-ESBL-producing and ESBL-producing E. coli isolates (230/230, 100% and 115/135, 85.1%, respectively). The rates of susceptibility of the non-ESBL-producing and ESBL-producing K. pneumoniae isolates were 37/50 (74%) and 24/35 (68.6%), respectively. Conclusion The in vitro susceptibility results obtained support the usage of mecillinam as a first-line agent. The high susceptibility of non-ESBL-producing E. coli and K. pneumoniae isolates established in vitro brings the hope that this antibiotic could soon be used in clinical practice in Turkey.

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Prevalence of Resistance to Quinolone and Fluoroquinolone Antibiotics and Screening of qnr Genes Among Escherichia coli Isolates From Urinary Tract Infection

International Journal of Enteric Pathogens ◽

10.15171/ijep.2017.24 ◽

2017 ◽

Vol 5 (4) ◽

pp. 100-105 ◽

Cited By ~ 1

Author(s):

Mohadese Amiri ◽

Maziar Jajarmi ◽

Reza Ghanbarpour

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Nalidixic Acid ◽

Diffusion Method ◽

Biochemical Tests ◽

Phylogenetic Groups ◽

Disk Diffusion Method ◽

E Coli ◽

Fluoroquinolone Antibiotics ◽

Tract Infections

Background: Antibiotic resistance (AR) is an important challenge in prevention, treatment and control of infectious diseases and is a public health threat for human. Escherichia coli strains are the major causes of urinary tract infections (UTIs). Objective: This research aimed to determine prevalence of resistance to quinolone and fluoroquinolone antibiotics and screen qnr genes among E. coli isolates from UTIs. Materials and Methods: A total of 105 E. coli isolates were obtained from UTI cases in Bojnord city (northeast of Iran) and confirmed by biochemical tests. All strains were studied to determine their resistance to 3 antibiotics including ciprofloxacin, nalidixic acid, and levofloxacin via disk diffusion method. Moreover, the frequency of qnrA, qnrB and qnrS genes and phylogroups was studied by conventional Polymerase chain reaction (PCR). Results: In this study, prevalence of phenotypic AR to ciprofloxacin, nalidixic acid and levofloxacin was 47.6%, 44.8% and 38.1%, respectively. Three isolates were positive for qnrS and 1 isolate was positive for qnrA. Seven phylogenetic groups were also identified as follows: 18% A0, 6.7% A1, 7.6% B1, 1.9% B22, 23.8% B23, 15.3% D1 and 26.7% D2. Conclusion: Prevalence of qnr genes was very low; thus, other types of qnr and plasmid-mediated quinolone resistance genes were probably responsible for the resistance. Phenotypic AR to the 3 antibiotics was found in approximately half of E. coli strains. It is strongly recommended that antibiogram tests should be done before prescribing the ciprofloxacin, nalidixic acid and levofloxacin for UTIs.

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Antibiotic resistance pattern and phylogenetic groups of the uropathogenic Escherichia coli isolates from urinary tract infections in Hamedan, west of Iran

Iranian Journal of Microbiology ◽

10.18502/ijm.v12i5.4598 ◽

2020 ◽

Author(s):

Somayeh Bakhtiari ◽

Hassan Mahmoudi ◽

Sara Khosravi Seftjani ◽

Mohammad Ali Amirzargar ◽

Sima Ghiasvand ◽

...

Keyword(s):

Escherichia Coli ◽

Antibiotic Resistance ◽

Urinary Tract ◽

Nalidixic Acid ◽

Urinary Tract Infections ◽

Diffusion Method ◽

Phylogenetic Groups ◽

E Coli ◽

Group A ◽

Tract Infections

Background and Objectives: Escherichia coli is the most common causative agent of urinary tract infections (UTIs) in 90-80% of patients in all age groups. Phylogenetic groups of these bacteria are variable and the most known groups are A, B1, B2 and D. The present study aimed to evaluate the phylogenetic groups of E. coli samples obtained from UTIs and their relation with antibiotic resistance patterns of isolates. Materials and Methods: In this study 113 E. coli isolates were isolated from distinct patients with UTIs referred to Hamadan hospitals. After biochemical and molecular identification of the isolates, typing and phylogenetic grouping of E. coli strains were performed using multiplex PCR targeting chu, yjaA and TSPE4.C2 genes. The anti-microbial susceptibility of the isolates to amikacin, ampicillin, trimethoprim-sulfamethoxazole, amoxicillin/clavulanic acid, ciprofloxacin, cefotaxime, imipenem, aztreonam, gentamicin, meropenem, nitrofurantoin, nalidixic acid and cefazolin was determined using disk diffusion method. Results: Of 113 isolates, 50 (44.2%), 35 (31%), 23 (20.4%) and 5 (4.4%) of samples belonged to group B2, group D, group A and group B1 phylogenetic groups respectively. All isolates were susceptible to meropenem, imipenem (100%), followed by amikacin (99.1%). The highest resistance rates were observed against ampicillin (74.3%) and nalidixic acid (70.8%). Correlation between phylogenetic groups and antibiotic susceptibilities was significant only with co-amoxiclav (P = 0.006), which had the highest resistance in phylogenetic group A. Conclusion: Prevalence of different phylogroup and resistance associated with them in E. coli samples could be variable in each region. Therefore, investigating of these items in E. coli infections, could be more helpful in selecting the appropriate antibiotic treatment and epidemiological studies.

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In vitro Activity of Ceftolozane/Tazobactam for the Treatment of Complicated Urinary Tract Infections by Escherichia coli in the Era of Antibiotic Resistance “Rejuvenate the mystery”

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2019/v30i330270 ◽

2019 ◽

pp. 1-7

Author(s):

Lubna Farooq ◽

Shaikh Nadeem Ahmed ◽

Muhammad Aitmaud Uddolah Khan ◽

Akhtar Ali ◽

Sehrish Mehmood ◽

...

Keyword(s):

Urinary Tract ◽

Urinary Tract Infections ◽

Bacterial Infections ◽

Diffusion Method ◽

Susceptibility Pattern ◽

E Coli ◽

Microbiological Methods ◽

Tract Infections ◽

Pathogen Burden

Background: Urinary tract infections are found to be commonest bacterial infections across the globe. Various studies have demonstrated high prevalence rate of UTIs in Pakistan. Multiple broad spectrum antibiotics are being used for the treatment of UTI but the resistance by the pathogen against these drugs is increasing worldwide. As the resistance in the organisms is increasing day by day, and it is now hall mark and matter of concern for clinicians to treat uropathogenic E. coli, so there is a pertinent need to explore new sensitive antibiotics or alternative options to manage the disease. Aims: To determine the pathogen burden and susceptibility pattern of ceftolozane/tazobactam against MDR E. coli isolates from clinical specimens of urinary tract infections in Karachi. Study Design: It was an in-vitro clinical study. Study Settings: The study was conducted in department of Pharmacology, Baqai Medical University and isolates were collected from Microbiology laboratory of Karachi. Methodology: On the basis of identification methods, one hundred and fifty (150) strains of E. coli were isolated from 650 specimen of urine. Clinical isolates were identified by standard and specific microbiological methods. The antibiotic susceptibility pattern was determined by Kirby Bauer Disc diffusion method. Samples were processed as per procedures defined by Clinical and Laboratory Standards Institute (CLSI) guidelines 2018. Results: Out of 150 isolates of E. coli, 95 (63.3%) were MDR E. coli. majority of the cases were obtained from age group 61-80 year (32.6%). Highest sensitivity was seen by ceftolozane/tazobactam (96%) followed by ceftriaxone (88%). Least sensitivity was observed with Imipenem (13.70%). However increased trend of resistance was seen among all empirical used drugs.

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Susceptibility pattern of Escherichia coli from urinary tract infections to antibiotics and methanol extracts of Olax subscorpioidea and Sida corymbosa

Journal of Pharmacy & Bioresources ◽

10.4314/jpb.v17i1.12 ◽

2020 ◽

Vol 17 (1) ◽

pp. 75-80

Author(s):

Philip A. Idowu ◽

Babatunde M. Okanlawon ◽

Habeeb O. Salam

Keyword(s):

Escherichia Coli ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Diffusion Method ◽

Dilution Method ◽

Agar Dilution Method ◽

Traditional Use ◽

E Coli ◽

Methanol Extracts ◽

Tract Infections

Antibiotic resistance in urinary tract infections (UTIs), of which Escherichia coli causes about 80% of cases is on increase, causing mortality, morbidity and increased health care costs. Clinical isolates of E. coli (13) from UTIs were tested for susceptibility to standard antibiotics and extracts of Olax subscorpioidea and Sida corymbosa. Methanol extracts of the plants were screened at 20, 40, 80 and 100 mg/ml against the isolates using agar-welldiffusion method while antibiogram was determined by Kirby-Bauer disc diffusion method. The minimum inhibitory concentrations (MICs) of the plants` extracts and two antibiotics were determined by agar dilution method. The isolates were mostly susceptible to ofloxacin and 100% resistance to augmentin. Extracts of the plants showed good and dose-dependent activities, even on the multidrug resistant E. coli isolates. The zones of inhibition of the extracts ranged 9-16 mm while the MICs ranged 0.5-10 mg/ml on the isolates. This study has shown that MDR E. coli in UTIs are still prevalent and that the roots of O. subscorpioidea and stem of S. corymbosa extracts have good antibacterial activities against the isolates. The results justified the traditional use of the plants to treat infections generally and the potential utilization in the treatment of UTIs. Keywords: Urinary tract infection; Antibiotics; Escherichia coli; Olax subscorpioidea; Sida corymbosa

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