Dissemination of Urinary Escherichia coli Phylogroup B2 in Provincial and Community Hospitals in Uthai Thani, Central Thailand.

Abstract

Escherichia coli is a Gram-negative bacterium that prominently causes a variety of clinical infections in humans, such as diarrhea, sepsis, and urinary tract infection. This bacterium is a common multidrug-resistant threat in community and hospital settings worldwide. This study examined the antimicrobial susceptibility and genetic relationship based on Clermont phylotyping and ERIC-PCR of 84 E. coli urinary isolates from provincial and community hospitals in Thailand. All the isolates were completely susceptible to nitrofurantoin, whereas almost all isolates were susceptible to carbapenem, fosfomycin, and amikacin. A high resistance rate was found to fluoroquinolone, ampicillin, and trimethoprim/sulfamethoxazole. Clermont phylogroup B2 was predominant (n=58). Subtyping of the B2 phylogroup revealed diverse subgroups, of which subgroup V (n=11) was predominant, followed by VII (n=9), III (n=6), and II (n=6). ERIC-PCR showed the strain of the B2 subgroups III and V were spread between provincial and community hospitals and between hospital wards. This evidence suggested the need for comprehensive infection control monitoring, with strong active surveillance at all hospital levels.