Abstract
The emergence of multidrug-resistant (MDR) Escherichia coli (E. coli) clonal lineages with high virulence potential is alarming. Lack of sufficient data on molecular epidemiology of such pathogens from countries with high infection burden, such as Bangladesh, hinders management and infection control measures. In this study, we assessed the population structure, virulence potential and antimicrobial susceptibility of clinical E. coli isolates from Dhaka, Bangladesh. A high prevalence of MDR (69%) and extended-spectrum β-lactamase production (ESBL) (51%) was found. Most E. coli isolates were susceptible to amikacin (95%), meropenem (94%) and nitrofurantoin (89%) antibiotics. A high prevalence of ST131 (22%) and ST95 (9%) followed by ST69 (4%) and ST73 (3%) was observed. Phylogroups B2 (46%), B1 (16%), D (10%) and F (9%) were prominent. blaCTX-M-15 (52%) and blaNDM-1 (5%) were the most prevalent ESBL and carbapenem resistance genes, respectively. Moreover, the predominant pathotype identified was extraintestinal pathogenic E. coli (ExPEC) (41%) followed by enteric pathogens (11%). In conclusion, our results suggest the transmission of clonal E. coli groups amidst diverse E. coli population that are associated with high virulence potential and MDR phenotype. This is of high concern and mandates more efforts towards molecular surveillance of antimicrobial resistance (AMR) in clinically significant pathogens.
Highlights
Urinary tract infection (UTI) is one of the most common bacterial infections, which has become a major public health burden worldwide [1]
Disc diffusion test entailing 16 antibiotics showed a high level of resistance among the E. coli isolates analyzed
Extraintestinal pathogenic E. coli (ExPEC) is the most frequent cause of community-acquired UTIs accounting for significant morbidity, mortality and health care costs
Summary
Urinary tract infection (UTI) is one of the most common bacterial infections, which has become a major public health burden worldwide [1]. E. coli is frequently implicated in bloodstream infections and neonatal meningitis [2,3]. The emergence of multidrug-resistant (MDR) E. coli producing extended-spectrum β-lactamase (ESBL). An increasing number of ExPEC strains producing β-lactamase such as CTX-M-15 is being associated with clonal lineages such as ST131 [5]. Isolates belonging to this lineage have spread extensively, and they are responsible for the rapid worldwide increase in the prevalence of bloodstream and urinary tract infections. The development of resistance to carbapenems among such pathogens is the greatest threat to public health because there are still no effective and safe
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