Abstract
BackgroundThis study aimed to investigate the phylogenetic characterization and virulence traits of uropathogenic Escherichia coli (UPEC) isolated from kidney transplant patients (KTPs) as well as non-KTPs and analyze the clonal distribution of Extended spectrum β-lactamases (ESBLs)-producing UPEC containing blaCTX-M gene.MethodsTo this end, we determined virulence marker and the phylogenetic characterization of UPEC in non-KTPs (n = 65) and KTPs (n = 46). The non-KTPs were considered the control group of the study. Also, according to the Achtman scheme, we performed multilocus sequence typing to assess the relationship between twenty-nine of ESBL-producing isolates containing blaCTX-M gene.ResultsAccording to the results of PCR assay, the prevalence of virulence factor genes ranged from 0% (cnf and papG III) to 93.7% (fimH). Also, KTP isolates significantly differed from non-KTP isolates only in terms of the prevalence of pap GI elements. Moreover, the most frequent UPEC isolates were in phylogenetic group B2, followed by group D (18.9%), and group A (13.5%). Furthermore, except for phylogenetic group C, there was no significant correlation between phylogenetic distribution in KTPs and non-KTPs. Additionally, MLST analysis of blaCTX-M carrying isolates identified 18 unique sequence types (ST) the most common of which was ST131 (24.1%), followed by ST1193 (10.3%), while fourteen STs were detected only once.ConclusionsThe results further revealed significant differences between the UPEC isolates from KTPs and non-KTPs regarding the phylogroups C and PAI gene. Based on MLST analysis, we also observed a relatively high diversity in UPEC isolates obtained from KTPs and non-KTPs. Moreover, clonal complex (CC) 131 and ST131 were found to be the most prevalent clones and ST types, respectively. Besides, for the first time, ST8503 were reported in KTPs. These results suggested regular studies on characterization of UPEC isolates among KTPs.
Highlights
This study aimed to investigate the phylogenetic characterization and virulence traits of uropathogenic Escherichia coli (UPEC) isolated from kidney transplant patients (KTPs) as well as non-Kidney transplant patients (KTP) and analyze the clonal distribution of Extended spectrum β-lactamases (ESBLs)-producing UPEC containing blaCTX-M gene
The most prevalent Extended-spectrum β-lactamases (ESBL) clone is related to the wide spreading of CTX-M, which has been replaced with blaSHV and blaTEM, as the most prevalent ESBL genes [5,6,7]
Study design and setting In this case–control study, UPEC isolates were collected from June 2019 to October 2019 from a total number of 111 patients, who were assigned to two groups of nonKTPs (n = 65) and KTPs (n = 46)
Summary
This study aimed to investigate the phylogenetic characterization and virulence traits of uropathogenic Escherichia coli (UPEC) isolated from kidney transplant patients (KTPs) as well as non-KTPs and analyze the clonal distribution of Extended spectrum β-lactamases (ESBLs)-producing UPEC containing blaCTX-M gene. In kidney transplant patients (KTPs), urinary tract infections (UTI) have been complicated by the widespread disseminated bacterial agents, Escherichia coli, which are resistant to first-line antimicrobial options [1, 2]. The worldwide increasing extended-spectrum β-lactamases (ESBL) and multi-drug resistance (MDR) of E. coli strains are responsible for a high proportion of UTI frequently affecting KTP [4]. The dissemination of CTX-M family among UPEC is mediated by the rapid spread of plasmids and mobile genetic elements. UTI with blaCTX-M-15-producing-UPEC in humans is a major concern especially in KTP [8]
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