Abstract
BackgroundAntibiotic resistance is an increasing phenomenon in many bacterial pathogens including uropathogenic Escherichia coli. Hypothetical anti-virulent agents could be a solution, but first clear virulence associated gene-pool of antibiotic resistant isolates have to be determined. The aim of this study is to investigate the significant associations between genes encoding VFs with antibiotic resistance and phylogenetic groups in UPEC isolates.ResultsThe majority of 248 UPEC isolates belonged to phylogenetic group B2 (67.3%). The maximum and minimum resistance was attributed to amoxicillin (90.3%) and both fosfomycin and imipenem (1.6%) respectively. 11.3% of isolates were resistant to all antibiotic agents except that of imipenem, nitrofurantoin and fosfomycin. These highly resistant isolates were placed only in group B2 and D. The most prevalent virulence gene was ompA (93.5%). The hlyA was the only virulence gene that was significantly more prevalent in the highly resistant isolates. The ompA, malX and hlyA genes were obviously more abundant in the antibiotic resistant isolates in comparison to susceptible isolates. The papC gene was associated with amoxicillin resistance (p-value = 0.006, odds ratio: 26.00).ConclusionsIncreased resistance to first line drugs prescribed for UTIs were detected in CA-UPEC isolates in our study.. Minimal resistance was observed against nitrofurantoin, fosfomycin and imipenem. Therefore, they are introduced for application in empirical therapy of UTIs. Fosfomycin may be the most effective antibiotic agent against highly resistant UPEC isolates. The presence of the ompA, malX and hlyA genes were significantly associated with resistance to different antibiotic agents. We assume that the ability of UPEC isolates to upgrade their antibiotic resistance capacity may occurs in compliance with the preliminary existence of specific virulence associated genes. But, more investigation with higher number of bacterial isolates, further virulence associated genes and comparison of gene pools from CA-UPEC isolates with HA-UPEC are proposed to confirm these finding and discovering new aspects of this association.
Highlights
Antibiotic resistance is an increasing phenomenon in many bacterial pathogens including uropathogenic Escherichia coli
Many bacterial pathogens are known as the causative agents of Urinary tract infection (UTI), but uropathogenic Escherichia coli (UPEC) is accounted as the most common agent (80–90%) of UTIs [2,3,4]
Data obtained from disk diffusion test showed various frequency of antibiotic resistance including, 90.3% amoxicillin, 67.7% trimethoprim-sulfamethoxazole, 61.3% cephalexin, 59.7% ceftriaxone, 58.1% cefotaxime, 43.5% ciprofloxacin, 41.9% azithromycin, 40.3% ceftazidime, 27.4% gentamycin and minimum antibiotic resistance was detected against fosfomycin (1.6%), nitrofurantoin (3.2%) and imipenem (1.6%)
Summary
Antibiotic resistance is an increasing phenomenon in many bacterial pathogens including uropathogenic Escherichia coli. Hypothetical anti-virulent agents could be a solution, but first clear virulence associated gene-pool of antibiotic resistant isolates have to be determined. The aim of this study is to investigate the significant associations between genes encoding VFs with antibiotic resistance and phylogenetic groups in UPEC isolates. Urinary tract infection (UTI) is a widespread medical condition that involves both men and women and can occur frequently in different ages [1]. About 150 million new case of UTI worldwide are reported every year that most of them are women [2]. Many bacterial pathogens are known as the causative agents of UTI, but uropathogenic Escherichia coli (UPEC) is accounted as the most common agent (80–90%) of UTIs [2,3,4]. The A and B1 groups are less virulent and usually originate from fecal samples instead [6]
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