Department of Microbiology and Infectious Diseases, B. P. Koirala Institute of Health Sciences (BPKIHS), Sunsari, Dharan, 56700, Nepal.
Department of Internal Medicine, B. P. Koirala Institute of Health Sciences (BPKIHS), Sunsari, Dharan, 56700, Nepal.
BMC Microbiol. 2019 Sep 2;19(1):204. doi: 10.1186/s12866-019-1587-3.
Escherichia coli has found to be the predominant uropathogen (50-90%) in uncomplicated, community acquired urinary tract infection (UTI). Uropathogenic Escherichia coli (UPEC) express a multitude of virulence factors, which enable the bacteria to establish UTI. The objective of this study was to evaluate the presence of different phenotypic virulence markers in UPEC isolates and determine their correlation with antibiotic resistance pattern.
Out of 105 patients, 56 (53%) were females and 49 (47%) were males. The age of the patients in the study ranged from 18 years to 87 years and majority of the patients belonged to the age group 20-29 years. Virulence factor was observed in 65% (n = 69) of UPEC and 20% (n = 22) of control isolates (P = 0.0001). Haemolysin production was observed in 34(32.3%) of uroisolates and 12 (11.4%) of control strain. Similarly, 62% of UPEC and 1% of control produced biofilm (P = 0.0001). The expression of Mannose-resistant hemagglutinin (MRHA) and mannose-sensitive hemagglutinin (MSHA) in uroisolates were 52.3% (n = 55) and 5.7% (n = 6) respectively, whereas in faecal isolates, 8.5% (n = 9) expressed MRHA and none produced MSHA. Antimicrobial resistance showed a high degree of resistance towards ampicillin, cotrimoxazole and norfloxacin. The resistance was observed in significant higher degree in biofilm formers as compared to non-formers. MDR and ESBL was observed in 51 and 46% of test strains and 9 and 7.6% of control strains (P = 0.0001).
A significant association between virulence factors of UPEC and antimicrobial resistance in UPEC was present. Routine testing of these factors and co-relation with AMR is recommended. These findings will certainly help understand the pathogenicity and proper management of UTI patients, thus decreasing the improper use of antibiotics.
大肠杆菌已被发现是复杂性较低的社区获得性尿路感染（UTI）的主要尿路病原体（50-90%）。尿路致病性大肠杆菌（UPEC）表达多种毒力因子，使细菌能够建立 UTI。本研究的目的是评估 UPEC 分离株中不同表型毒力标志物的存在，并确定其与抗生素耐药模式的相关性。
在 105 名患者中，56 名（53%）为女性，49 名（47%）为男性。患者的年龄在 18 岁至 87 岁之间，大多数患者属于 20-29 岁年龄组。在 UPEC 中观察到毒力因子的占 65%（n=69），而在对照组分离株中观察到的占 20%（n=22）（P=0.0001）。溶血素产生在 34 个（32.3%）尿分离株和 12 个（11.4%）对照菌株中观察到。同样，62%的 UPEC 和 1%的对照组产生生物膜（P=0.0001）。UPEC 中甘露糖抗性血凝素（MRHA）和甘露糖敏感血凝素（MSHA）的表达分别为 52.3%（n=55）和 5.7%（n=6），而在粪便分离株中，8.5%（n=9）表达 MRHA，无表达 MSHA。对氨苄西林、复方新诺明和诺氟沙星表现出高度耐药。与非生物膜形成者相比，生物膜形成者表现出更高程度的耐药性。在测试菌株中观察到 51%和 46%的 MDR 和 ESBL，在对照菌株中观察到 9%和 7.6%的 MDR 和 ESBL（P=0.0001）。
UPEC 的毒力因子与 UPEC 中的抗生素耐药性之间存在显著相关性。建议常规检测这些因素并与 AMR 相关联。这些发现肯定有助于了解 UTI 患者的致病性和适当的管理，从而减少抗生素的不当使用。
