Correlation between antibiotic resistance and phylogenetic types among multidrug-resistant isolated from urinary tract infections.

OBJECTIVES

Emergence of multidrug resistance has reduced the choice of antimicrobial regimens for UTIs. To understand the association of phenotype and genotype among uropathogens.

MATERIALS AND METHODS

Six hundred and twenty-eight (628) urine samples were collected and analyzed. Antibiotic sensitivity pattern was determined by the Kirby-Bauer Disc Diffusion Method and minimum inhibitory concentration (MIC) was tested by the E test. Fluoroquinolone resistant mutations in QRDR of and , phylogenetic groups, and PAI subtype were detected by PCR.

RESULTS

Most prevalent uropathogens were (53.2%) followed by (21%). Multidrug- resistance was observed in > 50% cases for third-generation cephalosporins and ciprofloxacin and lowest in meropenem. (66.2%) and (64.4%) were extended-spectrum β-lactamases (ESBLs) producers. MIC to trimethoprim-sulfamethoxazole was highest in (>1024 µg/ml). In 80 (24%) of the 334 isolates analyzed in detail, 54 fluoroquinolones (FQ) resistant isolates carried mutations (S83L, D87N, S80I, E84V) in QRDR of and . Out of 54 FQ-resistant isolates, 43 (79.6%) isolates belonged to the phylogenetic group B2, and 11(20.4%) belonged to group D. Isolates belonged to group B2, 38 (88.4%) of the 43 isolates carried PAI subtype IIa and high frequency of mutation E84V in was detected in 37 (97.4%). Other mutations, such as S80I, S83L in and D87N in were found in all resistant isolates.

CONCLUSION

Correlations between phenotype and genotype provided a basis to understand the resistance development in uropathogens, and PAI subtyping indicated that belonged to the B2 group.