Distribution of virulence determinants among antimicrobial‑resistant and antimicrobial-susceptible Escherichia coli implicated in urinary tract infections.
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Date
2016-10
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Abstract
Introduction: Uropathogenic Escherichia coli (UPEC) rely on the correlation of virulence expression with antimicrobial
resistance to persist and cause severe urinary tract infections (UTIs). Objectives: We assessed the virulence pattern
and prevalence among UPEC strains susceptible and resistant to multiple antimicrobial classes. Methods: A total
of 174 non‑duplicate UPEC strains from patients with clinically significant UTIs were analysed for susceptibility to
aminoglycoside, antifolate, cephalosporin, nitrofuran and quinolone antibiotics for the production of extended‑spectrum
β‑lactamases and for the presence of six virulence determinants encoding adhesins (afimbrial, Type 1 fimbriae, P and
S‑fimbriae) and toxins (cytotoxic necrotising factor and haemolysin). Results: Relatively high resistance rates to
nalidixic acid, ciprofloxacin, cephalothin and trimethoprim‑sulfamethoxazole (82%, 78%, 62% and 59%, respectively)
were observed. Fourteen distinct patterns were identified for the virulence determinants such as afaBC, cnfI, fimH, hylA,
papEF and sfaDE. The toxin gene, cnfI (75.3%), was the second most prevalent marker to the adhesin, fimH (97.1%). The
significant association of sfaDE/hylA (P < 0.01) among antimicrobial resistant and susceptible strains was also observed
notwithstanding an overall greater occurrence of virulence factors among the latter. Conclusions: This study provides
a snapshot of UPEC complexity in Jamaica and highlights the significant clonal heterogeneity among strains. Such
outcomes emphasise the need for evidence‑based strategies in the effective management and control of UTIs.
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Keywords
Adhesins, Escherichia coli, fluoroquinolone resistance, uropathogenic, virulence
Citation
Stephenson S A M, Brown P D. Distribution of virulence determinants among antimicrobial‑resistant and antimicrobial-susceptible Escherichia coli implicated in urinary tract infections. Indian Journal of Medical Microbiology. 2016 Oct-Dec; 34(4): 448-456.