Koley, SnehashisMukherjee, MandiraHalder, PrantikiBose, AmbarLahre, DushyantMukhopadhyay, SumiMallik, Sudeshna2023-06-172023-06-172022-10Koley Snehashis, Mukherjee Mandira, Halder Prantiki, Bose Ambar, Lahre Dushyant, Mukhopadhyay Sumi, Mallik Sudeshna. Clinico-microbiological Profile of Urinary Tract Infection with Special Reference to Uropathogenic E coli : Antibiotic susceptibility Pattern, Phylogenetic Background and Virulent Factor Distribution from West Bengal, India. Journal of The Indian Medical Association. 2022 Oct; 120(10): 48-530019-5847http://imsear.searo.who.int/handle/123456789/216630Background and Objectives : Routine surveillance and monitoring studies pose a constant need to update clinicians on prevalent pathogens and rational and empirical treatment in Urinary Tract Infection (UTI). Escherichia coli (E coli) is the most commonly isolated uropathogen globally. Extended-Spectrum ?-Lactamase (ESBL) production and ?-Lactamase Inhibitor Resistance (BLIR) among these pathogens together with their uro-virulence determinants further complicate treatment approaches. This study investigated the clinico-microbiological pattern of UTI and determined the antibiotic sensitivity pattern, the phylogenetic background, and virulence determinants of E coli, the most commonly isolated uropathogen. Methods : Uropathogens isolated by urine culture from community and hospitalized patients were biochemically speciated. Antibiotic susceptibility was tested by Kirby-bauer disk diffusion method. Phylogenetic background and virulence determinants of E coli isolates were identified by PCR. SPSS 16.0 was used for statistical interpretation. Results : 45% of the urine samples showed growth positivity. 44% amongst them were E coli. All isolates were multidrug-resistant. 50% and 40% were ESBL producers and BLIR respectively. Former showed highest resistance to quinolone, fluoroquinolones, cotrimoxazole, and latter were resistant against all drugs tested except nitrofurantoin. Significant correlation existed between the ?-lactams, quinolone, fluoroquinolones, cotrimoxazole (p<0.05) resistance pattern. BLIR and ESBL E coli recorded highest prevalence of pathogenic phylogroup B2 and D respectively. Varied prevalence of fimbrial (fimH, papC, papEF, papG, GII) and toxin genes (iroN, hlyA, cnfI, i ucD, cdtBU) in ESBL, BLIR and non-ESBL isolates were observed. Their distribution was statistically significant (p=0.05). Interpretation and Conclusions : Nitrofurantoin is the drug of choice in empirical treatment of uncomplicated UTI. Aggressive and consistent investigation and health education are highly recommended for effective clinical management in UTI.Antibiotic resistancePhylogenetic backgroundVirulence factorUropathogenic E coliUrinary Tract InfectionJournal ArticleIndiaDepartment of Biochemistry and Medical Biotechnology, School of Tropical Medicine, Kolkata 700073M Tech, Research ScholarPhD, Associate ProfessorMD, Assistant Professor, Department of Tropical MedicineMSc, Research ScholarMD, Senior Resident, Department of Tropical MedicinePhD, Research Associate, Department of Laboratory MedicineMD, Associate Professor, Department of Tropical Medicine and Correspondence Author