Virulence Factors and Antibiotic Resistance in Uropathogenic and Commensal Escherichia coli Isolates

Abstract

Background: Urinary Tract Infections (UTIs), including cystitis and pyelonephritis, are the most common infectious diseases in childhood. Aim and Objectives: Escherichia coli (E. coli) account for as much as 90% of the community-acquired and also 50% of nosocomial UTIs. Therefore, the identification of E. coli strains and antibiotic resistance patterns is important for both clinical and epidemiological implications. Material and Methods: To characterize uropathogenic strains E. coli, we studied 100 strains recovered from both urine samples of children aged less than 7 years with community-acquired UTIs and stool samples of healthy children, respectively. Results: We assessed Virulence Factors (VFs) and drug sensitivities of E. coli isolates. Drug sensitivities of the isolates were 94% (amikacin), 90% (nitrofurantoin), 66% (gentamicin), 56% (cefixime), 40% (nalidixic acid) and 28% (cotrimoxazol). Laboratory tests showed that the prevalence of virulence factors ranged from 18% for hemolysin and P-fimbriae to 2% for type1-fimbriae. Most drug resistance was cotrimoxazole and amikacin was the lowest. P-fimbriae and hemolysin in uropathogenic E. coli were more frequent than non-pathogen type of E. coli. Conclusion: Although amikacin appeared to be the first choice for UTI in children, but nitrofurantoin seems to be practical and could be considered as the selective choice for uncomplicated lower UTIs.

Keywords

• Escherichia coli
• Virulence factor
• Drug resistance
• Urinary Tract Infection