title: Uropathogens from diabetic patients in Libya: virulence factors and phylogenetic groups of Escherichia coli isolates.
abstract: Urinary tract infections (UTIs) in patients with diabetes mellitus (DM) are reported mainly from developed countries. In addition to this underreporting from developing countries, there is a lack of information pertaining to the virulence factors (VFs) and phylogenetic grouping of uropathogenic Escherichia coli (UPEC) from DM and non-DM patients in developing countries. Between July 2005 and June 2006, urine specimens were collected from 135 DM and 164 non-DM patients, all with clinically diagnosed UTIs, attending Elkhadra Hospital and the Diabetic Center in Tripoli, Libya. Specimens were examined for different uropathogens using standard microbiological procedures. Isolated uropathogens were tested for their susceptibility to antimicrobial agents by a disc diffusion method. In addition, UPEC was grouped phylogenetically by PCR and subsequently tested for 19 VFs. Uropathogens were isolated from 77 (57 %) of the DM group and from 110 (67 %) of the non-DM group (P >0.05). E. coli was isolated from 18 (13 %) and 29 (18 %), Klebsiella species from 18 (13 %) and 23 (14 %), and Staphylococcus aureus from 12 (9 %) and 12 (7 %) of the DM and non-DM groups, respectively (P >0.05). Age, gender, education level and marital status had no significant influence on the isolation rates of different organisms from the DM group compared with the non-DM group. With very few exceptions, no differences were observed in the antimicrobial resistance profiles of uropathogens from the DM and non-DM patients. In addition, UPEC from the DM patients was significantly less virulent and was associated with phylogenetic group A, whilst UPEC from the non-DM patients was significantly more virulent and was associated with group D. The results of our surveillance of UTI infections in DM patients agree, in general, with observations reported previously from several developed countries.
authors.affiliation: Department of Microbiology and Immunology, Faculty of Medicine, Al-Fateh University for Medical Sciences, Tripoli, Libya.
authors.forename: Khalifa Sifaw
authors.initials: KS
authors.lastname: Ghenghesh
authors.affiliation: Department of Zoology, Faculty of Sciences, Al-Fateh University, Tripoli, Libya.
authors.forename: Einass
authors.initials: E
authors.lastname: Elkateb
authors.affiliation: Department of Zoology, Faculty of Sciences, Al-Fateh University, Tripoli, Libya.
authors.forename: Nuri
authors.initials: N
authors.lastname: Berbash
authors.affiliation: Clinical Trials Program, Molecular Epidemiology Unit, NAMRU-3, Cairo, Egypt.
authors.forename: Rania
authors.initials: R
authors.lastname: Abdel Nada
authors.affiliation: Clinical Trials Program, Molecular Epidemiology Unit, NAMRU-3, Cairo, Egypt.
authors.forename: Salwa F
authors.initials: SF
authors.lastname: Ahmed
authors.affiliation: Department of Microbiology and Immunology, Faculty of Medicine, Al-Fateh University for Medical Sciences, Tripoli, Libya.
authors.forename: Amal
authors.initials: A
authors.lastname: Rahouma
authors.affiliation: Department of Microbiology and Immunology, Faculty of Medicine, Al-Fateh University for Medical Sciences, Tripoli, Libya.
authors.forename: Nadia
authors.initials: N
authors.lastname: Seif-Enasser
authors.affiliation: Department of Urology, Elkhadra Hospital, Tripoli, Libya.
authors.forename: Mohamed-Abdulwahab
authors.initials: MA
authors.lastname: Elkhabroun
authors.affiliation: Diabetic Center, Tripoli, Libya.
authors.forename: Taher
authors.initials: T
authors.lastname: Belresh
authors.affiliation: Clinical Trials Program, Molecular Epidemiology Unit, NAMRU-3, Cairo, Egypt.
authors.forename: John D
authors.initials: JD
authors.lastname: Klena
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003920:Diabetes Mellitus / Q000382:microbiology*; D004926:Escherichia coli / Q000235:genetics*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology; D029968:Escherichia coli Proteins / Q000235:genetics / Q000378:metabolism; D005260:Female; D005798:Genes, Bacterial; D006801:Humans; D008002:Libya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D037521:Virulence Factors / Q000235:genetics / Q000378:metabolism*; D055815:Young Adult
chemical_list: D029968:Escherichia coli Proteins; D037521:Virulence Factors