title: Lower prevalence of hlyD, papC and cnf-1 genes in ciprofloxacin-resistant uropathogenic Escherichia coli than their susceptible counterparts isolated from southern India.
abstract: OBJECTIVE
  The study was conducted to determine the association of the hlyD, papC and cnf-1 virulence genes with drug resistance in uropathogenic Escherichia coli (UPEC) isolated from cases of urinary tract infection (UTI).
  
  
  METHODS
  A total of 193 E. coli strains isolated from symptomatic cases of UTI in a tertiary care teaching hospital in Raichur, Northern Karnataka, India were included in the study. The antibiotic susceptibility pattern was determined by Kirby-Bauer's Disk Diffusion method, and the strains resistant to any of the third generation cephalosporins tested were further confirmed for extended-spectrum beta-lactamase (ESBL)-production by an E-strip test. Genotypic virulence markers, namely, hlyD, papC and cnf-1, were detected by the uniplex PCR method and the phylogenetic characterization was performed by a multiplex PCR assay.
  
  
  RESULTS
  The majority of the E. coli isolates belonged to the B2 phylogenetic group were significantly associated with ciprofloxacin-sensitivity and non-ESBL production (p<0.05). An increased prevalence of ciprofloxacin-sensitive strains over ciprofloxacin-resistant strains were observed among the UPEC isolates harboring the papC (72.9% vs. 40.2%; p<0.001), hlyD (43.7% vs. 21.6%; p<0.001) and cnf-1 (30.2% vs. 12.3%; p<0.05) genes. The presence of a multivirulent gene in the non-ESBL E. coli strains (44.5%) was significantly higher (p<0.05) than in the ESBL-producing strains (21%).
  
  
  CONCLUSIONS
  Among the UPEC isolates, the predominant B2 phylogenetic group was significantly associated with the ciprofloxacin-sensitive strains, as well as with the non-ESBL E. coli strains. The genotypic virulence markers of UPEC were associated with ciprofloxacin-sensitivity, and a significant number of the non-ESBL strains harbored multivirulent genes. The relationship between the presence of the virulence genes and ESBL production was complex and warrants further intensive studies.
authors.affiliation: Dept. of Microbiology, Navodaya Medical College, Raichur, Karnataka, India. Electronic address: dr.anandmicro@gmail.com.
authors.forename: Anandkumar
authors.initials: A
authors.lastname: Harwalkar
authors.affiliation: Dept. of Microbiology, St. John's Medical College, Bangalore, Karnataka, India.
authors.forename: Soham
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Dept. of Microbiology, Navodaya Medical College, Raichur, Karnataka, India.
authors.forename: Achut
authors.initials: A
authors.lastname: Rao
authors.affiliation: Dept. of Microbiology, St. John's Medical College, Bangalore, Karnataka, India.
authors.forename: Hiresave
authors.initials: H
authors.lastname: Srinivasa
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001427:Bacterial Toxins / Q000032:analysis / Q000235:genetics*; D002939:Ciprofloxacin / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology; D029968:Escherichia coli Proteins / Q000032:analysis / Q000235:genetics*; D005260:Female; D006460:Hemolysin Proteins / Q000032:analysis / Q000235:genetics*; D006784:Hospitals, Teaching; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D026901:Membrane Transport Proteins / Q000032:analysis / Q000235:genetics*; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058889:Molecular Typing; D016133:Polymerase Chain Reaction; D018272:Porins / Q000032:analysis / Q000235:genetics*; D015995:Prevalence; D062606:Tertiary Care Centers; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000382:microbiology*; D056689:Uropathogenic Escherichia coli / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D037521:Virulence Factors / Q000032:analysis / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D029968:Escherichia coli Proteins; D006460:Hemolysin Proteins; C065231:HlyD protein, E coli; D026901:Membrane Transport Proteins; D018272:Porins; D037521:Virulence Factors; C111243:atpG protein, E coli; C060296:cytotoxic necrotizing factor type 1; D002939:Ciprofloxacin
keywords: Diabetes mellitus; ESBL; Phylogenetic characterization; Uropathogenic Escherichia coli; Virulence genes