title: Relationship between phylogenetic groups, antibiotic resistance and patient characteristics in terms of adhesin genes in cystitis and pyelonephritis isolates of Escherichia coli.
abstract: Extraintestinal pathogenic Escherichia coli (E. coli) is considered as the main causative agent of urinary tract infections worldwide. The relationship between antimicrobial resistance, phylogenetic groups, patient characteristics and adhesin virulence genes are complex and not fully understood. In this study, among 146 urinary isolates of E. coli, phylogenetic groups and various adhesin virulence genes were examined with multiplex Polymerase Chain Reaction methods. Patient characteristics divided into sex, cystitis and pyelonephritis; community-acquired and hospital-acquired; complicated and uncomplicated infection. Antimicrobial resistance was also determined. The papAH gene was seen more often in pyelonephritis than cystitis and female than male patients. iha gene was more frequent in hospital-acquired infections than in community-acquired infections. sfa/focDE was more frequent in ampicillin, amikacin, gentamicin, nalidixic acid, norfloxacin, cefuroxime, ceftriaxone, cefazolin, cefotaxime, ciprofloxacin and trimethoprim/sulfamethoxazole susceptible and extended-spectrum β-lactamase (ESBL) and multi-drug resistance (MDR) negative isolates. focG was seen more often in nalidixic acid, norfloxacin, cefuroxime, ceftriaxone, ciprofloxacin susceptible and MDR negative isolates. fimH and papAH were more commonly observed in amoxicillin/clavulanic acid and cefotaxime susceptible isolates, respectively. iha and afa/draBC genes were more frequent in resistant isolates than the susceptible ones; for iha, in ampicillin, amoxicillin/clavulanic acid, nalidixic acid, cefuroxime, ceftriaxone resistant and ESBL and MDR positive isolates; for afa/draBC, in cefotaxime, cefuroxime, ciprofloxacin, trimethoprim/sulfamethoxazole resistant and ESBL and MDR positive isolates, this trend was observed. ST 131 E. coli virulence gene pattern has a direct effect on resistance profile. Isolates belong to that clonal group has MDR and commonly harbour afa/draBC and iha genes. Our findings may provide new insights into the relationships between pathogenesis, patient characteristics and resistance of E. coli UTI.
authors.affiliation: Department of Medical Microbiology, Institute of Health Sciences, Kocaeli University, Turkey. Electronic address: doganhan_er@yahoo.com.
authors.forename: Doganhan Kadir
authors.initials: DK
authors.lastname: Er
authors.affiliation: Department of Medical Microbiology, School of Medicine, Kocaeli University, Turkey.
authors.forename: Devrim
authors.initials: D
authors.lastname: Dundar
authors.affiliation: Department of Medical Microbiology, Institute of Health Sciences, Kocaeli University, Turkey.
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uzuner
authors.affiliation: Department of Medical Microbiology, Institute of Health Sciences, Kocaeli University, Turkey.
authors.forename: Agim
authors.initials: A
authors.lastname: Osmani
mesh_terms: D018829:Adhesins, Bacterial / Q000032:analysis* / Q000235:genetics; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D017714:Community-Acquired Infections / Q000382:microbiology; D003428:Cross Infection / Q000382:microbiology; D003556:Cystitis / Q000382:microbiology*; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial; D004927:Escherichia coli Infections / Q000382:microbiology*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058889:Molecular Typing; D060885:Multiplex Polymerase Chain Reaction; D011704:Pyelonephritis / Q000382:microbiology*; D014421:Turkey; D056689:Uropathogenic Escherichia coli / Q000145:classification* / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D037521:Virulence Factors / Q000032:analysis* / Q000235:genetics; D055815:Young Adult
chemical_list: D018829:Adhesins, Bacterial; D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D037521:Virulence Factors
keywords: Antimicrobial resistance; ExPEC; ST 131 clonal group; Urinary tract infection; Virulence