title: Phylogenetic group distributions, virulence factors and antimicrobial resistance properties of uropathogenic Escherichia coli strains isolated from patients with urinary tract infections in South Korea.
abstract: Urinary tract infections (UTIs) are one of the most common diseases by which humans seek medical help and are caused mainly by uropathogenic Escherichia coli (UPEC). Studying the virulence and antibiotic resistance of UPEC with respect to various phylogenetic groups is of utmost importance in developing new therapeutic agents. Thus, in this study, we analysed the virulence factors, antibiotic resistance and phylogenetic groups among various UPEC isolates from children with UTIs. The phylogenetic analysis revealed that majority of the strains responsible for UTIs belonged to the phylogenetic groups B2 and D. Of the 58 E. coli isolates, 79·31% belonged to group B2, 15·51% to group D, 3·44% to group A and 1·72% to B1. Simultaneously, the number of virulence factors and antibiotic resistance exhibited were also significantly high in groups B2 and D compared to other groups. Among the isolates, 44·8% were multidrug resistant and of that 73% belonged to the phylogenetic group B2, indicating the compatibility of antibiotic resistance and certain strains carrying virulence factor genes. The antibiotic resistance profiling of UPEC strains elucidates that the antimicrobial agents such as chloramphenicol, cefoxitin, cefepime, ceftazidime might still be used in the therapy for treating UTIs.
  
  
  CONCLUSIONS
  As the antibiotic resistance pattern of uropathogenic Escherichia coli varies depending on different geographical regions, the antibiotic resistance pattern from this study will help the physicians to effectively administer antibiotic therapy for urinary tract infections. In addition, the frequency of virulence factors and antibiotic resistance genes among various phylogenic groups could be effectively used to draw new targets for uropathogenic Escherichia coli antibiotic-independent therapies. The study emphasizes need of public awareness on multidrug resistance and for more prudent use of antimicrobials.
authors.affiliation: Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: J H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: B
authors.initials: B
authors.lastname: Subhadra
authors.affiliation: Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Son
authors.affiliation: Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: D H
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: H S
authors.initials: HS
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: J M
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea.
authors.forename: S H
authors.initials: SH
authors.lastname: Koo
authors.affiliation: Department of Nanobiomedical Science, Dankook University, Cheonan, Korea.
authors.forename: M H
authors.initials: MH
authors.lastname: Oh
authors.affiliation: Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea.
authors.forename: C H
authors.initials: CH
authors.lastname: Choi
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000077723:Cefepime; D002440:Cefoxitin / Q000627:therapeutic use; D002442:Ceftazidime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D002701:Chloramphenicol / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D004927:Escherichia coli Infections / Q000188:drug therapy* / Q000382:microbiology; D029968:Escherichia coli Proteins / Q000235:genetics; D006801:Humans; D008826:Microbial Sensitivity Tests; D010802:Phylogeny; D056910:Republic of Korea; D014552:Urinary Tract Infections / Q000188:drug therapy* / Q000382:microbiology; D056689:Uropathogenic Escherichia coli / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity; D037521:Virulence Factors / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D029968:Escherichia coli Proteins; D037521:Virulence Factors; D002701:Chloramphenicol; D002440:Cefoxitin; D000077723:Cefepime; D002442:Ceftazidime
keywords: antimicrobial resistance; children; community UTI; phylogenetic group; uropathogenic Escherichia coli; virulence