High Prevalence of Multidrug-Resistance and Extended-Spectrum-β-Lactamases-Producing Escherichia coli Isolated from Patients with Urinary Tract Infection in Hamedan, Iran.

The current study was conducted to determine the antibiotic resistance profile and prevalence of extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli among the uropathogenic E. coli (UPEC) strains (n = 100), isolated from patients with urinary tract infection (UTI) in Hamedan, western Iran. In addition, the molecular prevalence of antibiotic resistance genes (ARGs) and ESBL genes among these strains was investigated using polymerase chain reaction. Out of 100 UPEC isolates, 46 (46%) and 40 (40%) isolates were phenotypically identified as multidrug-resistance (MDR) strains and ESBLs producer strains, respectively. UPEC isolates showed the highest resistance to trimethoprim/sulfamethoxazole (55%), followed by amoxicillin (51%) and ampicillin (45%). The most prevalent ARG in UPEC strains was tetA (10%), followed by aadA1 (9%), sul1 (9%), qnrs (7%), and dfrA1-like (3%). Among the 40 UPEC isolates that phenotypically confirmed as ESBL producers, 19 (475%) isolates harbored blaCTX-M gene, 9 (22.5%) harbored blaTEM gene, 8 (20%) harbored blaOXA gene, and 4 (10%) harbored blaCIT-M. The ESBL gene blaCTX-M displayed a significant association with ESBL phenotypic isolates at p value <0.05. Due to the relatively high prevalence of MDR-UPEC strains and ESBLs producer UPEC isolates among patients with UTI reported herein and also regarding incidence of ARGs and β-lactamase gene among these isolates, applying precise antibiotic stewardship, continuous surveillance to use appropriate antibiotics, and the control of UTI infections seem necessary to decrease ESBLs producer UPEC and MDR-UPEC strains.