Molecular biology reports · 2025
Dynamics of urinary tract infections: a comprehensive study on antimicrobial susceptibility, virulence profiling and molecular epidemiology of uropathogenic Escherichia coli from Pakistan.
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Ashraf Zia, Rasool Muhammad Hidayat, Aslam Bilal, Ejaz Hasan, Mujahid Fatima, Khurshid Mohsin
Аннотация
BACKGROUND: Urinary tract infections (UTIs), primarily caused by Escherichia coli, pose a global health challenge owing to rising antimicrobial resistance (AMR), particularly carbapenem-resistant (Carb-RT) and extended-spectrum beta-lactamase (ESBL)-producing uropathogenic E. coli (UPEC). This study analyzed AMR trends, virulence determinants, and molecular epidemiology of UPEC isolates from community and hospital settings in Pakistan.
METHODS AND RESULTS: A total of 2700 urine samples were screened in this study. UPEC isolates underwent antimicrobial susceptibility testing, PCR screening for ESBL/carbapenemase genes (blaCTX-M, blaTEM, blaSHV, and blaNDM), virulence factor detection, and multilocus sequence typing (MLST) of Carb-RT strains. Among the 390 UPEC isolates, third-generation cephalosporin resistance was higher in hospital (80.2%) than in community (37.9%) strains. Carbapenem resistance varied between community-acquired (CA-UTI: 7.4%) and hospital-acquired (HA-UTI: 34.2%) infections. The ESBL genes included blaCTX-M (53.3%), blaTEM (39.7%), and blaSHV (13.35%), while blaNDM accounted for 89% of carbapenem resistance. Virulence profiling showed the prevalence of adhesion genes fimH(89.5%), papC (74.4%), and papG (58.5%), iron acquisition markers iutA (66.4%) and fyuA (50%), and capsule gene kpsMTII (60%). The hemolysin gene hlyA was detected in 66.7% of isolates. MLST identified sequence types ST405 (19%), ST10 (18%), ST101 (18%), and ST131 (13%). blaNDM was associated with major STs, except ST8051, indicating clonal resistance spread.
CONCLUSIONS: The high prevalence of Carb-RT UPEC with ESBLs and virulence genes in Pakistan poses a public health threat. The dominance of ST405 and ST131 highlights the need for genomic surveillance. These findings advocate for revised empirical therapies to combat AMR in healthcare and community settings.
METHODS AND RESULTS: A total of 2700 urine samples were screened in this study. UPEC isolates underwent antimicrobial susceptibility testing, PCR screening for ESBL/carbapenemase genes (blaCTX-M, blaTEM, blaSHV, and blaNDM), virulence factor detection, and multilocus sequence typing (MLST) of Carb-RT strains. Among the 390 UPEC isolates, third-generation cephalosporin resistance was higher in hospital (80.2%) than in community (37.9%) strains. Carbapenem resistance varied between community-acquired (CA-UTI: 7.4%) and hospital-acquired (HA-UTI: 34.2%) infections. The ESBL genes included blaCTX-M (53.3%), blaTEM (39.7%), and blaSHV (13.35%), while blaNDM accounted for 89% of carbapenem resistance. Virulence profiling showed the prevalence of adhesion genes fimH(89.5%), papC (74.4%), and papG (58.5%), iron acquisition markers iutA (66.4%) and fyuA (50%), and capsule gene kpsMTII (60%). The hemolysin gene hlyA was detected in 66.7% of isolates. MLST identified sequence types ST405 (19%), ST10 (18%), ST101 (18%), and ST131 (13%). blaNDM was associated with major STs, except ST8051, indicating clonal resistance spread.
CONCLUSIONS: The high prevalence of Carb-RT UPEC with ESBLs and virulence genes in Pakistan poses a public health threat. The dominance of ST405 and ST131 highlights the need for genomic surveillance. These findings advocate for revised empirical therapies to combat AMR in healthcare and community settings.
Предметные рубрики MeSH
HumansPakistanUrinary Tract InfectionsUropathogenic Escherichia coliEscherichia coli InfectionsMolecular EpidemiologyMultilocus Sequence TypingVirulence FactorsMicrobial Sensitivity Testsbeta-LactamasesVirulenceAnti-Bacterial AgentsFemaleMaleAdultMiddle AgedEscherichia coli ProteinsCarbapenemsAdolescentDrug Resistance, Multiple, BacterialYoung Adult