Prevalence of virulence gene encoding type 1 fimbriae (fimH) among UPEC and relationship with antimicrobial resistance

Introduction and Objectives: Escherichia coli is the most causative pathogen of causing urinary tract infection (UTI), the most common microbial infectious disease found in the clinical setting, leading to high medical costs and significant morbidity. Better understanding of the properties of virulence and its antibiotic resistance pattern helps clinicians anticipate the improvement of infection in the patients. Materials and Methods: E. coli strains were recovered from patients with urinary tract infections (UTI) who admitted in several major hospitals in Hamedan. Antibiotic susceptibility testing was done, according to CLSI guidelines. PCR screened the uropathogenic E. coli strains for the prevalence of virulence gene encoding type 1 fimbriae (fimH). Results: In total, 90 E. coli strains were subjected to the study. E. coli isolates were resistant to cefepime (78%), Cefotaxime (38.6%), Nalidixic acid (50%), Cotrimoxazole (64.28%), Amikacin (4.2%), cefixime (41.21%), ceftriaxone (35.86%), Gentamicin (9.8%), Nitrofurantoin (1.4%), and Cephalothin (74%) and susceptible to imipenem (100%) and meropenem (100%). The prevalence of gene coding for fimbrial adhesive systems was 63% for fimH. The strains isolated from hospitalized patients displayed a great diversity of gene associations compared to those isolated from ambulatory patients. Conclusion: The result showed that antibiotic resistance is escalating rapidly. UPEC strains causing infections are more likely to harbor specific virulence genes. In the current study, high resistance was observed against antibiotics widely used for the treatment of urinary tract infection; therefore, to reach better therapeutic outcomes, empiric treatment regimens have to be modified.

Keywords:

E. coli , fimH , antibiotic resistance