Phenotypic, genotypic characterization and antimicrobial resistance profiling of uropathogenic Escherichia coli in a tertiary care hospital, Puducherry, India

Sherief  Shebeena; Latha  Ragunathan; Kavitha  Kannaiyan; Thiyagarajan  Sanjeevi; Pramodhini  Subramanian; Pramodhini  Subramanian; Aravind C  Sasi; Jaishma  Rajni; Jenifer  Raj; Mohamed  Asarudeen

doi:10.18502/ijm.v17i3.18818

Sherief Shebeena Department of Microbiology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India
Latha Ragunathan Department of Microbiology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India
Kavitha Kannaiyan Department of Microbiology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India
Thiyagarajan Sanjeevi Department of Medical Biotechnology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India
Pramodhini Subramanian Department of Microbiology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India
Pramodhini Subramanian Department of Microbiology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India
Aravind C Sasi Department of Microbiology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India
Jaishma Rajni Department of Microbiology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India
Jenifer Raj Department of Microbiology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India
Mohamed Asarudeen Department of Microbiology, Aarupadai veedu Medical College and Hospital, Vinayaka Mission’s Research Foundation (DU), Kirumampakkam, Puducherry, India

DOI: https://doi.org/10.18502/ijm.v17i3.18818

Keywords: Urinary tract infection; Uropathogenic Escherichia coli; Antibiotic susceptibility testing; Antimicrobial resis- tance

Abstract

Background and Objectives: Uropathogenic Escherichia coli (E. coli) (UPEC) accounts for 70-95% of community-ac- quired urinary tract infections (UTIs) and a significant proportion of nosocomial UTIs. This study aimed to characterize the phenotypic and genotypic characteristics of E. coli isolates from symptomatic UTI patients and evaluate their antimicrobial susceptibility patterns.

Materials and Methods: A hospital-based observational study was conducted at Aarupadai Veedu Medical College and Hospital, Puducherry, India, from August 2022 to April 2024. A total of 106 UPEC isolates were obtained from symptomatic UTI patients. Antimicrobial susceptibility testing (AST) was performed using the Kirby-Bauer method, and virulence genes (hlyA, fimH, papC) were detected using PCR.

Results: The mean age of patients was 49.7 years, with a female predominance (69.8%). Diabetes mellitus was the most common comorbidity (29.2%). Fever (60.4%) and dysuria (38.7%) were the most common symptoms. AST showed high susceptibility (>90%) to amikacin, nitrofurantoin, meropenem, and piperacillin/tazobactam, while >60% resistance was ob- served to cefotaxime and ceftazidime. Phenotypically, 30.2% of the isolates produced mannose-resistant hemagglutinins, and 17.9% produced hemolysin. ESBL production was found in 46.3%. Biofilm production was moderate in 65.1%, weak in 30.2% and strong in 4.7% and significantly correlated with multidrug resistance (p<0.05). Genotypically, 80.2% had fimH, 51.9% had papC and 20.8% had hlyA. papC was associated with reduced cefotaxime susceptibility (p<0.05).

Conclusion: The study highlights the significance of phenotypic and genotypic characterization in understanding UPEC virulence and resistance patterns, and emphasizes the need for targeted empiric therapy to improve UTI management.