Molecular Epidemiology of Multidrug-Resistant Uropathogenic <i>Escherichia coli</i> O25b Strains Associated with Complicated Urinary Tract Infection in Children

Background: Uropathogenic <i>Escherichia coli</i> (UPEC) has increased the incidence of urinary tract infection (UTI). It is the cause of more than 80% of community-acquired cystitis cases and more than 70% of uncomplicated acute pyelonephritis cases. Aim: The present study describes the...

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Autores principales: Laura M. Contreras-Alvarado, Sergio Zavala-Vega, Ariadnna Cruz-Córdova, Juan Pablo Reyes-Grajeda, Gerardo Escalona-Venegas, Víctor Flores, Virginia Alcázar-López, José Arellano-Galindo, Rigoberto Hernández-Castro, Graciela Castro-Escarpulli, Juan Xicohtencatl-Cortes, Sara A. Ochoa
Formato: article
Lenguaje:EN
Publicado: MDPI AG 2021
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MDR
Acceso en línea:https://doaj.org/article/b5eba9a88ff54e6c803246ecbb108e5f
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Sumario:Background: Uropathogenic <i>Escherichia coli</i> (UPEC) has increased the incidence of urinary tract infection (UTI). It is the cause of more than 80% of community-acquired cystitis cases and more than 70% of uncomplicated acute pyelonephritis cases. Aim: The present study describes the molecular epidemiology of UPEC O25b clinical strains based on their resistance profiles, virulence genes, and genetic diversity. Methods: Resistance profiles were identified using the Kirby–Bauer method, including the phenotypic production of extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs). The UPEC serogroups, phylogenetic groups, virulence genes, and integrons were determined via multiplex PCR. Genetic diversity was established using pulsed-field gel electrophoresis (PFGE), and sequence type (ST) was determined via multilocus sequence typing (MLST). Results: UPEC strains (<i>n</i> = 126) from hospitalized children with complicated UTIs (cUTIs) were identified as O25b, of which 41.27% were multidrug resistant (MDR) and 15.87% were extensively drug resistant (XDR). The O25b strains harbored the <i>fimH</i> (95.23%), <i>csgA</i> (91.26%), <i>papG</i>II (80.95%), <i>chuA</i> (95.23%), <i>iutD</i> (88.09%), <i>satA</i> (84.92%), and <i>intl1</i> (47.61%) genes. Moreover, 64.28% were producers of ESBLs and had high genetic diversity. ST131 (63.63%) was associated primarily with phylogenetic group B2, and ST69 (100%) was associated primarily with phylogenetic group D. Conclusion: UPEC O25b/ST131 harbors a wide genetic diversity of virulence and resistance genes, which contribute to cUTIs in pediatrics.