Are we exposing ourselves to UTI causing Escherichia coli? appraisal on the virulence factors and antibiotic resistant trend among clinical and washroom water isolates

Abstract

One of the most prevalent bacterial infectious diseases that cause significant morbidity and cost-effective health issues is urinary tract infection (UTI). The most frequent cause of UTIs, uropathogenic Escherichia coli (UPEC), is a type of extraintestinal pathogenic E. coli that exhibits extremely diverse virulence factors and capable of multi-drug resistance (MDR). This study aimed to assess the prevalence of the virulence factors and antibiotic resistant pattern among clinical and washroom water isolates of UPEC. From a tertiary diagnostic center, a total of 126 urine samples from UTI patients and total 20 washroom water samples from domestic and public washrooms were collected within a same time period in Dhaka city, Bangladesh. The samples were cultured on MacConkey agar after that DNA of suspected E. coli isolates were extracted for Real-Time PCR and confirmed by using ECO primer. A total of 85 isolates from clinical and a total of 38 isolates from non-clinical isolates were confirmed as E. coli and further the virulence genes were detected using virulence gene primers of fimH, papC, hly, cnf, iucC, and fyuA for both, clinical and non-clinical isolates. Antibiotic susceptibility test was performed for both, clinical and non-clinical isolates, using amoxicillin (AML) (10 μg), ciprofloxacin (CIP) (5 μg), ceftriaxone (CRO) (30 μg), azithromycin (AZM) (15 μg), cefexime (CFM) (5 μg), norfloxacin (NOR) (10 μg), nitrofurantoin (F) (300 μg), cefuroxime (CXM) (30 μg), meropenem (MEM) (10 μg), and cefepime (FEP) (30 μg). Hemolysin production was also observed for both, clinical and non-clinical isolates. According to results, among six virulence markers of pathogenicity-associated island (PAI), in both clinical and non-clinical isolates, fimH was found in highest percentage 80% and 52.63%, respectively. Moreover, cnf gene was found in least percentage, 7.06% and 2.63% for both clinical and non-clinical isolates, respectively. In case of antibiotic susceptibility pattern, the highest resistance against amoxicillin was observed 92.94% and 63.16%, in clinical and non-clinical isolates, respectively. Moreover, the lowest resistance was seen against meropenem, 57.65% in clinical isolates and 50% in non-clinical isolates. Blood Agar hemolysis pattern among clinical and non-clinical isolates showed 58.82% clinical isolates and 31.58% non-clinical isolates exhibited β-hemolytic pattern. Public water supplies in Dhaka, Bangladesh, are frequently contaminated with E. coli strains with virulence factors that cause UTIs and multi-drug resistance patterns. In metropolitan settings, the transmission of plasmids and resistant gene to bacteria through the supply water acts as a major risk to public health. This quick evaluation of bacterial pathogenicity may help healthcare providers treat patients with urinary tract infections more effectively.