Clonal Diversity, Virulence Potential and Antimicrobial Resistance of Escherichia coli Causing Community Acquired Urinary Tract Infection in Switzerland

Abstract

Objectives: The aim of this study was to assess the clonal structure, virulence potential and antibiotic susceptibility of uropathogenic Escherichia coli (UPEC) isolates causing community acquired urinary tract infection (CAUTI) in unselected primary care patients in Switzerland.Methods: We performed multilocus sequence typing, virulence factor determination, and phenotypic and genotypic antimicrobial resistance testing on 44 non-duplicate UPEC isolates.Results: Twenty-seven different sequence types (STs) were identified. Major UPEC clones were represented by 19 (43.2%) of the isolates, including E. coli ST131, ST69 (both 13.6%), ST73 (6.8%), ST10 (4.5%), ST127, ST140, (both 2.3%). Five (11.4%) isolates belonged to ST141.Aggregate virulence factor (VF) scores were highest among isolates belonging to ST127 and ST141. Overall, 50% of the isolates were susceptible to all 12 antimicrobials tested, and all isolates remained susceptible to fosfomycin and nitrofurantoin. Resistance to sulfamethoxazole and ciprofloxacin were found in 31.8, and 15.9% of the isolates, respectively. Plasmid-mediated resistance genes were detected in ST69 and ST131 and included aac(6′)-Ib-cr (2.3% of all isolates) blaCTX−M−14 and blaCTX−M−15 (9%), and mph(A) (13.6%). None of the isolates tested positive for mcr-1 or mcr-2.Conclusions: Our results show that CAUTI in Switzerland is caused by a wide variety of UPEC STs for which fosfomycin remains a good treatment option. We suggest that ST141 is an emerging clone associated with UTI in the community, and warrants closer attention. Moreover, the high rate of E. coli harboring mph(A) from patients without a history of antimicrobial therapy or hospitalization indicates that UPEC is an important reservoir for mph(A).

Antimicrobial resistance, multilocus sequence types and virulence profiles of ESBL producing and non-ESBL producing uropathogenic Escherichia coli isolated from cats and dogs in Switzerland

“…This is a remarkable increase compared to the prevalence of 7.5% ESBL producers among UPEC isolated from companion animals at our institution between 2010-2011 (Huber et al, 2013), and poses a threat to the efficacy of third-generation cephalosporins approved for use in veterinary medicine, such as cefovecin (Stegemann et al, 2006). Further, the high prevalences of 26.6% aac(6')-Ib-cr and 13.6% mph(A) among the UPEC analysed in this study contrast noticeably with the 2.3% and 13.6%, respectively, observed for these genes in UPEC from human primary care patients in Switzerland (Nüesch-Inderbinen et al, 2017), and indicate that companion animals, particularly dogs, may serve as reservoirs for E. coli harbouring these resistance genes.…”

“…Further, all strains were screened for the plasmid-mediated azithromycin resistance gene mph(A) using previously described primers (Ojo et al, 2004). DNA samples from isolates described previously were used as positive controls (Nüesch-Inderbinen et al, 2017;Zurfluh et al, 2014).…”

Prevalence of E. coli ST131 among Uropathogenic E. coli Isolates from Iraqi Patients in Wasit Province, Iraq

“…Thus, rapid initiation of appropriate empirical treatment requires a good knowledge of epidemiological data concerning the sensitivity of uropathogens to antibacterial agents [ 34 ]. In this investigation, the highest rate of resistance in E. coli ST131 isolates was against β -lactams, tetracycline, trimethoprim-sulfamethoxazole, nalidixic acid, and ciprofloxacin which was comparable with the results of several studies around the globe [ 3 , 17 , 19 , 27 , 32 , 35 , 36 ], and this may be due to several reasons including inexpensive antimicrobials, indiscriminate antibiotic usage without medical prescription, and use of antibiotics for a nonoptimal duration. In addition, plasmids harboring resistance determinants can be transferred between bacteria, even between species, leading to the acquisition of resistance to new antibiotics via the emergence of mutant strains [ 4 ].…”

Clonal Structure, Virulence Factor-encoding Genes and Antibiotic Resistance of Escherichia coli, Causing Urinary Tract Infections and Other Extraintestinal Infections in Humans in Spain and France during 2016

“…ST141 was also identified among 44 E. coli isolated from UTIs in Switzerland during 2016. It accounted for 11.4% of the isolates, whereas ST131 and ST69 accounted, each, for 13.6%, and ST73 for 6.8% [23]. These features suggest that the clonal structure of E. coli in Germany and Switzerland seems to be closer to that of Spain and France than to that of UK.…”