Molecular Study of Escherichia albertii in Pediatric Urinary Tract Infections

Abstract

Background: There are insufficient data about the presence of E. albertii as a causative organism in urinary tract infection in pediatric patients. Objective: The present study aimed to detect E. albertii by polymerase chain reaction (PCR) for detection of uidA, mdh, and lysP genes among isolated E.coli from children with urinary tract infection. Methods: The present study was a cross-sectional retrograde study which was carried out on 100 isolates of phenotypically confirmed E.coli detected in urine samples of children suffering from urinary tract infection. The isolates were subjected to molecular identification by PCR for uidA, mdh, and lysP genes. Results: E. albertii was identified by PCR in 7% of the isolates and E.coli was identified in 93% of the isolates. Two mdh and lysP genes were detected for E. albertii and the uidA gene for E. coli. E. albertii isolates had marked resistance to gentamicin (71.4%), followed by resistance to ciprofloxacin (57.1%), meropenem and imipenem (42.9% each) and ESBL activity by double discs method was reported in 57.1% of the isolates. However, none of the isolates had shown resistance to nalidixic acid and only one isolate had resistance to norfloxacin. There was a statistically insignificant difference between resistance to the used antibiotics such as aztreonam (P=0.083), ampicillin/clavulanate (P=0.5), ciprofloxacin (P=0.69), gentamicin (P=0.3) and ceftazidime (P=1.00). Conclusion: The present study highlights the emergence of E. albertii as a pathogen associated with urinary tract infections in children. There is marked antibiotic resistance of this pathogen, especially toward extended spectrum beta-lactams antibiotics. The identification method depends mainly on genetic studies. Further longitudinal studies with large number of patients are required to verify the accurate prevalence of this bacterium.

Escherichia albertii as a Potential Enteropathogen in the Light of Epidemiological and Genomic Studies

“…Other researchers, Afshin et al [38] and Zaki et al [39], also described cases of urinary tract infections with E. albertii as the etiological agent. In addition, a single case of E. albertii bacteremia was reported in an elderly woman with multiple comorbidities, possibly due to its ability to move from the intestinal lumen to other extraintestinal sites [35,40].…”

Microbiology and Epidemiology of Escherichia albertii—An Emerging Elusive Foodborne Pathogen

“…Afshin et al [ 113 ] and Zaki et al [ 114 ] reported five and seven cases of E. albertii -associated urinary tract infections, respectively. A single case of E. albertii bacteremia has been reported in an old lady with multiple comorbidities probably because of its ability to translocate from the intestinal lumen to other extraintestinal sites [ 5 , 34 , 115 ].…”

“…As with most bacteria, antimicrobial resistance is a major concern. Several strains of E. albertii have been shown to be resistant to a significant number of important antibiotics including tetracycline, macrolides except for azithromycin, lincosamides, ampicillin, penicillin G, oxacillin, gentamicin, ciprofloxacin, trimethoprim, sulfamethoxazole, fusidic acid, rifampicin, meropenenem, imipenem, and norfloxacin [ 26 , 38 , 50 , 51 , 67 , 90 , 114 ]. Moreover, multidrug-resistant E. albertii strains [ 67 ], that displayed resistance or encode resistance determinates to antibiotics from at least eleven classes have been reported [ 6 , 116 ].…”

“…The infectious dose, transmission routes, incidence rates, prevalence, epidemiology, and predisposing factors of E. albertii have not yet been fully elucidated, making risk assessment difficult. However, early indications suggest that children below 10 years and immunosuppressed individuals with multiple commodities might be at higher risk, but outbreaks have also been reported in seemly healthy people [ 5 , 7 , 8 , 12 , 14 , 34 , 45 , 113 , 114 ]. Poor hygiene conditions especially during food preparation, consumption of raw or minimally cooked meat particularly poultry, and drinking untreated water seems to increase the likelihood of E. albertii infection [ 14 , 17 , 18 , 112 ].…”

Escherichia albertii isolated from the bloodstream of a patient with liver cirrhosis in China: A case report

“…Infection in humans could occur due to contact with these animals or the consumption of contaminated food. It has implicated gastrointestinal disease and several urinary tract infections (UTI) [ [8] , [9] , [10] ]. The incidence of bacteremia caused by E. albertii is generally uncommon and rare, with only one reported case in the literature [ 11 ].…”