Phylogenetic Group Distribution of Uropathogenic Escherichia coli and Related Antimicrobial Resistance Pattern: A Meta-Analysis and Systematic Review

Abstract

The phylogenetic classification of Escherichia coli isolates is of great importance not only for understanding the populations of E. coli but also for clarifying the relationship between strains and diseases. The present study aimed to evaluate the prevalence of phylogenetic groups, antibiotic susceptibility pattern, and virulence genes among uropathogenic E. coli (UPEC) isolated from different parts of Iran through a systematic review and meta-analysis. Several international electronic sources, including Web of Science, PubMed, Scopus, and Embase, were searched (2000–2020) in order to identify the studies compatible with our inclusion criteria. The meta-analysis was performed using the metaprop program in the STATA (version 11) software. Based on our comprehensive search, 28 studies meeting the eligibility criteria were included in the meta-analysis. The pooled prevalence of phylogroups B2, D, B1, and A was 39%, 26%, 18%, and 8%, respectively. In addition, there was a significant heterogeneity among different phylogroups. However, according to the results of Begg’s and Egger’s tests, there were no significant publication bias in phylogroups B2, D, B1, and A. This research provided the first comprehensive study on phylogroups of UPEC isolated in Iran. Our findings indicated that phylogroup B2 and group D were the most predominant phylogenetic groups among UPEC isolates in various regions of Iran. In addition, we observed that certain phylogenetic groups are more antibiotic resistant than the others. It was also observed that the dissemination of virulent phylogroup B2 and D should be controlled via comprehensive infection control measures. Additionally, certain strategies should be developed for monitoring the antibiotic therapy.

Genetic Diversity, Carbapenem Resistance Genes, and Biofilm Formation in UPEC Isolated from Patients with Catheter-Associated Urinary Tract Infection in North of Iran

“…So, figuring out the types of antibiotic resistance, how they spread, the characteristics of resistant bacteria, and the clonal relationships between isolates can help make treatment guidelines [ 25 ].…”

Bacteriological Profile and Antimicrobial Susceptibility Patterns of Gram-Negative Bloodstream Infection and Risk Factors Associated with Mortality and Drug Resistance: A Retrospective Study from Shanxi, China

“…Overall, the risk factors for MDR, ESBLs-producing and carbapenem-resistant GNBSI in this study provide possibilities to prevent such kind of GNBSI. 55 …”

“…Overall, the risk factors for MDR, ESBLs-producing and carbapenem-resistant GNBSI in this study provide possibilities to prevent such kind of GNBSI. 55 Our study has some limitations. Firstly, this research was conducted in a single center, and we used the retrospective observational study.…”

Antibiotic Susceptibility Patterns and Biofilm Production by Uropathogenic Escherichia coli from Reproductive Age Women in a Region of NSW

“…These results confirm previous findings worldwide [8], highlighting a relationship between biofilm production and phylogenetic groups B2 and D. As previously argued, it is very challenging to work out how this relationship works as there several other competing factors. For example, multidrug resistance tends to be confined to these phylogenetic groups [37,38] as well as a multiplicity of other VFs, all of which have been linked to biofilm production). We have previously shown that group B2 strains on average carry more VF genes than other groups, and hence argue that probably the phylogeny forms the basis for virulence in UPEC [39].…”