Virulence factors related to the recurrence of urinary tract infection of extended-spectrum β-lactamase-producing Escherichia coli

Abstract:

Objective To explore the relationship between the virulence factors of extended-spectrum β-lactamases-producing uropathogenic Escherichia coli (ESBLs-UPEC) and recurrence of urinary tract infection (UTI). Methods 469 ESBLs-UPEC strains were obtained from patients with UTI in the First Affiliated Hospital of Chongqing Medical University and the People's Hospital of Dazu District from January 2019 to September 2021. Multiple PCR amplification was used to identify virulence factors. All patients were followed up for UTI within 6 months. Results 469 ESBLs-UPEC strains were susceptible to tigecycline, ertapenem and amikacin, while showed high resistance to levofloxacin, cotrimoxazole, and ampicillin. There was no statistically significant difference in antimicrobial susceptibility of ESBLs-UPEC before and after UTI recurrence(P>0.05). 90.4% of the 469 ESBLs-UPEC strains carried the virulence factor fimH, while the detection rate of sfaDE was the lowest (8.3%). There was no obvious correlation between the number and combination of different virulence factors and UTI recurrence (P>0.05). The carria- ge rate of virulence factor iucD in ESBLs-UPEC isolated from UTI was higher in patients group with ≥3 recurrences (P=0.008). There was no statistically significant difference in the carriage rate of virulence factors in ESBLs-UPEC isolated from recurrent and non-recurrent groups of patients of the same gender and age group (P>0.05). Among postmenopausal female patients, the carriage rate of virulence factor kps MT Ⅱ in ESBLs-UPEC isolated from recurrent group was higher than that in the non-recurrent group (61.7% vs 45.6%, P=0.037). Conclusion Antimicrobial resistance of ESBLs-UPEC strains is serious. The virulence factor most commonly carried by ESBLs-UPEC is fimH. The carriage rate of virulence factor iucD in ESBLs-UPEC from patients with ≥3 recurrences of UTI is high. The carriage rate of virulence factor kps MT Ⅱ in ESBLs-UPEC from postmenopausal women with recurrent UTI is high.