Virulence factors and antimicrobial susceptibility pattern of uropathogenic Escherichia coli isolated from urinary tract infected patients at Jimma University Medical Center, Jimma, Ethiopia

Abstract

Background: Uropathogenic Escherichia coli (E. coli) have evolved multitude of virulence factors and strategies that facilitate bacterial growth and persistence within the adverse settings of the urinary tract of thehost. Thus, it is essential to determine the virulence factors and antimicrobial susceptibility profile of uropathogenic E.coli. The purpose of this study was to determine the virulence factors and antimicrobial susceptibility profile of E. coli isolated from symptomatic urinary tract infected (UTI) patients in Jimma University Medical Center.
Methods: Midstream urine from suspected symptomatic UTI patients were cultured following standard bacteriological procedures. Antimicrobial susceptibility testing was done by the Kirby-Bauer disk diffusion method according to the CLSI 2021 recommendations. The virulence factor determinants of uropathogenic E. coli were tested using standard protocols. Data was analyzed using SPSS version 20 statistical software. Chi-square and binary logistic regression test results were used.
Results: A total of 387 urine samples were cultured, and of which 154 (39.8%) showed significant bacteriuria. Uropathogenic E. coli (UPEC) was isolated from 105 (68.1%) study participants among which 77 (73.3%) were women. E. coli strains showed various virulence markers such as hemolysin production (42%), cell surface hydrophobicity (32.3%), ESBL production (32.3%) and biofilm formation (52.3%). Antimicrobial susceptibility testing revealed a higher rate of resistance against ampicillin (90.4 %%) and
augmentin (60%).
Conclusions: E. coli was the most common cause of UTIs; many isolates showed virulence factors and multidrug resistance. Therefore, the acquaintance of virulence factors of E. coli and their antibiotic susceptibility pattern will help in better understanding of the organism and in proper management of UTI patients, thus will contribute to reduce the emergence and spread of antibiotic resistance.