Genotypic characterization and antibiofilm formation of resistant Escherichia coli isolates causing urinary tract infections among pregnant women at Kisii, Kenya
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20254411Keywords:
Antibiofilm, AMR, ESβL, E. coli, Resistance genesAbstract
Background: Urinary tract infections (UTIs) during pregnancy are among the most common infections worldwide, leading to poor perinatal and maternal outcomes. This study aimed at profiling ESBL-resistant genes and deducing the antibiofilm formation activity of Escherichia coli isolates obtained from pregnant women against the commonly used antibiotics.
Methods: Hospital-based cross-sectional study was conducted from March to June 2020, total of 199 pregnant women were involved. Mid-stream urine samples were collected and cultured on CLED at 370C overnight. Positive growths were biochemically analysed for the E. coli isolates identification, drug susceptibility tests were conducted by Kirby Bauer disc diffusion technique and the PCR technique was used to detect the ESBL genes. The antibiofilm formation was analyzed using the ordinary one-way ANOVA Dunnett’s multiple comparison tests (GraphPad Prism, version 9.3) and data was presented in bar graphs.
Results: Out of the positive growth, 28 (23.5%) isolates, E. coli species demonstrate resistance to selected antibiotics. From 12 (42.9%) isolates that shows high drug resistance were investigated for ESBL gene profiling, where 8 (42.1%) of them had blaCTX-M, 6 (31.6%) had blaTEM and blaSHV 5 (26.31%) and 8 (66.7%) showed the ability to form antibiofilm against the commonly used antibiotics with 91.66% statistical significance at different levels.
Conclusions: The MDR for commonly prescribed drugs and the high prevalence of bacterial UTI were observed with a significant number of ESBL producers. In light of these findings, biofilm formation with antimicrobial resistance genes in urinary tract infection may lead to difficult-to-treat infections.
Metrics
References
Olin SJ, Bartges JW. Urinary tract infections: treatment/comparative therapeutics. Veterinary Clinics. Small An Pract. 2015;45(4):721-46. DOI: https://doi.org/10.1016/j.cvsm.2015.02.005
Jhang JF, Kuo HC. Recent advances in recurrent urinary tract infection from pathogenesis and biomarkers to prevention. Tzu Chi Med J. 2017;29(3):131-7. DOI: https://doi.org/10.4103/tcmj.tcmj_53_17
Onuoha SC, Fatokun K. Prevalence and antimicrobial susceptibility pattern of urinary tract infection (UTI) among pregnant women in Afikpo, Ebonyi State, Nigeria. Am J Life Sci. 2014;2(2):46-52. DOI: https://doi.org/10.11648/j.ajls.20140202.12
Nji E, Kazibwe J, Hambridge T, Joko CA, Larbi AA, Damptey LA, Nkansa-Gyamfi NA, Stålsby Lundborg C, Lien LT. High prevalence of antibiotic resistance in commensal Escherichia coli from healthy human sources in community settings. Scientific Reports. 2021;11(1):3372. DOI: https://doi.org/10.1038/s41598-021-82693-4
World Health Organization. "Antibacterial agents in clinical development: an analysis of the antibacterial clinical development pipeline, including tuberculosis." In Antibacterial agents in clinical development: an analysis of the antibacterial clinical development pipeline, including tuberculosis. 2017.
Sule H, Uba A, Kumurya AS. Antibiotic susceptibility pattern of uropathogens from some selected hospitals in Kano-Nigeria. J Microbiol Exp. 2018;6(2):127-34. DOI: https://doi.org/10.15406/jmen.2018.06.00202
Fatima T, Rafiq S, Iqbal A, Husnain S. Prevalence and antibiogram of MDR E. colistrains isolated from UTI patients—1-Year retrospective study at Nishtar medical hospital, Multan. SN Comprehensive Clinical Med. 2020;2(4):423-31. DOI: https://doi.org/10.1007/s42399-020-00246-8
Mhondoro M, Ndlovu N, Bangure D, Juru T, Gombe NT, Shambira G, Nsubuga P, Tshimanga M. Trends in antimicrobial resistance of bacterial pathogens in Harare, Zimbabwe, 2012–2017: a secondary dataset analysis. BMC Infec Dis. 2019;19(1):746. DOI: https://doi.org/10.1186/s12879-019-4295-6
Odongo I, Ssemambo R, Kungu JM. Prevalence of Escherichia coli and its antimicrobial susceptibility profiles among patients with UTI at Mulago Hospital, Kampala, Uganda. Interdisciplinary Perspect Infect Dis. 2020;20(1):8042540. DOI: https://doi.org/10.1155/2020/8042540
Muloi D, Ward M, Hassell J, Bettridge JM, Robinson TP, Pedersen A, Kang'ethe EK, Kariuki S, Fèvre EM, Woolhouse ME. One Health genomic epidemiology of antimicrobial resistant Escherichia coli carriage in sympatric humans and livestock in Nairobi, Kenya. 2020. DOI: https://doi.org/10.1016/j.jiph.2020.01.043
Omwenga EO, Simba SM, Musyoki SK. Prevalence of E. colias a causative agent of urinary tract infections and its drug susceptibility patterns among pregnant mothers seeking medicare at Kisii teaching and referral hospital, Kenya. 2020.
Bajpai T, Pandey M, Varma M, Bhatambare GS. Prevalence of TEM, SHV, and CTX-M Beta-Lactamase genes in the urinary isolates of a tertiary care hospital. Avicenna J Med. 2017;7(1):12-6. DOI: https://doi.org/10.4103/2231-0770.197508
Nakama R, Shingaki A, Miyazato H, Higa R, Nagamoto C. Current status of extended spectrum β-lactamase-producing Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis in Okinawa prefecture, Japan. J Infect Chemoth. 2016;22(5):281-6. DOI: https://doi.org/10.1016/j.jiac.2016.01.008
Høiby N, Bjarnsholt T, Moser C, Bassi GL, Coenye T. ESCMID guideline for the diagnosis and treatment of biofilm infections 2014. Clin Microbiol Infect. 2015;21:1-25. DOI: https://doi.org/10.1016/j.cmi.2014.10.024
Omwenga EO, Awuor SO. The bacterial biofilms: formation, impacts, and possible management targets in the healthcare system. Canadian J Infect Dis Med Microbiol. 2024;2024(1):1542576. DOI: https://doi.org/10.1155/cjid/1542576
Awuor SO, Omwenga EO, Mariita RM, Daud II. Cholera outbreak: antibiofilm activity, profiling of antibiotic-resistant genes and virulence factors of toxigenic Vibrio cholerae isolates reveals concerning traits. Microbiology. 2022;4(3):324.
Pantanella F, Valenti P, Natalizi T, Passeri D, Berlutti F. Analytical techniques to study microbial biofilm on abiotic surfaces: pros and cons of the main techniques currently in use. Annali di Igiene Medicina Preventiva e di Comunità. 2013;25(1):31-42.
Aslanzadeh J. "Biochemical profile-based microbial identification systems." In Advanced techniques in diagnostic microbiology, Boston, MA: Springer US. 2006: 84-116. DOI: https://doi.org/10.1007/0-387-32892-0_6
Lewis II, James S. Performance standards for antimicrobial susceptibility testing. 2024.
Kisuba K, Guyah B, Awuor SO, Ouma C. Uro-pathogens: Prevalence of bacterial agents, and antimicrobial susceptibility profiles of urinary tract infections among pregnant women living with HIV in Kisumu County, Kenya. 2025.
Andre NH, Dramowski A, Mehtar S. "Maternal colonization or infection with extended-spectrum beta-lactamase-producing Enterobacteriaceae in Africa: a systematic review and meta-analysis." Int J Infect Dis. 2017;64:58-66. DOI: https://doi.org/10.1016/j.ijid.2017.08.015
miruka HN, Eric OO, Musyoki S, Awuor SO. Incidence, antifungal resistance properties, and virulence traits of candida species isolated from HIV/AIDS Patients from the hospital system in Kenya. Microbiology. 2023;3:620-6. DOI: https://doi.org/10.1099/acmi.0.000620.v1
Mihret T, Fiseha M, Alebachew M, Gedefie A, Ebrahim E, et al. "Uro-pathogens: Multidrug resistance and associated factors of community-acquired UTI among HIV patients attending antiretroviral therapy in Dessie Comprehensive Specialized Hospital, Northeast Ethiopia." PloS One. 2024;19(5):296480. DOI: https://doi.org/10.1371/journal.pone.0296480
Tenover FC, Raney PM, Williams PP, Rasheed JK, Biddle JW. Evaluation of the NCCLS extended-spectrum β-lactamase confirmation methods for Escherichia coli with isolates collected during Project ICARE. J Clin Microbiol. 2003;41(7):3142-6. DOI: https://doi.org/10.1128/JCM.41.7.3142-3146.2003
Kiiru J, Kariuki S, Goddeeris BM, Butaye P. Analysis of β-lactamase phenotypes and carriage of selected β-lactamase genes among Escherichia coli strains obtained from Kenyan patients during an 18-year period. BMC Microbiol. 2012;12(1):155. DOI: https://doi.org/10.1186/1471-2180-12-155
World Health Organization. WHO bacterial priority pathogens list, 2024: bacterial pathogens of public health importance, to guide research, development and strategies to prevent and control antimicrobial resistance. World Health Organization. 2024.
Maina D, Makau P, Nyerere A, Revathi G. Antimicrobial resistance patterns in extended-spectrum β-lactamase producing Escherichia coli and Klebsiella pneumoniae isolates in a private tertiary hospital, Kenya. Microbiol Discovery. 2013;1(5):1567. DOI: https://doi.org/10.7243/2052-6180-1-5
Alibi S, Ferjani A, Boukadida J. Molecular characterization of extended spectrum beta-lactamases produced by Klebsiella pneumoniae clinical strains from a Tunisian Hospital. Medecine et maladies infectieuses. 2015;45(4):139-43. DOI: https://doi.org/10.1016/j.medmal.2015.01.010
Mshana SE, Hain T, Domann E, Lyamuya EF, Chakraborty T, Imirzalioglu C. Predominance of Klebsiella pneumoniae ST14 carrying CTX-M-15 causing neonatal sepsis in Tanzania. BMC Infect Dis. 2013;13(1):466. DOI: https://doi.org/10.1186/1471-2334-13-466
Yong C, Shimoda S, Shimono N. "Current epidemiology, genetic evolution and clinical impact of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae." Infection, Gen Evol. 2018;61:185-8. DOI: https://doi.org/10.1016/j.meegid.2018.04.005
Reuland EA, Overdevest IT, Al Naiemi N, Kalpoe JS, Rijnsburger MC, Raadsen SA, Ligtenberg‐Burgman I. High prevalence of ESBL‐producing Enterobacteriaceae carriage in Dutch community patients with gastrointestinal complaints. Clin Microbiol Infect. 2013;19(6):542-9. DOI: https://doi.org/10.1111/j.1469-0691.2012.03947.x
O'Connell ND, Kavanagh K. Detection and characterization of extended-spectrum beta-lactamase-producing Enterobacteriaceae in high-risk patients in an Irish tertiary care hospital. J Hospital Infect. 2015;90(2):102-7. DOI: https://doi.org/10.1016/j.jhin.2015.01.018
Michael GB, Freitag C, Wendlandt S, Eidam C, Fessler AT. Emerging issues in antimicrobial resistance of bacteria from food-producing animals. Future Microbiol. 2015;10(3):427-43. DOI: https://doi.org/10.2217/fmb.14.93
Juma BW, Kariuki S, Waiyaki PG, Mutugi MM, Bulimo WD. The prevalence of TEM and SHV genes among Extended-Spectrum Beta-Lactamase-producing Klebsiella pneumoniae and Escherichia coli. African J pharmacol Therapeut. 2016;5(1):872.
Webale MK, Wanjala C, Guyah B, Shaviya N, Munyekenye GO, Nyanga PL. Epidemiological patterns and antimicrobial resistance of bacterial diarrhea among children in Nairobi City, Kenya. Gastroenterol Hepatol. 2020;13(3):238.
Mitema ES, Kikuvi GM, Wegener HC, Stohr K. An assessment of antimicrobial consumption in food producing animals in Kenya. J Veter Pharmacol Therapeut. 2001;24(6):385-90. DOI: https://doi.org/10.1046/j.1365-2885.2001.00360.x
Awuor SO, Omwenga EO, Mariita RM, Musila JM, Musyoki S. Monitoring the battleground: exploring antimicrobial resistance and virulence factors in wound bacterial isolates. Microbiology. 2023;5(11):613-6. DOI: https://doi.org/10.1099/acmi.0.000613.v6
Awuor SO, Omwenga EO, Mariita RM, Daud II. Cholera outbreak: antibiofilm activity, profiling of antibiotic-resistant genes and virulence factors of toxigenic Vibrio cholerae isolates reveals concerning traits. Microbiology. 2022;4(3):324. DOI: https://doi.org/10.1099/acmi.0.000324
Morgan DJ, Okeke IN, Laxminarayan R, Perencevich EN, Weisenberg S. Non-prescription antimicrobial use worldwide: a systematic review. Lancet Infect Dis. 2011;11(9):692-701. DOI: https://doi.org/10.1016/S1473-3099(11)70054-8
Dimitrova L, Kaleva M, Zaharieva MM, Stoykova C. Prevalence of antibiotic-resistant Escherichia coli isolated from swine faeces and lagoons in Bulgaria. Antibiotics. 2021;10(8):940. DOI: https://doi.org/10.3390/antibiotics10080940
Downloads
Published
How to Cite
Issue
Section
