Fluoroquinolone Resistance in Relation to Phylogenetic Background and Iron Uptake Associated Virulence Profile among Urinary Escherichia coli Isolates from HIV and Non-HIV Patients
Introduction: Urinary tract infection is a major cause of morbidity among HIV patients and is more often underestimated in developing countries. Urinary Escherichia coli isolated from HIV and non-HIV patients in South India were analyzed to determine the virulence profile and phylogenetic distribution and their correlation with fluoroquinolone (FQ) resistance. Methods: This study aimed to assess the difference in the incidence of iron uptake associated virulence genes among urinary E. coli isolated from HIV (n= 76) and non-HIV antenatal patients (n=42). We compared the incidence of virulence associated genes (VAGs) among the E. coli isolates in relation to FQ resistance, phylogeny and host immunocompromise. Results: fyuA was higher among the isolates from HIV than from non-HIV patients (P=0.00024). E. coli isolates from HIV, non-HIV patients primarily belonged to the phylogroups D and B2 respectively. Q and FQ resistance were higher among isolates from HIV patients compared to nonHIV patients (P=0.000414, P<0.0001 respectively). PhylogroupB2 strains were predominant among the FQ susceptible than FQ-resistant strains (P=0.000652). fyuA and iutA was higher among the Qresistant isolates than their susceptible counterparts (P<0.0001; P=0.000132). FQ resistant isolates harboured fyuA, iutA than the susceptible isolates (P=0.0063; P=0.000478). Hly+ phenotype was significantly associated with FQ-susceptible isolates (P=0.003253). Discussion: Our results establish the relative predominance of non-hemolytic, fyuA+, Q, FQ resistant E. coli isolates primarily of phylogroup-D among the HIV patients and there by suggests that non-B2 strains with lower virulence but with increased antibiotic resistance establish infection in HIV patients.
Dr. Kesavaram Padmavathy
Department of Microbiology, Research Laboratory for Oral and Systemic Health, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research, Chennai, India and Department of Microbiology, Dr. ALM PGIBMS, University of Madras, Chennai, India.
Dr. Krishnan Padma
Department of Microbiology, Dr. ALM PGIBMS, University of Madras, Chennai, India.
Dr. Sikhamani Rajasekaran
Government Hospital of Thoracic Medicine, Chennai, India.
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