Antibiotic-resistant ST38, ST131 and ST405 strains are the leading uropathogenic Escherichia coli clones in Riyadh, Saudi Arabia

J Antimicrob Chemother. 2015 Oct;70(10):2757-62. doi: 10.1093/jac/dkv188. Epub 2015 Jul 16.

Abstract

Objectives: We investigated the molecular epidemiology of uropathogenic Escherichia coli (UPEC) from a tertiary care hospital in Riyadh, Saudi Arabia, revealing, for the first time, the population structure of UPEC in the region.

Methods: A total of 202 UPEC isolates were recovered from hospital and community patients with urinary tract infection in December 2012 and January 2013. Strains were characterized by MLST, antibiotic susceptibility determination and virulence gene detection.

Results: The most common lineages were ST131 (17.3%), ST73 (11.4%), ST38 (7.4%), ST69 (7.4%), ST10 (6.4%), ST127 (5.9%), ST95 (5.4%), ST12 (3.5%), ST998 (3.5%) and ST405 (3%). ST131 and ST405 isolates were significantly associated with high levels of antibiotic resistance (60% of ST131 carried CTX-M-14 or CTX-M-15 and 66.7% of ST405 isolates carried CTX-M-15). ST131, CTX-M-15-positive isolates were predominantly of the fimH30/clade C group, resistant to fluoroquinolones; members of this sub-group were more likely to carry a high number of genes encoding selected virulence determinants. The relatively high proportion of ST38 was notable and four of these isolates harboured aggR.

Conclusions: Our findings highlight the presence of MDR, CTX-M-positive ST38, ST131 and ST405 UPEC in Saudi Arabia. The high proportion of isolates with CTX-M is a particular concern. We suggest that ST38 UPEC warrant further study.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Escherichia coli Infections / epidemiology*
  • Escherichia coli Infections / microbiology*
  • Humans
  • Microbial Sensitivity Tests
  • Multilocus Sequence Typing
  • Prevalence
  • Saudi Arabia / epidemiology
  • Urinary Tract Infections / epidemiology
  • Urinary Tract Infections / microbiology
  • Uropathogenic Escherichia coli / classification*
  • Uropathogenic Escherichia coli / drug effects*
  • Uropathogenic Escherichia coli / genetics
  • Virulence / genetics

Substances

  • Anti-Bacterial Agents