Abstract
The relevance of vaginal colonization of pregnant women by Escherichia coli is poorly understood, despite these strains sharing a similar virulence profile with other extraintestinal pathogenic E. coli producing severe obstetric and neonatal infections. We characterized the epidemiology, antimicrobial susceptibility and virulence profiles of 84 vaginal E. coli isolates from pregnant women from Rabat (Morocco) and Manhiça (Mozambique), two very distinct epidemiological settings. Low levels of antimicrobial resistance were observed to all drugs tested, except for trimethoprim-sulfamethoxazole in Manhiça, where this drug is extensively used as prophylaxis for opportunistic HIV infections. The most prevalent virulence factors were related to iron acquisition systems. Phylogroup A was the most common in Rabat, while phylogroups E and non-typeable were the most frequent in Manhiça. Regardless of the apparently "low virulence" of these isolates, the frequency of infections is higher and the outcomes more devastating in constrained-resources conditions, especially among pregnant women and newborns.
MeSH terms
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Anti-Bacterial Agents / pharmacology
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Drug Resistance, Bacterial
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Escherichia coli / drug effects*
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Escherichia coli Infections / complications*
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Escherichia coli Infections / diagnosis
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Female
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HIV Infections / complications
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Humans
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Microbial Sensitivity Tests
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Morocco
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Mozambique
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Phylogeny
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Pregnancy
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Pregnancy Complications, Infectious / microbiology
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Prevalence
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Trimethoprim, Sulfamethoxazole Drug Combination / therapeutic use
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Vagina / microbiology*
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Virulence / drug effects
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Virulence Factors / metabolism
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beta-Lactamases / therapeutic use
Substances
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Anti-Bacterial Agents
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Virulence Factors
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Trimethoprim, Sulfamethoxazole Drug Combination
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beta-Lactamases
Grants and funding
This study was supported by the Instituto de Salud Carlos III under the grants CM13/00260, CP11/00269, PI10/01579 and PI13/00127; the European Directorate-General for Research and Innovation Grant Agreement 612216; the Spanish Agency of International Cooperation and Development (AECID) 07-CO1-021. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.