Preprint Brief Report Version 1 Preserved in Portico This version is not peer-reviewed

Resistance and Virulence Properties of Extraintestinal Pathogenic E. Coli Causing Nosocomial-and Community-Acquired Urinary Tract Infections in Hospitalized Patients in Rio de Janeiro, Brazil

Version 1 : Received: 24 September 2020 / Approved: 27 September 2020 / Online: 27 September 2020 (02:40:41 CEST)

How to cite: Campos, A.C.D.C.; Andrade, N.; Correal, J.C.D.; Santos, C.C.; du Teil Espina, M.; Dijl, J.M.V.; Chlebowicz-Fliss, M.A.; Friedrich, A.W.; Mutters, N.T.; Damasco, P.V.; Rosa, A.C.D.P.; W. A. Rossen, J. Resistance and Virulence Properties of Extraintestinal Pathogenic E. Coli Causing Nosocomial-and Community-Acquired Urinary Tract Infections in Hospitalized Patients in Rio de Janeiro, Brazil. Preprints 2020, 2020090655 (doi: 10.20944/preprints202009.0655.v1). Campos, A.C.D.C.; Andrade, N.; Correal, J.C.D.; Santos, C.C.; du Teil Espina, M.; Dijl, J.M.V.; Chlebowicz-Fliss, M.A.; Friedrich, A.W.; Mutters, N.T.; Damasco, P.V.; Rosa, A.C.D.P.; W. A. Rossen, J. Resistance and Virulence Properties of Extraintestinal Pathogenic E. Coli Causing Nosocomial-and Community-Acquired Urinary Tract Infections in Hospitalized Patients in Rio de Janeiro, Brazil. Preprints 2020, 2020090655 (doi: 10.20944/preprints202009.0655.v1).

Abstract

Background: Extraintestinal pathogenic Escherichia coli (ExPEC) is the most common cause of urinary tract infections (UTIs). They are often multidrug-resistant (MDR), making them challenging to treat. Additionally, virulence mechanisms as biofilm formation are associated with persistent UTIs. Aims: To reveal a possible association between patients’ risk factors and UTIs caused by MDR or biofilm-forming ExPECs and characterize ExPECs causing asymptomatic bacteriuria, community- (CA), or hospital-acquired (HA) UTIs in hospitalized patients in Brazil. Methods: Bacterial DNA was extracted from the urine of 63 hospitalized patients and sequenced using short-read sequencing. Antibiotic susceptibility was evaluated using VITEK-2, and the biofilm-forming, adhesion, and invasion abilities were quantitatively assessed. Results: Antibiotic resistance rates were high, and the majority of UTIs were complicated CA-UTIs. Most MDR- and ESBL-producing E. coli isolates belonged to high-risk lineages and were associated with UTIs in patients with comorbidities and over 60 years of age. The mortality rate of patients infected with MDR-isolates was higher than of those infected with non-MDR isolates. Most isolates were biofilm-forming, but no association with patients’ risk factors was found. Conclusions: Complicated UTIs caused by MDR- and biofilm-forming bacteria are frequently found in hospitalized patients in Brazil suffering from a UTI and are associated with high-risk lineages.

Subject Areas

urinary tract infections; multi-drug resistance; biofilm; virulence genes; WGS

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