Virulence and resistance of Escherichia coli isolates from pregnant and non-pregnant women with community-acquired urinary tract infections in a Kuwait hospital

Abstract number: p1856

Draghijeva  E., Egbase  P., Mathai  S.

Objective: 

To compare the availability of virulence factors and the resistance of E. coli isolates from pregnant women with uncomplicated community-acquired urinary tract infections (CA-UTIs) and non-pregnant women in London hospital in Kuwait over a period of two years.

Methods: 

Eighty-six pregnant and 90 non-pregnant women with signs of CA-UTIs were enrolled in the study. The strains isolated from the patients who had significant bacteriuria were included in the microbiological analyses. The identification of the strains was performed using the API 20E system (BioMerieux), while their susceptibility was determined by disk diffusion method. The interpretation of the results was realized according to NCCLS guidelines. Quality control was performed using reference strain E. coli ATCC 25922. O-serotyping was carried out with polyvalent and monovalent antisera. Hemolysin production was tested on human blood agar plates. Possession of K1 antigen by E. coli was tested with agglutination by murine monoclonal antibodies to the group B meningococcal capsule.

Results: 

We found O serogroups O1, O2, O4, O6, O7, O18 and O75 among strains isolated from pregnant and non-pregnant women. Hemolysin was presented in 35% and 40% respective. K1 antigen was presented in 40% of strains in studied groups. There are some statistically significant differences in antimicrobial resistance between both groups. Amoxicillin-clavulanate (AMX-CLV) resistance was higher among UTI haemolytic isolates of E. coli in pregnant women (54%) then in non-pregnant women (38%). Similar distinction in Cefuroxime resistance was found – 15% and 0. Amikacin resistance was higher among UTI isolates of E. coli in non-pregnant women (47%) then in pregnant women (23%).

Conclusions: 

There are no significant differences in expression of virulence factors of E. coli from pregnant and non-pregnant women with CA-UTIs in London hospital, Kuwait. The resistance rates of E. coli from pregnant women to AMX-CLV and Cefuroxime are significantly higher than in non-pregnant women.