What question did this study set out to answer?

This study aims to characterize the antimicrobial resistance profiles and phylogenetic distribution of Escherichia coli in hospitalized patients with urinary tract infections.

May 29, 2026Antibiotics0 citationsOpen Access

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Antimicrobial Resistance, Biofilm Formation, and Phylogenetic Distribution of Escherichia coli in Hospitalized Patients with Community-Onset Urinary Tract Infections in Western Mexico

LZLuis Asdrúval Zepeda-GutiérrezUniversidad de Guadalajara SRSol Ramírez-OchoaHospital Civil de Guadalajara MAMauricio Alfredo Ambriz-AlarcónHospital Civil de Guadalajara

Key Points

This study aims to characterize the antimicrobial resistance profiles and phylogenetic distribution of Escherichia coli in hospitalized patients with urinary tract infections.
Seventy E. coli isolates examined from September 2023 to September 2024.
Multiplex PCR and crystal violet biofilm quantification were used for analysis.
Associations were assessed using Fisher's exact test with BH-FDR correction.
ESBL phenotype and MDR detected in 57.1% and 58.6% of isolates respectively.
Phylogroup B2 was inversely associated with recurrent UTI (adjusted OR = 0.19; 95% CI: 0.05–0.81; p = 0.025).
The majority of ESBL producers had blaTEM (85.0%).

Abstract

Background/Objectives: Escherichia coli is the predominant pathogen in community-onset urinary tract infections (UTIs) requiring hospitalization. This study characterized antimicrobial resistance profiles, biofilm formation, extended-spectrum β-lactamase (ESBL) gene distribution, and phylogenetic background of E. coli isolates from hospitalized UTI patients in Western Mexico. Methods: Seventy isolates (September 2023–September 2024) underwent susceptibility testing (CLSI M100, 35th edition), multiplex PCR for blaTEM, blaCTX-M, and blaSHV genes, crystal violet biofilm quantification, and Clermont quadruplex PCR phylotyping. Associations were evaluated by Fisher’s exact test with Benjamini–Hochberg FDR (BH-FDR) correction. Results: ESBL phenotype and MDR were detected in 57.1% and 58.6% of isolates. After BH-FDR correction, ESBL production was significantly associated with amikacin (OR = 5.55; 95% CI: 1.80–18.74; q = 0.002) and TMP-SMX non-susceptibility (OR = 3.00; 95% CI: 1.02–9.23; q = 0.036); ciprofloxacin non-susceptibility was linked to MDR status (OR = 7.21; 95% CI: 1.28–75.66; q = 0.017) but not ESBL phenotype. Biofilm was detected in 77.1% of isolates. blaTEM predominated among ESBL producers (85.0%). Phylogroup B2 (51.4%) was inversely associated with recurrent UTI on both univariate (OR = 0.17; 95% CI: 0.03–0.73; p = 0.008) and adjusted analysis (adjusted OR = 0.19; 95% CI: 0.05–0.81; p = 0.025). Phylogroup C (22.9%) exhibited the highest MDR prevalence (81.3%) and the highest biofilm formation rate among phylogroups (87.5%). Conclusions: The high prevalence of ESBL-producing and MDR E. coli, combined with an unexpected predominance of blaTEM, reveals a distinctive local resistance landscape diverging from regional trends. The inverse association of phylogroup B2 with recurrence and TMP-SMX resistance reinforces the clinical value of phylogenetic surveillance in guiding UTI management strategies.

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Cite This Study

Zepeda-Gutiérrez et al. (Wed,) studied this question.

synapsesocial.com/papers/6a192ee7fab5b468c44182ba https://doi.org/https://doi.org/10.3390/antibiotics15060541

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