Antibiotic Resistance and Virulence Genes of Escherichia coli Isolated from Patients with Urinary Tract Infections After Kidney Transplantation from Deceased Donors

Figures & data

Table 1 PCR Primers Used to Detect Virulence Genes

Gene	Primer Sequence (5ʹ to 3ʹ)	Amplicon Size (bp)
Adhesions
pap	GACGGCTGTACTGCAGGGTGTGGCG	328
	ATATCCTTTCTGCAGGGATGCAATA
pap GI	TCGTGCTGAGGTCCGGAATTT	461
	TGGCATCCCCCAACATTATCG
pap GII	GGGATGAGCGGGCCTTTGAT	190
	CGGGCCCCCAAGTAACTCG
pap GIII	GTGGCAGTAGAGTAATGACCGTTA	258
	ATATCCTTTCTGCAGGGATGCATA
fim	GAGAAGAGGTTTGATTTAACTTATTG	559
	AGAGCCGCTGTAGAACTGAGG
sfa	CTCCGGAGAACTGGGTGCATCTTAC	410
	CATCAAGCTGTTTGTTCGTCCGCCG
Iron acquisition systems
irp2	AAGGATTCGCTGTTACCGGAC	413
	AACTCCTGATACAGGTGGC’
iroN	AAGTCAAAGCAGGGGTTGCCCG	665
	GACGCCGACATTAAGACGCAG
iuc	ATGAGAATCATTATTGACATAATTG CTCACGGGTGAAAATATTTT	1482
Toxins
hly	AACAAGGATAAGCACTGTTCTGGCT	1177
	ACCATATAAGCGGTCATTCCCGTCA
cnf	AAGATGGAGTTTCCTATGCAGGAG	498
	CATTCAGAGTCCTGCCCTCATTATT

Table 2 Comparative Analysis of Clinical Data from CA-UTIs and HA-UTIs in Kidney Transplantation

Variable	CA-UTIs (n=46)	HA-UTIs (n=18)	P
Gender, male	10(21.7)	5(27.8)	0.608
Age (years)	42.1±13.4	41.2±10.3	0.798
BMI (kg/m^2)	22.8±3.6	23.6±3.6	0.440
Pretransplantation conditions
Diabetes mellitus	11(23.9)	5(27.8)	0.748
Coronary heart disease	7(15.2)	4(22.2)	0.504
Chronic liver disease	4(8.7)	3(16.7)	0.358
Chronic lung disease	3(6.5)	1(5.6)	0.886
Induction therapy			0.030
Basiliximab	24(52.2)	4(22.2)
rATG	22(47.8)	14(77.8)
CMV mismatch (D+/R-)	6(13.0)	3(16.7)	0.708
Delayed graft function	3(6.52)	5(27.78)	0.021
ESBL positive	30(65.2)	17(94.4)	0.031
Length of hospital stay (d)	21.5±8.2	34.6±13.2	<0.001
Catheter retention time (d)	7.3±1.2	8.8±3.2	0.008

Abbreviations: rATG, rabbit anti-human thymocyte immunoglobulin; BMI, body mass index; CA-UTIs, community-acquired urinary tract infections; CMV, cytomegalovirus; D, donor; ESBL, extended spectrum β-lactamase; HA-UTIs, hospital-acquired urinary tract infections; R, recipient.

Table 3 Antibiotic Resistance Profiles of the Isolated E. coli Strains Causing UTIs in Kidney Transplant Recipients

Antibiotic	Total, n(%)	CA-UTIs, n(%) (n=46)	HA-UTIs, n(%) (n=18)	P*
Ampicillin	59(92.2)	42(91.3)	17(94.4)	0.674
Cefalotin	49(76.6)	33(71.7)	16(88.9)	0.145
Carbenicillin	52(81.3)	36(78.3)	16(88.9)	0.327
Ciprofloxacin	19(29.7)	10(21.7)	9(50)	0.026
Cotrimoxazole	40(62.5)	25(54.3)	15(83.3)	0.031
Gentamicin	23(35.9)	15(32.6)	8(44.4)	0.375
Levofloxacin	22(34.4)	13(28.3)	9(50)	0.100
Norfloxacin	18(28.1)	10(21.7)	8(44.4)	0.069
Pefloxacin	44(68.8)	30(65.2)	14(77.8)	0.330
Trimethoprim/sulfamethoxazole	37(57.8)	22(47.8)	15(83.3)	0.010
Amikacin	13(20.3)	6(13)	7(38.9)	0.021

Note: *P values for comparison between CA-UTI and HA-UTI E. coli isolates.

Table 4 Distribution of Virulence Genes in Isolated E. coli Strains [n(%)]

Virulence Genes	Total, n(%)	HA-UTIs, n(%) (n=18)	CA-UTIs, n(%) (n=46)	P*
Adhesions
pap	16(25.0)	4(22.2)	12(26.1)	0.748
pap GI	10(15.6)	3(16.7)	6(13)	0.708
pap GII	29(45.3)	8(44.4)	21(45.7)	0.930
pap GIII	9(14.1)	2(11.1)	7(15.2)	0.671
fim	41(64.1)	12(66.7)	29(63.0)	0.786
sfa	20(31.3)	8(44.4)	12(26.1)	0.154
Iron acquisition systems
irp2	36(56.3)	16(88.9)	20(43.5)	0.001
iroN	30(46.9)	14(77.8)	16(34.8)	0.002
iuc	15(23.4)	5(27.8)	10(21.7)	0.608
Toxins
hly	6(9.4)	3(16.7)	3(6.5)	0.211
cnf	3(4.7)	1(5.6)	2(4.3)	0.837

Note: *P values for comparison between CA-UTI and HA-UTI E. coli isolates.