Multidrug resistance and extended-spectrum β-lactamases genes among Escherichia coli from patients with urinary tract infections in Northwestern Libya

Figures & data

Table 1 Polymerase chain reaction (PCR) primer sequences for the detection of extended-spectrum β-lactamases genes in E. coli

Target gene	Oligonucleotide primer sequences (5′ to 3′)	Amplicon size (bp)	Reference
bla TEM-1F	CAGCGGTAAGATCCTTGAGA	643	11
bla TEM-1R	ACTCCCCGTCGTGTAGATAA
bla SHV-1F	GGCCGCGTAGGCATGATAGA	714	11
bla SHV-1R	CCCGGCGATTTGCTGATTTC
bla OXA-1F	AATGGCACCAGATTCAACTT	599	11
bla OXA-1R	CTTGGCTTTTATGCTTGATG
bla CTX-M-1F	GAAGGTCATCAAGAAGGTGCG	560	12
bla CTX-M-1R	GCATTGCCACGCTTTTCATAG

Table 2 Uropathogens isolates from patients (n=1,790) with UTIs

Organism	No. (%) positive
E. coli	208 (12)
Klebsiella spp.	69 (3.8)
K. pneumoniae	67 (3.7)
K. oxytoca	2 (0.1)
Enterobacter spp.	18 (1.0)
E. aerogenes	5 (0.3)
E. cloacae	13 (0.7)
Proteus mirabilis	22 (1.2)
Citrobacter spp.	12 (0.7)
C. freundii	5 (0.3)
C. koseri	7 (0.4)
Morganella morganii	6 (0.3)
Serratia marcescens	1 (0.05)
Aeromonas hydrophila/caviae	1 (0.05)
Pseudomonas aeruginosa	4 (0.2)
Acinetobacter spp.	8 (0.4)
A. baumannii	6 (0.3)
A. haemolyticus	1 (0.05)
A. lwoffii	1 (0.05)
Staphylococcus spp.	14 (0.8)
Enterococcus faecalis	4 (0.2)
Streptococcus agalactiae	6 (0.3)
Total	373 (20.8)^a

^aIn two patients, two different organisms were isolated from each of them.

Table 3 Distribution of E. coli, Klebsiella spp., and other uropathogens isolated from patients with UTIs according to gender and type of hospital admission

	No. (%) positive
Organism	Female (n=1,151)	Male (n=639)	Outpatients (n=1,134)	Inpatients (n=656)
E. coli	163 (14.2)^a	45 (7.0)	155 (13.7)^b	53 (8.1)
Klebsiella spp.	43 (3.7)	26 (4.1)	41 (3.6)	28 (4.3)
Other bacteria	65 (5.6)	31 (4.9)	68 (6.0)	28 (4.3)
Total	271 (23.5)^c	102 (16)	264 (23.3)^d	109 (16.6)

^aSignificantly higher than in male patients (P<0.000007, odds ratio [OR]=2.18); ^bsignificantly higher than in inpatients (P<0.0004, OR=1.80); ^csignificantly higher than in male patients (P<0.0002, OR=1.62); ^dsignificantly higher than in inpatients (P<0.0009, OR=1.52).

Table 4 Antimicrobial resistance patterns of E. coli and Klebsiella spp. from patients with UTIs

	No. (%) resistant to
Antimicrobial agent	E. coli (n=208)	Klebsiella spp. (n=69)	P (odds ratio)
Ampicillin	144 (69.2)	69 (100)	0.0000001 (Undefined)
Ampicillin/sulbactam	64 (30.8)	22 (31.9)	NS
Cefazoline	45 (21.6)	26 (37.7)	<0.008 (2.19)
Cefoxitin	8 (3.8)	4 (5.8)	NS
Ceftazidime	14 (6.7)	22 (31.9)	0.0000001 (6.49)
Ceftriaxone	14 (6.7)	23 (33.3)	0.0000000 (6.93)
Cefepime	13 (6.3)	22 (31.9)	0.0000000 (7.02)
Imipenem	1 (0.5)	4 (5.8)	<0.005 (12.74)
Meropenem	1 (0.5)	3 (4.3)	<0.02 (9.41)
Amikacin	0 (0.0)	1 (1.4)	NS
Gentamicin	23 (11.1)	16 (23.2)	<0.02 (2.43)
Tobramycin	17 (8.2)	9 (13)	NS
Ciprofloxacin	48 (23.1)	12 (17.4)	NS
Levofloxacin	40 (19.2)	9 (13)	NS
Nitrofurantoin	4 (1.9)	21 (30.4)	0.0000000 (22.31)
Trimethoprim/sulfamethoxazole	77 (37)	17 (24.6)	NS

Fig. 1 PCR products of bla _CTX-M (lines 1–8 and 9–14); L 100 bp ladder and 50 bp ladder. pos=positive control and neg=negative control.