Urinary tract infections associated with multidrug resistant enteric bacilli: characterization and genetical studies

Urinary tract infections (UTIs) are among the most commonly prevalent infections in clinical practice. Escherichia coli is the causative agent in about 85% of community-acquired UTIs, followed by Klebsiella that accounts for 6 to 17% of such infections. Present study is based on the isolation-identification and antibiotic resistance pattern of about 60 indigenous bacterial isolates from UTI patients. Prevalence rates were consistent with those from major recent studies reported in the literature, i.e. 73% isolates were identified as E. coli, 16% as K. pneumoniae and 11% as Proteus sp. Bases of identification included morpho-cultural and biochemical characteristics. To assess the breadth of multidrug resistance among these isolates, culture medium incorporation method was employed using ampicillin, fosfomycin, chloramphenicol, tetracycline, and three aminoglycosides (kanamycin, gentamicin, and streptomycin). Of these isolates, 30% offered multidrug resistance to three or more agents. Among multidrug resistant isolates, 100% were resistant to ampicillin, 47% to streptomycin, 41% to chloramphenicol, gentamicin and tetracycline, 35% offered resistance to kanamycin while only 6% showed resistance to fosfomycin. After curing treatment with acridine orange, some of the isolates lost their resistance, thereby indicating the extrachromosomal location of the resistance determinants. Plasmid DNA (bearing multidrug resistant genes) was isolated from the uncured cells, and was stably transformed into the competent cured recipient cells.