{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T08:58:06Z","timestamp":1791622686437,"version":"4.3.4"},"update-to":[{"DOI":"10.12688\/f1000research.125596.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T00:00:00Z","timestamp":1669593600000}}],"reference-count":32,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T00:00:00Z","timestamp":1669593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIL"}],"content-domain":{"domain":["f1000research.com"],"crossmark-restriction":false},"short-container-title":["F1000Res"],"abstract":"\n Background:<\/ns3:bold>\n Urinary tract infection(UTI) is one of the commonly prevalent bacterial infection in humans.The uropathogenic\n E. coli<\/ns3:italic>\n (UPEC) expresses a range of virulence factors that contribute to their pathogenicity\n .<\/ns3:italic>\n The emergence of multidrug resistance (MDR)-associated UTI is increasing.This study monitors the distribution of virulence factors among UPEC strains to note the antibiogram, outcome and type of associated UTI.\n <\/ns3:p>\n \n Methods:<\/ns3:bold>\n A prospective cross-sectional time-bound study of six months was done on clinically significant urinary isolates of\n Escherichia coli.<\/ns3:italic>\n Detection of haemolysin production and serum resistance was done by phenotypic methods. Genotypic characterization of the virulence genes (\n pap<\/ns3:italic>\n C,\n iut<\/ns3:italic>\n A,\n hly<\/ns3:italic>\n A,\n cnf<\/ns3:italic>\n 1) was done by multiplex PCR. Demographic data, clinical history, antibiogram and type of UTI was collected from clinical case records.\n <\/ns3:p>\n \n Results:<\/ns3:bold>\n 75\n E.coli<\/ns3:italic>\n isolates from patients with suspected UTIs were included.\n \n Females had a higher preponderance of UTI (66.7%). 93% of patients were adults and the remaining 7% were from paediatrics.\u00a0 24 (32%) isolates showed haemolysis by plate haemolysis and all isolates were serum-resistant. Out of 75 isolates, 65 were positive for at least one of four targeted genes, while remaining ten isolates were negative for all four genes.Multidrug resistance was found in 40 (53.3%) isolates. 97.4% of the UTI cases had a favourable clinical outcome at discharge. Mortality due to urosepsis was 2.6%.\n <\/ns3:p>\n \n Conclusion:<\/ns3:bold>\n Association of hemolysin production with resistance to imipenem and norfloxacin in UPEC strains was significant.Presence of\n hlyA<\/ns3:italic>\n gene is positively associated with ceftazidime resistance. Nitrofurantoin, piperacillin, tazobactam, and cefaperazone sulbactam are possible candidates for empirical therapy of UTIs. Drugs like aminoglycosides, carbapenems and fosfomycin may be used as reserve drugs in the treatment of MDR-UTI.However,\n \n inappropriate usage can increase antibiotic resistance. Hence proper selection of antibiotics in hospitals taking into account the local antibiogram is needed to reduce the emergence of antibiotic resistance.\n <\/ns3:p>","DOI":"10.12688\/f1000research.125596.2","type":"journal-article","created":{"date-parts":[[2022,11,28]],"date-time":"2022-11-28T13:20:17Z","timestamp":1669641617000},"page":"1163","update-policy":"https:\/\/doi.org\/10.12688\/f1000research.crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Characterization of virulence factors and antibiotic resistance pattern of uropathogenic Escherichia coli strains in a tertiary care center"],"prefix":"10.12688","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2697-2583","authenticated-orcid":false,"given":"Naveen","family":"Kumar M","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevitha","family":"Bhat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5200-5546","authenticated-orcid":false,"given":"Archana","family":"Bhat K","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishwas","family":"Saralaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalini","family":"Shenoy Mulki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2022,11,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"269-284","DOI":"10.1038\/nrmicro3432","article-title":"Urinary tract infections: epidemiology, mechanisms of infection and treatment options.","volume":"13","author":"A Flores-Mireles","year":"2015","journal-title":"Nat Rev Microbiol."},{"key":"ref2","doi-asserted-by":"publisher","first-page":"56-67","DOI":"10.1016\/j.molimm.2019.02.007","article-title":"Urinary tract infection: Pathogenicity, antibiotic resistance and development of effective vaccines against Uropathogenic Escherichia coli.","volume":"108","author":"M Asadi Karam","year":"2019 Apr","journal-title":"Mol Immunol."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"305-310","DOI":"10.4103\/ijmm.IJMM_14_291","article-title":"Molecular Characterisation of Uropathogenic Escherichia coli Isolates at a Tertiary Care Hospital in South India.","volume":"35","author":"A Chakraborty","year":"2017","journal-title":"Indian J. Med. Microbiol."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"e450-e453","DOI":"10.1016\/j.ijid.2013.01.025","article-title":"International Journal of Infectious Diseases Distribution of uropathogenic virulence genes in Escherichia coli isolated from patients with urinary tract infection.","volume":"17","author":"M Tarchouna","year":"2013","journal-title":"Int. J. Infect. Dis."},{"key":"ref5","doi-asserted-by":"publisher","first-page":"6811-6816","DOI":"10.5897\/AJMR12.1462","article-title":"Detection of uropathogenic Escherichia coli virulence factors in patients with urinary tract infections in Iran.","volume":"6","author":"A Karimian","year":"2012","journal-title":"Afr. J. Microbiol. Res."},{"key":"ref6","first-page":"1-9","article-title":"The effect of varying multidrug-resistence (MDR) definitions on rates of MDR gram- negative rods.","volume":"3","author":"A Wolfensberger","year":"2019","journal-title":"Antimicrob. Resist. Infect. Control."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"140-158","DOI":"10.20546\/ijcmas.2016.504.019","article-title":"A Study of Virulence Factors and Drug Resistance Pattern in Escherichia coli Isolated from Extra Intestinal Infections in a Tertiary Care Teaching.","volume":"5","author":"A Bhrugubalda","year":"2016","journal-title":"Int. J. Curr. Microbiol. App. Sci."},{"key":"ref9","first-page":"1699-1703","article-title":"Phenotypic Study of Virulence Factors in Escherichia Coli Isolated From Antenatal Cases, Catheterized Patients, and Faecal Flora.","volume":"6","author":"O Article","year":"2012","journal-title":"J. Clin. Diagnostic Res."},{"key":"ref10","doi-asserted-by":"publisher","first-page":"369-373","DOI":"10.1016\/S0255-0857(21)02053-3","article-title":"Virulence factors and drug resistance in Escherichia coli isolated from extraintestinal infections.","volume":"25","author":"S Sharma","year":"2007","journal-title":"Indian J. Med. Microbiol."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"43-48","DOI":"10.1016\/j.micpath.2016.03.001","article-title":"Microbial Pathogenesis Molecular characterization and clinical signi fi cance of extraintestinal pathogenic Escherichia coli recovered from a south Indian tertiary care hospital.","volume":"95","author":"A Chakraborty","year":"2016","journal-title":"Microb. Pathog."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"586-600","DOI":"10.1038\/s41585-020-0362-4","article-title":"Definition and treatment of complicated urinary tract infections.","volume":"17","author":"F Wagenlehner","year":"2020","journal-title":"Nat. Rev. Urol."},{"key":"ref13","first-page":"701-705","article-title":"Original Research Article Characterization and antibiogram of Uropathogenic Escherichia coli from a tertiary care hospital in Eastern India.","volume":"4","author":"S Bhattacharyya","year":"2015","journal-title":"Int. J. Curr. Microbiol. App. Sci."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"175-178","DOI":"10.4103\/0255-0857.129812","article-title":"Prevalence of adhesive genes among uropathogenic Escherichia coli strains isolated from patients with urinary tract infection in Mangalore.","volume":"32","author":"A Shetty","year":"2014 Apr-Jun","journal-title":"Indian J. Med. Microbiol."},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1-6","DOI":"10.1186\/s12866-019-1587-3","article-title":"Virulence factors of uropathogenic Escherichia coli (UPEC) and correlation with antimicrobial resistance.","volume":"19","author":"C Shah","year":"2019","journal-title":"BMC Microbiol."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"176-183","DOI":"10.1128\/IAI.68.1.176-183.2000","article-title":"Contribution of Escherichia coli Alpha-Hemolysin to Bacterial Virulence and to Intraperitoneal Alterations in Peritonitis.","volume":"68","author":"A May","year":"2000","journal-title":"Infect. Immun."},{"key":"ref17","doi-asserted-by":"publisher","first-page":"22-33","DOI":"10.1038\/s41385-019-0225-6","article-title":"Alpha-hemolysin of uropathogenic Escherichia coli induces GM-CSF-mediated acute kidney injury.","volume":"13","author":"C Wang","year":"2020","journal-title":"Mucosal Immunol."},{"key":"ref18","first-page":"71-77","article-title":"Hemolysin and Serum Resistance among ESBL Producing Extraintestinal Pathogenic Escherichia coli Isolated from a Tertiary Care Hospital.","volume":"5","author":"S Shetty","year":"2016"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e94786","DOI":"10.1371\/journal.pone.0094786","article-title":"Role of Capsule and O Antigen in the Virulence of Uropathogenic Escherichia coli.","volume":"9","author":"S Sarkar","year":"2014","journal-title":"PLoS One."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"51-57","DOI":"10.3855\/jidc.7903","article-title":"Original Article Detection of virulence genes, phylogenetic group and antibiotic resistance of uropathogenic Escherichia coli in Mongolia.","volume":"11","author":"Y Munkhdelger","year":"2017","journal-title":"J. Infect. Dev. Ctries."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"217-224","DOI":"10.24171\/j.phrp.2018.9.5.02","article-title":"Osong Public Health and Research Perspectives Relationships between Virulence Factors and Antimicrobial Resistance among Escherichia coli Isolated from Urinary Tract.","volume":"9","author":"M Karam","year":"2018","journal-title":"Osong. Public Health Res. Perspect."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"219-222","DOI":"10.1016\/j.ijid.2014.03.1393","article-title":"International Journal of Infectious Diseases Detection of virulence genes in Escherichia coli isolated from patients with cystitis and pyelonephritis.","volume":"29","author":"F Firoozeh","year":"2014","journal-title":"Int. J. Infect. Dis."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1393-1403","DOI":"10.22207\/JPAM.12.3.42","article-title":"Important Virulence Factors and Related Genes in Uropathogenic E. coli and their Relation to Fluoroquinolone Resistance.","volume":"12","author":"N Gohar","year":"2018","journal-title":"J. Pure Appl. Microbiol."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"1-10","DOI":"10.1155\/2014\/959206","article-title":"Identification of Virulence Factors Genes in Escherichia coli Isolates from Women with Urinary Tract Infection in Mexico.","volume":"2014","author":"D L\u00f3pez-banda","year":"2014","journal-title":"Biomed. Res. Int."},{"key":"ref25","first-page":"632-637","article-title":"Detection & characterization of necrotoxin producing Escherichia coli (NTEC) from patients with urinary tract infection (UTI).","volume":"139","author":"H Rahman","year":"2014","journal-title":"Indian J. Med. Res."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"1-9","DOI":"10.1186\/s12866-020-01933-1","article-title":"Significant association between genes encoding virulence factors with antibiotic resistance and phylogenetic groups in community acquired uropathogenic Escherichia coli isolates.","volume":"20","author":"Z Yazdanpour","year":"2020","journal-title":"BMC Microbiol."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1439-1443","DOI":"10.2147\/IDR.S201849","article-title":"Changing antibiotic susceptibility pattern in uropathogenic escherichia coli over a period of 5 years in a tertiary care center.","volume":"12","author":"S Prasada","year":"2019","journal-title":"Infect. Drug Resist."},{"key":"ref28","doi-asserted-by":"crossref","first-page":"1-7","DOI":"10.1186\/s12879-018-2960-9","article-title":"Empiric antibiotic therapy in urinary tract infection in patients with risk factors for antibiotic resistance in a German emergency department.","volume":"18","author":"S Bischoff","year":"2018","journal-title":"BMC Infect. Dis."},{"key":"ref29","first-page":"39-41","article-title":"Resistance Patterns Of Urinary Isolates In A Tertiary Indian Hospital.","volume":"19","author":"A Hasan","year":"2007","journal-title":"J. Ayub Med. Coll. Abbottabad."},{"key":"ref30","doi-asserted-by":"publisher","first-page":"37-46","DOI":"10.1089\/fpd.2011.0961","article-title":"Associations Between Multidrug Resistance, Plasmid Content, and Virulence Potential Among Extraintestinal Pathogenic and Commensal Escherichia coli from Humans and Poultry.","volume":"9","author":"T Johnson","year":"2012","journal-title":"Foodborne Pathog. Dis."},{"key":"ref31","doi-asserted-by":"crossref","first-page":"261-272","DOI":"10.1086\/315217","article-title":"Extended Virulence Genotypes of Escherichia coli Strains from Patients with Urosepsis in Relation to Phylogeny and Host Compromise.","volume":"181","author":"J Johnson","year":"2000 Jan","journal-title":"J Infect Dis."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"4589-4592","DOI":"10.1128\/JCM.02070-06","article-title":"Escherichia coli Isolates Associated with Uncomplicated and Complicated Cystitis and Asymptomatic Bacteriuria Possess Similar Phylogenies, Virulence Genes, and O-Serogroup Profiles.","volume":"44","author":"A Takahashi","year":"2006","journal-title":"J. Clin. Microbiol."},{"key":"ref33","doi-asserted-by":"publisher","author":"B Archana","year":"2022","DOI":"10.5061\/dryad.q83bk3jmd"}],"container-title":["F1000Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/f1000research.com\/articles\/11-1163\/v2\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-1163\/v2\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/f1000research.com\/articles\/11-1163\/v2\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T10:45:19Z","timestamp":1670409919000},"score":1,"resource":{"primary":{"URL":"https:\/\/f1000research.com\/articles\/11-1163\/v2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,28]]},"references-count":32,"URL":"https:\/\/doi.org\/10.12688\/f1000research.125596.2","relation":{"has-review":[{"id-type":"doi","id":"10.5256\/f1000research.141529.r156819","asserted-by":"subject"},{"id-type":"doi","id":"10.5256\/f1000research.141529.r156819","asserted-by":"object"}]},"ISSN":["2046-1402"],"issn-type":[{"value":"2046-1402","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,28]]},"assertion":[{"value":"Indexed","URL":"https:\/\/f1000research.com\/articles\/11-1163\/v2#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.5256\/f1000research.141529.r156819, Vignesh Ramachandran, Faculty of Medicine, Universiti Kuala Lumpur-Royal College of Medicine Perak, Ipoh, Malaysia, 05 Dec 2022, version 2, indexed","URL":"https:\/\/f1000research.com\/articles\/11-1163\/v2#referee-response-156819","order":0,"name":"referee-response-156819","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.5256\/f1000research.137922.r154567, Anusha Rohit, Division of Infectious Diseases, Nitte University Centre for Science Education and Research (NUCSER), Nitte (Deemed to Be University), Mangalore, Karnataka, India, 17 Nov 2022, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/f1000research.com\/articles\/11-1163\/v1#referee-response-154567","order":1,"name":"referee-response-154567","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"Archana Bhat K<\/b>; \nPosted: 24 Nov 2022<\/i>; As per reviewer suggestions, the following changes will be done accordingly and updated in the revised text of the manuscript and uploaded. 1. As 60% of the isolates were from complicated UTIs, can the authors explain why they suggest nitrofurantoin for therapy in the conclusion of the paper? The authors have updated the discussion and conclusion in the paper . Owing to the lower rate of resistance and ease of administration, nitrofurantoin maybe an effective oral drug in outpatients with UTI (added in conclusion). However, the therapeutic utility of nitrofurantoin in complicated UTI compared to uncomplicated UTI was not studied.(added in discussion) 2. Was any statistical analysis done for the association of the virulence factors detected and the resistance patterns of the isolates? Statistical analysis (Chi square test ) for the association of the virulence factors detected and the resistance patterns of the isolates was done .The authors have added a sentence on the same. The results of significance is already mentioned in the content of discussion with reference to table 4. 3. Why did the authors choose these genes for the detection of the virulence characterisation as many of these characteristics have multiple genes coding for them? The association between \npap<\/i>C\n, iut<\/i>A seemed to be the most common among the isolates. The authors have updated the content in Background of the study-\u201cBased on previously published literature, we aimed to look into the common genes \npap<\/i>C and \niutA<\/i> and apart from them, other genes \nhly <\/i>A and \ncnf1<\/i> were screened for epidemiological and virulence characterisation.\u201d 4. How many of these isolates were from patients who developed CAUTI due to the presence of a urinary catheter? The authors have updated the results and added the sentence \u201cCatheter associated UTI was seen in 33.3%(n=25) of the patients.\u201d","URL":"https:\/\/f1000research.com\/articles\/11-1163\/v2#referee-comment-9056","order":2,"name":"referee-comment-9056","label":"Referee Comment","group":{"name":"article-reports","label":"Article Reports"}},{"value":"The author(s) declared that no grants were involved in supporting this work","order":3,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}