{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:59:00Z","timestamp":1787032740231,"version":"build-2736575974"},"reference-count":37,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T00:00:00Z","timestamp":1629763200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Uropathogenic\n                      <jats:italic>Escherichia coli<\/jats:italic>\n                      (UPEC) is the causative agent of uncomplicated urinary tract infections (UTIs) in ambulatory patients. However, enteroaggregative\n                      <jats:italic>E. coli<\/jats:italic>\n                      (EAEC), an emergent bacterial pathogen that causes persistent diarrhoea, has recently been associated with UTIs. The aim of this study was to determine the frequency of EAEC virulence genes, antibiotic resistance, as well as biofilm production of UPEC isolates obtained from ambulatory patients with non-complicated UTIs that attended to the ISSSTE clinic in Chilpancingo, Guerrero, Mexico, and correlate these with the patients\u2019 urinary tract infection symptomatology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      One hundred clinical isolates were obtained. The identification of clinical isolates, antimicrobial susceptibility testing, and extended spectrum beta-lactamases (ESBLs) production were performed using the Vitek automated system. Assignment of\n                      <jats:italic>E. coli<\/jats:italic>\n                      phylogenetic groups was performed using the quadruplex phylo-group assignment PCR assay. UPEC virulence genes (\n                      <jats:italic>hlyA<\/jats:italic>\n                      ,\n                      <jats:italic>fimH<\/jats:italic>\n                      ,\n                      <jats:italic>papC<\/jats:italic>\n                      ,\n                      <jats:italic>iutA<\/jats:italic>\n                      , and\n                      <jats:italic>cnf1<\/jats:italic>\n                      ) and EAEC virulence genes (\n                      <jats:italic>aap<\/jats:italic>\n                      ,\n                      <jats:italic>aggR<\/jats:italic>\n                      , and\n                      <jats:italic>aatA<\/jats:italic>\n                      ) were detected by multiple PCR.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We found that 22% of the isolates carried the\n                      <jats:italic>aggR<\/jats:italic>\n                      gene and were classified as UPEC\/EAEC. The main phylogenetic group was B2 (44.1% were UPEC and 77.27% UPEC\/EAEC isolates, respectively). Over half of the UPEC\/EAEC isolates (63.64%) were obtained from symptomatic patients, however the\n                      <jats:italic>aatA<\/jats:italic>\n                      gene was the only one found to be associated with the risk of developing pyelonephritis (OR = 5.15,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.038). A total of 77.71% of the UPEC\/EAEC isolates were ESBL producers and 90.91% multidrug-resistant (MDR). In conclusion, UPEC\/EAEC isolates are more frequent in symptomatic patients and the\n                      <jats:italic>aatA<\/jats:italic>\n                      gene was associated with a higher risk of developing pyelonephritis, along with UPEC genes\n                      <jats:italic>hlyA<\/jats:italic>\n                      and\n                      <jats:italic>cfn1<\/jats:italic>\n                      . UPEC\/EAEC isolates obtained from UTI showed ESBL production and MDR.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.11726","type":"journal-article","created":{"date-parts":[[2021,8,24]],"date-time":"2021-08-24T04:20:01Z","timestamp":1629778801000},"page":"e11726","source":"Crossref","is-referenced-by-count":18,"title":["Enteroaggregative\n                    <i>Escherichia coli<\/i>\n                    is associated with antibiotic resistance and urinary tract infection symptomatology"],"prefix":"10.7717","volume":"9","author":[{"given":"Ver\u00f3nica I.","family":"Mart\u00ednez-Santos","sequence":"first","affiliation":[{"name":"C\u00e1tedras CONACyT, Universidad Aut\u00f3noma de Guerrero, Chilpancingo, Guerrero, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Ru\u00edz-Rosas","sequence":"additional","affiliation":[{"name":"Laboratorio Cl\u00ednico, \u00c1rea Microbiolog\u00eda, Cl\u00ednica Hospital ISSSTE Chilpancingo, Chilpancingo, Guerrero,  M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Ramirez- Peralta","sequence":"additional","affiliation":[{"name":"Laboratorio de Patometabolismo Microbiano, Facultad de Ciencias Qu\u00edmico Biol\u00f3gicas, Universidad Aut\u00f3noma de Guerrero, Chilpancingo, Guerrero, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Zaragoza Garc\u00eda","sequence":"additional","affiliation":[{"name":"Laboratorio de Investigaci\u00f3n en Microbiolog\u00eda, Facultad de Ciencias Qu\u00edmico Biol\u00f3gicas, Universidad Aut\u00f3noma de Guerrero, Chilpancingo, Guerrero, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Armando","family":"Resendiz-Reyes","sequence":"additional","affiliation":[{"name":"Laboratorio de Investigaci\u00f3n en Microbiolog\u00eda, Facultad de Ciencias Qu\u00edmico Biol\u00f3gicas, Universidad 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