Abstract
To explore of the detection of enterohemorrhagic Escherichia coli with extended-spectrum beta-lactamase (ESBLs) in patients with urinary tract infections (UTIs) after bladder cancer surgery, and analysis of their genotypic distribution and drug resistance. From February 2022 to February 2024, patients who underwent bladder cancer surgery at our hospital were collected. Among them, those who developed UTIs with enterohemorrhagic E coli postoperatively had their urine specimens isolated and cultured, resulting in 87 strains of enterohemorrhagic E coli. Cultures were conducted on the obtained enterohemorrhagic E coli samples, ESBLs production was screened, and drug sensitivity tests were performed to investigate the resistance rate and antibacterial effects. Additionally, genotypic testing was conducted. This study successfully isolated 87 strains of E coli, among which 49 strains (56.32%) were found to produce ESBLs after screening. The resistance rates of these ESBL-producing E coli to cefotaxime and ampicillin were relatively high (93.88% and 97.96%, respectively), while the resistance rate to imipenem was the lowest (2.04%). Genotypic testing revealed that among the 49 strains of ESBL-producing E coli, the detection rate of blaCTX-M-14 was the highest at 53.06%, followed by bla-TEM at 30.61%. The detection rates of bla-SHV (4.08%), bla-OXA (2.04%), blaCTX-M-3 (2.04%), blaCTX-M-15 (2.04%), as well as combinations of several genotypes (blaCTX-M-3 + bla-TEM, blaCTX-M-14 + bla-TEM, blaCTX-M-15 + bla-TEM, all with a detection rate of 2.04%), were relatively low. Strains carrying the bla-TEM genotype exhibited 100% resistance rates to ampicillin and tetracycline. Strains carrying the blaCTX-M-14 genotype showed a 100% resistance rate to ampicillin and a 96.15% resistance rate to cefotaxime. Bladder cancer patients with postoperative complications of E coli urinary tract infection have a detection rate of 56.32% for ESBL-producing E coli. The detected ESBL-producing strains show a high resistance rate to ampicillin and cefotaxime, with the lowest resistance rate observed against imipenem. Genotypic analysis reveals that blaCTX-M-14 and bla-TEM are the main ESBL genes, with blaCTX-M-14 having the highest detection rate.