Abstract
Abstract in English, Malay (macrolanguage) The rapid emergence of multidrug-resistant (MDR) uropathogenic Escherichia coli (UPEC) strains pose a critical challenge in urinary tract infection (UTI) treatments. However, little work elucidated the resistance mechanisms of the MDR UPEC clinical strains in Malaysia. Therefore, this study aimed to determine the antimicrobial susceptibility profiles and the prevalence of antimicrobial resistance genes among the UPEC strains. Polymerase chain reactions were conducted to detect the presence of 6 antimicrobial resistance genes among 60 UPEC strains. Meanwhile, the antimicrobial resistance profiles against 9 antimicrobials were examined through the Kirby-Bauer disk diffusion method. In this study, the MDR isolates accounted for 40.0% (24/60), with the highest prevalence of resistance towards ampicillin (43/60; 71.7%), followed by tetracycline (31/60; 51.7%), nalidixic acid (30/60; 50.0%), co-trimoxazole (20/60, 33.3%), ciprofloxacin (19/60, 31.7%), levofloxacin (16/60, 21.6%) and chloramphenicol (10/60, 16.7%). In contrast, low resistance rates were observed among minocycline (1/60; 1.7%) and imipenem (0/60; 0.0%). bla TEM was the most prevalent gene (36/60; 60.0%), followed by tetA (27/60; 45.0%), sul2 (25/60; 41.7%), sul1 (13/60; 21.7%) and tetB (8/60; 13.3%). Surprisingly, bla SHV was not detected among the UPEC isolates. The MDR, ampicillin and tetracycline-resistant isolates were significantly associated with a higher prevalence of tetA, sul1, sul2 and bla TEM. In contrast, tetB displayed no significant relationship with any of the antimicrobials tested. The patient's age and gender were not the risk factors for the carriage of the resistance genes. Our findings identified the common resistance genes carried by the antimicrobial resistant UPEC isolates and provide valuable insights into developing the best antibiotic prescription regime to treat UTIs in our local scene. Kemunculan pesat strain Escherichia coli (UPEC) uropathogenik tahan multidrug (MDR) menimbulkan cabaran kritikal dalam rawatan jangkitan saluran kencing (UTI). Di Malaysia, kami menghadapi kekurangan informasi penyelidikan tentang mekanisme rintangan strain klinikal MDR UPEC. Oleh itu, kajian ini bertujuan untuk menentukan profil kerentanan antimikrob dan kelaziman gen rintangan antimikrob dalam kalangan strain UPEC di Malaysia. Tindak balas rantai polimerase telah dijalankan untuk mengesan kehadiran 6 gen rintangan antimikrob di antara 60 strain UPEC. Sementara itu, profil kerentanan antimikrob terhadap 9 antimikrob telah diperiksa melalui kaedah Kirby-Bauer. Dalam kajian ini, isolat MDR menyumbang 40.0% (24/60), dengan prevalens rintangan tertinggi terhadap ampicillin (43/60; 71.7%), diikuti oleh tetrasiklin (31/60; 51.7%) dan asid nalidiksik (30/60; 50.0%). Sebaliknya, kadar kerentanan yang tinggi diperhatikan di kalangan minocycline (59/60; 98.3%) dan imipenem (60/60; 100.0%). bla TEM adalah gen yang paling lazim (36/60; 60.0%), diikuti oleh tetA (27/60; 45.0%), sul2 (25/60; 41.7%), sul1 (13/60; 21.7%) dan tetB (8/60; 13.3%). Yang menghairankan, blaSHV tidak dikesan di kalangan isolat UPEC. MDR, ampicillin dan tetracycline dikaitkan dengan prevalens tetA, sul1, sul2 dan bla TEM yang tinggi. Sebaliknya, tetB tidak menunjukkan hubungan yang signifikan dengan mana-mana antimikrobial yang diuji. Umur dan jantina pesakit bukanlah faktor risiko untuk membawa gen rintangan. Penemuan kami mengenal pasti gen rintangan biasa yang dibawa oleh pengasingan UPEC yang tahan antimikrob dan memberikan pandangan berharga untuk membangunkan rejim preskripsi antibiotik terbaik untuk merawat UTI di tempat kejadian tempatan kami.