Phylogenetic Analysis of Escherichia coli according to Phenotypic Resistance in Urinary Tract Infections in Children, Lima, Peru.

Abstract

Background: Phylogenetic studies are essential for understanding the virulence and resistance factors of bacteria, especially in evaluating their distribution within specific populations for effective infection control. Urinary tract infections (UTIs) caused by Escherichia coli are highly prevalent and pose significant health challenges from childhood to adulthood. The rising incidence of multidrug-resistant (MDR) strains highlights the urgent need for research aimed at developing preventive measures and epidemiological control strategies. This study aimed to analyze phylogenetically uropathogenic E. coli strains and their resistance phenotypes in children.

Materials and methods: A retrospective analysis was conducted on 111 urine culture samples collected from June 2023 to February 2024 at the Pediatric Emergency Hospital (PEH) in Lima, Peru. The phylogroups of E. coli were identified using Clermont's protocol based on polymerase chain reaction.

Results: UTIs were predominantly observed in females (85.6%) and infants under two years old (42.3%). The most frequent uropathogenic E. coli phylogroups were B2 (30.6%), D (29.7%), and A (25.2%). These phylogroups showed significant correlation with MDR and the production of extended spectrum beta-lactamases (ESBL).

Conclusion: At PEH, UTIs in children are primarily caused by uropathogenic E. coli from the B2 and D phylogroups, which demonstrate high virulence and resistance factors. The correlation between these phylogroups, MDR, and ESBL production, along with the increasing infection rates associated with phylogroup A, suggests a potential for horizontal gene transfer. This underscores the urgent need for vigilant control measures.