Molecular Pathotyping of Escherichia Coli Colonising Urinary Tract and Their Drug Susceptibility Patterns Among Patients at Outpatient Department of Zonal Referral Hospital in Southern Highlands, Tanzania

Abstract

Background: Uropathogenic E. coli (UPEC) is the most common causative agent of both community-acquired and hospital-acquired urinary tract infections (UTIs). However, E. coli encompasses several other pathotypes that cause a wide range of intestinal and extraintestinal infections. For intestinal infections, the main pathotypes include Enteropathogenic E. coli (EPEC), Shiga toxin-producing E. coli (STEC), Enteroaggregative E. coli (EAEC), Enterotoxigenic E. coli (ETEC), Entero-invasive E. coli (EIEC), and Diffusely Adherent E. coli (DAEC).
Methods: This was a cross-sectional hospital-based study conducted in the Mbeya Zonal Referral Hospital (MZRH) from December 2022 to March 2023. A total of 315 participants from whom the urine samples were collected conveniently by using a standard formula (N = (Z²X P (1-P)/e². Whereby N = minimum required sample size, Z = corresponding level of confidence (95%), P = proportion of the characteristics of interest (23%) and e = margin of error (5%). This enabled the calculation of the minimum sample size of 292 plus 10% of non-respondents.
Results: A total of 315 participants were recruited in the study; the median age (IQR) was 37 (25-53), whereby 46.7% were aged between 18 and 34 years, 30.1% were aged between 35 and 54 years, and 23.2% were older than 54 years. Male participants were 44.4%, urban participation made up 52.7% of the participants, and 60.6% of them were unemployed
Conclusions: The findings of this study showed that the predominant pathotype associated with urinary tract infections was UPEC, followed by EAEC and EPEC, with ETEC being the least frequently identified. The study also indicated that all isolated pathotypes were resistant to ampicillin and amoxicillin/clavulanic acid.