Recurrent <i>E. coli</i> Urinary Tract Infections in Nursing Homes: Insight in Sequence Types and Antibiotic Resistance Patterns

• Main Authors: Soemeja Hidad (Author), Boas van der Putten (Author), Robin van Houdt (Author), Caroline Schneeberger (Author), Sacha Daniëlle Kuil (Author)
• Format: Book
• Published: MDPI AG, 2022-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Introduction: Recurrent urinary tract infections (rUTI) largely contribute to antibiotic use in older adults. Understanding the genetic characteristics of <i>Escherichia coli (E.coli)</i> is needed to identify patients at risk for recurrence. The aim of this study was to obtain a greater understanding of the genetics of <i>E. coli</i> rUTI in nursing home residents. Methods: This is a secondary analysis of a multicenter Dutch nursing home study (PROGRESS). <i>E. coli</i> strains from residents with a suspected UTI and positive urine culture were analyzed using antimicrobial susceptibility testing and whole-genome sequencing (WGS). Same-strain recurrences were identified by single-nucleotide polymorphism (SNP) analysis. Result: In total, 121 <i>E. coli</i> strains were analyzed using WGS, of which 54 belonged to a rUTI episode. One third of <i>E. coli</i> rUTI episodes were caused by the same strain (<i>n</i> = 18, 33.3%). Same-strain recurrence occurred anywhere between 30 and 434 days after the index UTI, caused by sequence types (ST): ST12, ST23, ST73, ST131, ST453, ST538 and ST2522, in seven nursing home residents. In both single UTI and rUTI, antimicrobial resistance rates were low. Conclusion: Recurrent UTI in nursing home residents are caused by same-strain <i>E. coli</i> as well as due to different <i>E. coli</i> strains or other uropathogens. Same-strain recurrence can occur over 400 days after the index UTI, suggesting that some strains have the ability to colonize the bladder or gut for longer periods.

Item Description

10.3390/antibiotics11111638
2079-6382