The frequency of hybrid Enteroaggregative/Uropathogenic Escherichia coli isolated from clinical samples of Isfahan hospitals, Iran

Abstract

Background: It has not been long since hybrid Escherichia coli pathotypes have been reported in scientific literatures. These isolates harbor a higher number of virulence factors and have greater pathogenicity. Here, for the first time, we reported the hybrid Enteroaggregative/Uropathogenic E. coli (EAEC/UPEC) isolates from clinical samples of hospitalized patients of Isfahan, Iran. Methods: In this cross-sectional study, 196 E. coli isolates were collected from hospitals of Isfahan. PCR was performed for the detection of fimH, chuA, fyuA, and papc genes in UPEC isolates as well as aap, aggR, and aatA genes in EAEC isolates. DNA sequencing was conducted to confirm the presence of virulence genes in EAEC and UPEC pathotypes. Data were statistically analyzed by chi-square (X2) test. Results: Based on our results, EAEC and UPEC pathotypes were isolated from 17 (8.6) and 49 (25) clinical samples, respectively. Also, according to the results, from a total of 196 E. coli isolates, 135 (68.8), 113 (57.6), 89 (45.4), 73 (37.2), 40 (20.4), 26 (13.2) and 15 (7.6) carried the fimH, chuA, fyuA, papc, aap, aggR, and aatA genes, respectively. Interestingly, according to our data, 26 (13.2) isolates were identified as hybrid UPEC/EAEC and this was confirmed by DNA sequencing and the BLAST results. Statistical analysis showed a significant correlation between EAEC or UPEC pathotypes (p = 0.00) and their isolation source. Conclusion: There is an urgency to identify heteropathogen EAEC/UPEC isolates that can carry different virulence factors attributed to both diarrheagenicity and uropathogenicity. © 2021 Elsevier Inc.