Escherichia coli in West Bengal: active surveillance of uropathogenicity, ESBL, MDR and XDR

Background: Urinary tract infection (UTI) is one of the Escherichia coli (E. coli) induced extraintestinal disorders that dramatically raise morbidity and mortality rates. Treatment ineffectiveness resulted from the emergence of multidrug resistance (MDR), extensive-drug resistance (XDR), and extended-spectrum β-lactamases (ESBL). This study in West Bengal, India, explored the prevalence of uropathogenic, ESBL, MDR, and XDR E. coli strains. Methods: It was a cross-sectional study. Examining 77 clinical isolates from diverse regions of West Bengal, the research identified ESBL, AmpC, metallo-β-lactamase (MBL), MDR, and XRD production through phenotypic methods and polymerase chain reaction (PCR). Results: Disc agar diffusion (DAD) test detected 84.4% as ESBL producers, with 31.19% AmpC, 6.49% MBL, and 12.98% carbapenem-resistant isolates. 87.01% and 2.95% isolates were suspected to be MDR and XDR. The presence of specific 16S rRNA identifies all isolates as E. coli. Confirmation via PCR revealed ESBL genes in 92.2% of isolates, predominantly blaCTX-M (75.3%), blaTEM (62.3%), and blaSHV (22.1%). Uropathogenicity was confirmed in 80.5% of isolates, all of which co-occurred with ESBL genes. Conclusions: The study underscores the common occurrence of uropathogenic and antibiotic-resistant E. coli in tertiary care settings, emphasizing the need for robust antimicrobial stewardship and strict infection control practices to address the proliferation of drug-resistant pathogens.