Evaluation of resistance pattern of uropathogenic Esherichia coli isolates from diabetic patients with urinary tract infections at Tanta University Hospitals

Background: Uropathogenic Escherichia coli (UPEC) is the leading cause of Urinary Tract Infections (UTIs) among diabetic patients. Antibiotic resistance prevalence in UPEC is rapidly increasing worldwide, which limits the treatment options available for UTIs. Objectives: This study aimed to detect the incidence of UPEC among diabetic patients and analyze their phenotypes and resistant patterns. Methods: A total of 130 midstream urine samples were collected aseptically from diabetic patients with signs of UTI. Bacterial identification was performed using standard microbiological techniques. An antibiogram analysis of E. coli isolates was conducted by the disc diffusion method and colistin broth disk elution, along with phenotypic confirmation of Extended Spectrum Beta-Lactamase (ESBL), ampC β-lactamases, and carbapenemase production. Results: 61.5% of samples yielded significant growth. 60% of isolated pathogens were retrieved from female patients, and 41.2% were from the age group 45-60. The most common isolates were E. coli, representing 50% of isolated pathogens. Most of E. coli isolates were susceptible to carbapenems and aminoglycosides, whereas most resistance was recorded to the penicillin group. According to the resistant patterns, 36% and 42% were multidrug-resistant and extensively drug-resistant, respectively. Regarding the resistant mechanism, 50%, 80%, and 12% were ESBL, ampC β-lactamase, and carbapenemase producers, respectively. Conclusion: UTIs are more common in females and are mainly caused by E. coli. Reporting of UPEC resistance patterns is crucial for better prescription of empirical treatment.