What question did this study set out to answer?

To evaluate antibiotic susceptibility and detect resistance genes in E. coli from UTI patients.

April 14, 2026Open Access

Antibiotic Resistance Pattern and Molecular Characterization of Resistant Genes in Escherichia Coli Isolated from Patients with Urinary Tract Infections

HBHira BibiAbdul Wali Khan University Mardan JDJalal Ud DinAbdul Wali Khan University Mardan MKMuhammad Akbar Sajjad KhanUniversity of Lahore

Key Points

To evaluate antibiotic susceptibility and detect resistance genes in E. coli from UTI patients.
Isolated E. coli from urine samples of UTI patients
Detected antibiotic-resistance genes using molecular techniques
Analyzed antibiotic susceptibility patterns by testing against various antimicrobial agents
75% of E. coli strains showed resistance to norfloxacin
Identified multiple antibiotic-resistance genes, including Mcr-2 and Bla-CTX-M
estB gene was present in 96.6% of samples, more common in females (99.4%) than males (89.4%)

Abstract

Background: The Urinary tract infection (UTI), is a critical factor in renal diseases and prevalent bacterial infection. Females have higher prevalence of UTI than males, which could be attributable to variety of physiochemical factors such as anatomic, hormonal and behavioral differences. Objective: To evaluate the antibiotic susceptibility patterns of pathogenic bacteria and detect antibiotic-resistance genes in Escherichia coli isolated from UTI patients. Method: This study was conducted from March to August 2024 at the Department of Biotechnology, Abdul Wali Khan University Mardan, in collaboration with the Department of Pathology, Khyber Teaching Hospital (KTH), Peshawar. Urine samples were collected from UTI patients attending the hospital. Pathogenic bacteria were isolated and identified, and antibiotic resistance genes (Mcr-2, Mcr-3, Bla-TEM, AAc(3)IV, Bla-SHV, Bla-CTX-M, aadA, astA, fanA, estB, estA, and elt) were detected in E. coli isolates. A total of 457 urine samples were collected during the study period. Results: E. coli strains showed 75% resistance to norfloxacin and were multidrug resistant (MDR) with resistance to at least three antimicrobial agents. Several antibiotic-resistance genes, including Mcr-2, Mcr-3, Bla-TEM, Bla-CTX-M, Bla-SHV, AAc(3)IV, and aadA, were detected in the isolates. The predominant virulence gene, estB, exhibited a prevalence of 96.6% and was detected more frequently in female UTI patients (99.4%) compared to males (89.4%), showing a significant difference (P=0.0001). Both astA and estB genes were present in 99.4% of cases, with some isolates carrying 1-4 virulence genes. A significant difference in antibiotic-resistance genes between female and male UTI patients was observed. Conclusion: The study highlights the high prevalence of multidrug-resistant E. coli and antibiotic-resistance genes among UTI patients in Peshawar, Pakistan. These findings emphasize the importance of monitoring antibiotic resistance patterns to support appropriate antimicrobial therapy for the effective management of UTIs.

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