Study of Urinary Tract Infection with isolation of uropathogen with their antibiotic susceptibility pattern and detection of dfrA1 gene in trimethoprim resistance Escherichia coli in Pregnant Women

Open Access

Abstract

Background: Urinary tract infections (UTIs) frequently occur during pregnancy, primarily due to Escherichia coli and various other Gram-negative and Gram-positive bacteria. Excessive use of antibiotics has resulted in multidrug resistance (MDR), which includes resistance to trimethoprim through the dfrA1 gene. This research sought to identify pathogens causing UTIs, assess their antibiotic resistance, and find dfrA1 in E. coli. Methods & Materials: This cross-sectional research conducted at Dhaka Medical College (July 2023–June 2024) involved 152 pregnant individuals (≥28 weeks) with potential urinary tract infection (UTI). Aseptically collected urine samples were cultured, identified, and tested for antibiotic susceptibility, with chosen isolates undergoing further analysis for MIC and the dfrA1 resistance gene. Data were examined with SPSS v25, and ethical clearance was secured from the appropriate committees. Results: Out of 125 isolates from pregnant women, E. coli was the most prevalent (62.4%), succeeded by Pseudomonas spp (11.2%), Enterobacter spp (9.6%), Klebsiella spp (8.0%), Candida spp (4.8%), and Enterococcus spp (4.0%). Gram-negative bacteria exhibited significant resistance to beta-lactam antibiotics, whereas all Enterococcus spp were susceptible to linezolid, vancomycin, teicoplanin, and fosfomycin, but showed resistance to amoxicillin. MIC testing showed Pseudomonas spp colistin MIC 8–64 μg/ml and tigecycline MIC in gram-negatives 16–128 μg/ml. The dfrA1 gene was found in 23.3% of E. coli isolates resistant to trimethoprim. Conclusion: E. coli was the main uropathogen exhibiting significant antibiotic resistance, and the presence of the dfrA1 gene underscores increasing resistance, stressing the importance of prudent antibiotic use and regular susceptibility testing.