Recent Data Characterizing the Prevalence and Resistance Patterns of FimH-producing Uropathogenic Escherichia coli Isolated from Patients with Urinary Tract Infections in North Lebanon

Abstract

Background: The adhesin gene (FimH) of uropathogenic Escherichia coli (UPEC) plays a critical role in mediating the first contact of UPEC bacterial strains with uroepithelial cells, leading to colonization and invasion of host cells. Objectives: This study aimed to determine the prevalence of FimH in UPEC strains isolated from patients with urinary tract infections (UTIs) in North Lebanon and characterize the resistance profile of UPEC isolates. Methods: A total of 881 urine samples were collected from UTI-symptomatic patients admitted to different hospitals and laboratories in North Lebanon. Seventy UPEC isolates were identified and transferred to the Biomedical Laboratory of Beirut Arab University (BAU) for further analysis. All UPEC isolates were subjected to antimicrobial susceptibility testing, phenotypic assays for ESBL detection, and PCR to detect the FimH gene. Results: The prevalence of UTIs reached 42% (370/881), with UPEC representing 19% (70/370) of the detected uropathogens. The highest and the lowest resistance among UPEC isolates were reported against Ampicillin (80%; 56/70) and carbapenem (0%; 0/70), respectively. A high prevalence of MDR (68%; 48/70) and ESBL (64%; 45/70) was reported. Molecular analysis revealed that most of the tested UPEC (98.6%; 69/70) harbored the FimH gene. A significant correlation was found between FimH expression and the antimicrobial resistance properties of UPEC (P < 0.05). Conclusions: This study highlighted the high prevalence of the FimH adhesin gene among UPEC isolates, revealing its crucial role in enhancing the resistance of these bacteria to antimicrobial agents.