Escherichia coliBcteriuria in pregnant women in Ghana: Antibiotic resistance pattern, Virulence Factors and Resistant genetic markers

The relevance of Escherichia coli associated bacteriuria infection in pregnant women is poorly understood, despite these strains sharing a similar virulence profile with other extra intestinal pathogenic E. coli producing severe obstetric and neonatal infections. We characterized and determined the antimicrobial susceptibility, resistant genes and virulence profiles of 82 E. coli isolates associated with asymptomatic bacteriuria in some pregnant in five very distinct hospitals in the Volta region from January, 2016 to April, 2016 using Kirby-Bauer disc diffusion and polymerase chain reaction. High levels of antimicrobial resistance was observed to Ampicillin (79.3%), Tetracycline (70.7%) and Cotrimoxazole (59.8%), except for Cefuroxime (32.9%). Resistant genes analyses revealed 58.5% were positive for Bla TEM and 14.6% for aph(3)-Ia( aphA2). Virulence factors (VFs) was more widespread in pregnant women in the 2 nd and 3 rd trimesters than 1 st trimester. VFs relating to adhesion ( pap C and iha ), Protectins ( tra T), aerobactin acquisition ( iut A) and iron acquisition systems ( fyu A and irp 2) were more prevalent in the resistant E. coli isolates. This study provides additional evidence for a link in bacteriuria and transmission of extra-intestinal E. coli in pregnant women to cause multi-resistant severe obstetric or neonatal infections. Considering the involvement of extra-intestinal E. coli in infections, our results may be helpful to develop strategies to prevent maternal and/ neonatal infections. In addition continuous surveillance is required to guide appropriate antibiotic usage in pregnant women.