Objective: This study aimed to determine the prevalence of antibiotic resistance and virulence genes of Escherichia coli  strains among patients with urinary tract infections (UTIs) after kidney transplantation from deceased donors.
Methods: Between January 2014 and June 2018, 64 patients who received kidney transplants from deceased donors at our institution developed a UTI due to E. coli . Polymerase chain reaction was used to detect virulence genes in E. coli  strains. The Kirby–Bauer method was used to evaluate the antibiotic susceptibility pattern of the isolates.
Results: Among the study cohort, 46 (71.9%) UTIs were community-acquired (CA), and 18 (28.1%) were hospital-acquired (HA). The percentages of isolated E. coli  strains that showed antibiotic resistance were as follows: 92.2% to ampicillin, 76.6% to cefalotin, 81.3% to carbenicillin, 29.7% to ciprofloxacin, 62.5% to cotrimoxazole, 35.9% to gentamicin, 34.4% to levofloxacin, 28.1% to norfloxacin, 68.8% to pefloxacin, 57.8% to trimethoprim/sulfamethoxazole, and 20.3% to amikacin. HA E. coli  showed higher resistance to ciprofloxacin, cotrimoxazole, trimethoprim/sulfamethoxazole and amikacin, compared with CA E. coli  (P < 0.05). The most prevalent virulence genes among the E. coli  strains were fim  (64.1%), followed by irp2  (56.3%), iroN  (46.9%), pap GII  (45.3%), sfa  (31.3%), pap  (25%), iuc  (23.4%), pap GI  (15.6%), pap GIII  (14.1%), hly  (9.4%), and cnf  (4.7%). The irp2  and iroN  genes were found more frequently in the HA E. coli  than in the CA E. coli  (P < 0.05).
Conclusion: The E. coli  strains, especially HA E. coli , isolated from UTI patients after kidney transplantation from deceased donors showed resistance to multiple antibiotics and harbored numerous virulence genes. These findings provide insight for genetic characterizations and epidemiological studies of E. coli  strains causing UTIs in patients after kidney transplantation from deceased donors.
Keywords: Escherichia coli , antimicrobial resistance, virulence genes, urinary tract infections, kidney transplantation