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Published online ahead of print on 15 June 2009 as doi:10.1099/jmm.0.007146-0
Journal of Medical Microbiology 2009;58:1006.

J Med Microbiol (2009), DOI: 10.1099/jmm.0.007146-0
© 2009 Society for General Microbiology
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Uropathogens from Diabetic Patients in Libya: virulence factors and phylogenetic groups of isolated Escherichia coli

Khalifa Sifaw Ghenghesh1,6, Einass Elkateb2, Nuri Berbash2, Rania Abdel Nada3, Salwa F Ahmed3, Amal Rahouma1, Nadia Seif-Enasser1, Mohamed-Abdulwahab Elkhabroun4, Taher Belresh5 and John D Klena3

1 Faculty of Medicine, Al-Fateh University for Medical Sciences;

2 Faculty of Sciences, Al-Fateh University;

3 Clinical Trails Program Molecular Epidemiology, NAMRU-3, Cairo, Egypt;

4 Departmen of Urology, Elkhadra Hospital, Tripoli, Libya;

5 Diabetic Center, Tripoli, Libya

6 E-mail: ghenghesh_micro{at}yahoo.com

Received October 7, 2008
Accepted May 3, 2009

Urinary tract infections (UTI) in patients with diabetes mellitus (DM) are reported mainly from developed countries. In addition to this underreporting, there is lack of information pertaining to the virulence factors (VFs) and phylogenetic grouping of uropathogenic Escherichia coli (UPEC) from diabetic and non-diabetic patients in developing countries. Between July 2005 and June 2006 urine specimens were collected from 135 diabetic patients and 164 non-diabetics, both groups with clinically diagnosed urinary tract infections (D-UTI and ND-UTI, respectively) attending Elkhadra Hospital and the Diabetic Center in Tripoli, Libya. Specimens were examined for different uropathogens using standard microbiological procedures. Isolated uropathogens were tested for their susceptibility to antimicrobial agents by the disc diffusion method. In addition, uropathogenic E. coli (UPEC) were grouped phylogenetically by PCR and subsequently tested for 19 VFs. Uropathogens were isolated from 77 (57%) D-UTI and from 110 (67%) ND-UTI (P>0.05). E. coli was isolated from 18 (13%) and 29 (18%), Klebsiella species from 18 (13%) and 23 (14%), and Staphylococcus aureus from 12 (9%) and 12 (7%) of D-UTI and ND-UTI respectively (P>0.05). Age, gender, education level and marital status had no significant influence on the isolation rates of different organisms from D-UTI when compared with ND-UTI. Also, with very few exceptions, no differences were observed in the antimicrobial resistance profiles of uropathogens from diabetics and non-diabetics. In addition, UPEC isolates from diabetics were significantly less virulent and associated with phylogenetic group A, while UPEC from non-diabetics were significantly more virulent and associated with group D. The results of our surveillance of UTI infections in diabetic patients agree with, in general, observations reported previously from several developed countries.






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