Objectives: Antibiotic resistance, phylogenetic groups and Pulsed-Field Gel Electrophoresis
(PFGE) patterns were evaluated in urinary tract infection (UTI) Escherichia coli (E. coli)
isolates from outpatients and inpatients.
Methods: In this study, antibiotic resistance to E. coli isolated from non-hospitalized and hospitalized
patients (153 outpatients and 147 inpatients ) was evaluated in Shiraz County, Iran. Phylogenetic
groups and Pulse Field Gel Electrophoresis (PFGE) patterns of 143 ESBLs-producing E. coli
were also assessed.
Results: The prevalence of ESBL-producing E. coli was shown to be 46.4% and 49% in the outpatient
and inpatient UTI E. coli isolates, respectively. Most ESBL-producers were detected on patients
hospitalized in clinical surgery units (66.7%) and intensive care units (62.5%). Phylogenetic
group D was the dominant group in both the outpatient and inpatient isolates (67.6% and 61.1%,
respectively) and also in internal, clinical surgery and ICU units. PFGE results showed more relatedness
(>80% similarity) among inpatient isolates. PFGE analysis of 49 ESBL-producing inpatient
E.coli in hospital units revealed 17 different pulsotypes, consisting of 11 clones and 6 single
patterns. There were no clonal patterns in outpatient isolates, and similarity among the outpatient
isolates and also between inpatient and outpatient isolates was less than 80% (75% and 66%, respectively).
Conclusion: The results showed extreme genomic diversity among the ESBL-producing E. coli
isolates in terms of the community and multiclonal dissemination of ESBL-producing E. coli isolated
from hospital units.