Uropathogenic Escherichia coli in the high vaginal swab samples of fertile and infertile women; virulence factors, O-serogroups and phenotyping and genotyping characterization of antibiotic resistance

Abstract Transmission of urinary tract infections into the reproductive system is unavoidable. The present research was done to assess the distribution of virulence genes, O-serogroups and antibiotic resistance properties of UPEC strains isolated from the high vaginal swab samples of fertile and infertile women. Four-hundred and sixty high vaginal swab samples were taken from fertile and infertile women. Distribution of virulence factors and serogroups and antibiotic resistance properties of the E. coli isolates were assessed. Sixty-five out of 460 (14.13%) swab samples were positive for E. coli. Prevalence of E. coli in samples taken from fertile and infertile women were 13.63% and 14.58%, respectively. O1 (7.69%), O2 (6.15%) and O6 (6.15%) were the most frequently detected serogroups. The most frequently detected virulence genes were sfa (72.72%), afa (72.72%), cnf1 (72.72%) and fim (72.72%). The most commonly detected antibiotic resistance genes were tetA (95.45%), CITM (88.63%), aac(3)-IV (86.36%) and sul1 (72.72%). UPEC strains harbored the highest prevalence of resistance against tetracycline (88.63%), ampicillin (79.54%), gentamicin (77.27%) and enrofloxacin (52.27%). Seventeen out of 26 (65.38%) UPEC strains isolated from infertile women were resistant toward more than ten antibiotic agents. Infertile women with history of urinary tract infections had the higher prevalence of UPEC strains and also their other characters. High prevalence of the virulent and resistant UPEC strains in the high vaginal part of the infertile women with history of urinary tract infections may show an important role of these pathogens as causes of female infertility. However, further researches should address to confirm this hypothesis.