Evaluating the antibiotic resistance and frequency of adhesion markers among Escherichia coli isolated from type 2 diabetic patients with urinary tract infection and its association with common polymorphism of Mannose-binding lectin (MBL) gene

Abstract Background The present paper aims to determine the frequency and antibiotic resistance pattern of pathogenic bacteria, virulence factor profile of Escherichia coli, and Mannose-binding lectin (MBL) gene polymorphism in patients with Diabetes Mellitus (DM) and urinary tract infection (UTI). Methods The population under study in this research includes 130 patients with Type 2 diabetes mellitus (T2DM) and UTI. The patients’ clinical characteristics and urine and blood samples (5 cc) were collected. Antibiotic resistance was determined using disk diffusion method (DDM), and the results were interpreted according to Clinical and Laboratory Standards Institute (CLSI). The presence of virulence genes was detected by multiplex polymerase chain reaction (PCR). In order to detect the MBL gene polymorphism, PCR and restriction fragment length polymorphism (RFLP) methods were applied. Results The predominant Gram-negative and positive bacteria included E. coli and Streptococcus spp.viridans group, respectively. Women were more susceptible to the incidence of UTIs than men. E. coli isolates showed a high level of resistance to amoxicillin-clavulanic acid (87.35%), while Nitrofurantoin and ceftizoxime were the most effective antimicrobial agents on E. coli. Cefotaxime and ceftizoxime were the most effective antimicrobial agents on Enterobacter spp. Norfloxacin and ciprofloxacin were the most effective antimicrobial agents on Staphylococcus epidermidis and Staphylococcus saprophyticus. The papGII (52.87%) and papEF (1.14%) had the highest and lowest frequency among examined genes in E. coli isolates, respectively. Furthermore, the GG genotype had the highest frequency among patients with T2DM and UTI. Conclusion The results show that the detection of E. coli in individuals with AA genotype, codon 54 of the MBL gene, can play an important role in the molecular diagnosis and timely treatment of bacterial infections in patients with diabetes.