Uropathogenic Escherichia coli in Mexico, an Overview of Virulence and Resistance Determinants: Systematic Review and Meta-analysis: Archives of Medical Research 54 (2023) x–x

Manuel G. Ballesteros-Monrreal, Pablo Mendez-Pfeiffer, Edwin Barrios-Villa, Margarita M.P. Arenas-Hernández, Yessica Enciso-Martínez, César O. Sepúlveda-Moreno, Enrique Bolado-Martínez, Dora Valencia*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Background: Urinary tract infections (UTI) are one of the most common pathologies in Mexico and the majority are caused by uropathogenic Escherichia coli (UPEC). UPEC possesses virulence and resistance determinants that promote UTI development and affect diagnosis and treatment. This study aims to systematically review published reports of virulence genes, antibiotic resistance, and phylogenetic groups prevalent in clinical isolates of UPEC in the Mexican population. Methods: Systematic review with meta-analysis was performed following PRISMA guidelines. Articles in both English and Spanish were included. Total prevalence with a 95% confidence interval of each characteristic was calculated. Heterogeneity between studies and geographical areas was assessed by the Cochran Q test (Q), I-square (I2), and H-square (H2). Egger's test was used for risk of bias in publications and asymmetry evaluations. Results: Forty-two articles were analyzed. The most prevalent virulence genes were ecp (97.25%; n = 364) and fimH (82.34%; n = 1,422), which are associated with lower UTI, followed by papGII (40.98%; n = 810), fliC (38.87%; n = 319), hlyA (23.55%; n = 1,521), responsible for with upper UTI. More than 78.13% (n = 1,893) of the isolates were classified as multidrug-resistant, with a higher prevalence of resistance to those antibiotics that are implemented in the basic regimen in Mexico. The most frequently reported Extended Spectrum β-Lactamase (ESBL) was CTX-M-1 (55.61%; n = 392), and the predominant phylogroup was B2 (35.94%; n = 1,725). Conclusion: UPEC strains are responsible for a large portion of both lower and upper UTI in Mexico, and their multi-drug resistance drastically reduces the number of therapeutic options available.

Original languageEnglish
Pages (from-to)247-260
Number of pages14
JournalArchives of Medical Research
Volume54
Issue number3
DOIs
StatePublished - Apr 2023

Bibliographical note

Funding Information:
First author had CONACYT Fellowship during the performance of this work (Scholarship No. 617232).

Publisher Copyright:
© 2023 Instituto Mexicano del Seguro Social (IMSS)

Keywords

  • Antibiotic resistance of UPEC in Mexico
  • ESBL
  • Phylogenetic Groups of UPEC
  • UTI in Mexico
  • Uropathogenic Escherichia coli in Mexico
  • Virulence factors of UPEC in Mexico

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