Uropathogenic Escherichia coli in India—an Overview on Recent Research Advancements and Trends

Abstract

Urinary tract infection (UTI), a prevalent disease in India, also ranks among the most common infections in developing countries. The rapid emergence of antibiotic-resistant uropathogenic Escherichia coli (UPECs), the leading etiologic agent of UTI, in the last few years, led to an upsurge in the health care cost. This caused a considerable economic burden, especially in low-middle income country, India. This review aimed to provide an explicit overview of the recent advancements in E. coli–mediated UTI in India by incorporation of valuable information from the works published in PubMed and Google Scholar in the last six years (2015 to August, 2020). The literature survey demonstrated UPECs as the most predominant uropathogen in India, especially among females, causing both asymptomatic bacteriuria (ABU) and symptomatic UTI. An overall increasing national trend in resistance to penicillins, cephalosporins, aminoglycosides, fluoroquinolones, and sulfonamides was perceived irrespective of ABU and symptomatic UPECs during the aforementioned study period. High incidences of multidrug resistance, extended-spectrum β-lactamases, metallo β-lactamases, and AmpCs in UPECs were reported. Notable information on the pathogenic profiles, phylogroups, pathogenicity islands, and evidence of pathoadaptive FimH mutations was described. Alternative therapeutics and potential drug targets against UPECs were also reconnoitered. Therefore, the nationwide widespread occurrences of highly virulent MDR UPEC together with the limited availability of therapeutics highlighted the urgent need for promotion and invention of alternative therapeutics, search for which had already been started. Moreover, investigation of several mechanisms of UPEC infection and the search for potential drug targets might help to design newer therapeutics.

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Acknowledgements

The authors would like to express their sincere gratitude to Prof (Dr.) Pratip Kumar Kundu, Director, Calcutta School of Tropical Medicine, Kolkata West Bengal, India, for his kind support and cooperation.

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The study was supported by grants received from the Science and Engineering Research Board (SERB), Department of Science and Technology, Government of India, (Grant No. EMR/2016/001670 dated 22.08.17); Department of Higher Education, Science and Technology and Biotechnology, Government of West Bengal, India (Grant No. 62 (Sanc.)/BT/P/Budget/RD-60/2017 dated 12.03.2018); and the INSPIRE fellowship grant from Department of Science and Technology, New Delhi, Government of India, No.-DST/INSPIRE Fellowship/2016/ IF160069 (2016-2019).

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A. Ghosh, D. Bandyopadhyay, and S. Koley contributed equally in the data collection, compilation, and writing of this manuscript. M. Mukherjee participated in the preparation and correction of the manuscript.

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Correspondence to Mandira Mukherjee.

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Ghosh, A., Bandyopadhyay, D., Koley, S. et al. Uropathogenic Escherichia coli in India—an Overview on Recent Research Advancements and Trends. Appl Biochem Biotechnol (2021). https://doi.org/10.1007/s12010-021-03521-z

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Keywords

  • Uropathogenic Escherichia coli
  • Urinary tract infection, multidrug resistance
  • Alternative therapeutics
  • India