Phylogenetic diversity and virulence gene characteristics of Escherichia coli from pork and patients with urinary tract infections in Thailand.

Extraintestinal pathogenic Escherichia coli (ExPEC), especially uropathogenic E. coli (UPEC) are responsible for urinary tract infections (UTIs), while diarrheagenic E. coli (DEC) cause foodborne illnesses. These pathogenic E. coli are a serious threat to human health and a public concern worldwide. However, the evidence on pork E. coli (PEC) harboring UPEC virulence-associated genes is currently limited. Therefore, this study aimed to determine the phylogroups, virulence genes, and their association between PEC and UPEC from UTI patients. In this study, 330 E. coli were obtained from archived stock culture isolated from pork (PEC; n = 165) and urine of patients with UTIs (UPEC; n = 165) during 2014-2022. Phylogroups, UPEC- and diarrheagenic E. coli (DEC) associated virulence genes were assessed using PCR assays. The results showed that phylogroups A (50.3%), and B1 (32.1%) were commonly found among PEC whereas phylogroups B2 (41.8%), and C (25.5%) were commonly detected in the UPEC. PEC and UPEC carried similar virulence-associated genes with different percentages. The most frequent UPEC virulence-associated gene among UPEC, and PEC strains was fimH, (93.3%, and 92.1%), followed by iucC (55.2%, and 12.7%), papC (21.8%, and 4.2%), afaC (22.4%, and 0%), hlyCA (17%, and 0.6%), cnf (16.4%, and 0.6%), and sfa/focDE (8.5%, and 4.8%). Additionally, 6 of 27 UPEC virulence-associated gene patterns were found in both PEC and UPEC strains regardless of phylogroups. Furthermore, the DEC virulence-associated genes were found in only 3 strains, one from PEC harboring eae, and two from UPEC carried fimH-bfpA or afaC-CVD432 indicating hybrid strains. Cluster analysis showed a relationship between PEC and UPEC strains and demonstrated that PEC harboring UPEC virulence-associated genes in pork may be associated with UPEC in humans. Food safety and hygiene practices during pork production chain are important procedures for minimizing cross-contamination of these strains that could be transmitted to the consumers.

Nosocomial surgical site infection among Photharam Hospital patients with surgery: incidence, risk factors and development of risk screening form.

OBJECTIVE: A cross-sectional analytic study of 268 patients who received surgery at Photharam Hospital was conducted to assess the incidence and risk factors of nosocomial surgical site infection (SSI). MATERIAL AND METHOD: The studied patients who voluntarily participated and signed informed consents were interviewed Pus specimens from SSI patients diagnosed by use of CDC criteria were cultured After risk factor analysis, the risk screening form was developed and calculated by the Receiving Operating Curve. RESULTS: The results revealed that incidence of nosocomial SSI was 20.52% (55/268 cases). Of 55 SSIpatients, 45.46% were positive for bacterial culture. Risk factors for nosocomial SSI from univariate analysis were (a) age of patients > 60 years, OR = 1.91 (p = 0.043), (b) gender as male, OR = 2.20 (p = 0.024), (c) admitted ward as male surgical ward, OR = 2.42 (p = 0. 028), (d) current patients' illness as diabetes mellitus (DM), OR = 7.92 (p < 0.001) and tuberculosis, OR = 11.88 (p = 0.001), (e) abnormal ASA score, OR = 3.47 (p < 0.001), 60 smoking, OR = 3.72 (p < 0.001), (g) incorrect prophylactic drug use, OR = 2.98 (p = 0.002), (h) duration of admission > 10 days, OR = 4.87 (p < 0.001), and (i) wound dressing > 1 time/day, OR = 4.16 (p < 0.001). After multiple logistic regression analysis, the significant risk factors were (a) current patient's illness as DM, OR = 14.43 (p = 0.005), (b) smoking, OR = 13.18 (p = 0.001), (c) duration of admission > 10 days, OR = 4.88 (p = 0.032) and (d) wound dressing >1 time/day, OR = 23.32 (p < 0.001). The risk screening form was developed and showed approximately 65% sensitivity and 78% specificity when a cut-off score at risk > 18 was used CONCLUSION: This risk screening form should be considered in other hospitals. When a postoperative patients has a score of 18, they should be considered a potential risk for nosocomial SSI and preventive measures should be integrated to reduce the risk for nosocomial SSI.