Mohammed Suliman AlMogbel

Abstract

Escherichia coli is a significant source of morbidity and mortality in humans due to their enhanced virulence and colonization capacities, which enable them to cause a range of extraintestinal manifestations, including wound infection, neonatal meningitis, urosepsis, and urinary tract infection. In the recent past, globally, fluoroquinolone-resistant (FQr) E. coli sequence type ST1193 has emerged as a major causative agent of E. coli infections in humans. Here, we present a case report of a 54-year-old male who was presented with urethral strictures as well as an overactive bladder (OAB). The patient got a recurrent urinary tract infection (UTI) five times (during the timespan from 31/12/2018 to 18/06/2019). The causative agent was identified as extended-spectrum beta-lactamase (ESBL) positive; AmpC beta-lactamase positive, and ciprofloxacin-resistant E. coli ST1193. This is the first case of recurrent UTI caused by ESBL & AmpC beta-lactamase generating ST1193 E. coli in Ha'il, Saudi Arabia, to our knowledge. The ST1193 ESBL-producing E. coli isolates cultured in this study were resistant to ciprofloxacin and belonged to serogroup H5. Further regional studies are needed to assess the relevance of ESBL-producing E. coli ST1193 which could turn into a nosocomial pathogen in Saudi Arabia. For this recently emerged E. coli ST1193 clone, strategic surveillance, and control techniques will be required in the future.