Uropathogenic Escherichia coli (UPEC) is the leading cause of urinary tract infections worldwide. ESBL-producing UPEC poses an escalating public health threat, yet its molecular epidemiology remains completely uncharacterized in Yemen. A cross-sectional study of 400 urine samples was conducted in Sana’a, Yemen. ESBL production was phenotypically screened. Multiplex PCR detected fimH and papC, confirmed by Sanger sequencing. Of 180 UPEC isolates, 75 (41.7%) were ESBL-producers. ESBL production was significantly associated with ICU admission, diabetes, and urinary tract abnormalities (P < 0.001). Resistance to third-generation cephalosporins exceeded 95%. Meropenem (96.0%), imipenem (92.0%), and amikacin (82.7%) were the most effective agents. fimH was detected in 89.3% and papC in 86.7% of ESBL-UPEC isolates; 84% co-harbored both genes. Sequencing confirmed high identity to reference sequences (99.37% and 98.25%, respectively). This first molecular study from Yemen reveals a high prevalence of multidrug-resistant ESBL-UPEC harboring fimH and papC in both hospital and community settings, underscoring an urgent public health threat.
Uropathogenic E. coli, Extended-Spectrum β-lactamase, Type 1 Fimbriae, P Fimbriae, Virulence Factors, Sequencing, Yemen
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