Researchers at the Quadram Institute have studied urinary tract infections (UTIs) in hundreds of NHS patients from across Norfolk in the first study of its kind for the region.

Scientists studied one of the main bacteria which causes UTIs, E.coli, in samples taken from nearly 200 NHS patients to understand more about antimicrobial resistance (AMR).

UTIs are a major cause of antibiotic prescribing and higher rates of antibiotic uses can lead to bacteria becoming resistant to the drugs. In 2021 UTIs also cost the NHS in Norfolk £860,161 in antibiotic prescribing.

The new study by scientists at the Quadram Institute and the Norfolk and Norwich University Hospital (NNUH) showed that 6.5 per cent of UTIs were resistant to a number of antibiotics used to treat them.

There is no national surveillance programme for specifically monitoring E. coli causing UTIs. Researchers recommended better monitoring of UTIs caused by multidrug resistance E. coli would help reduce the burden and cost of the disease.

Lead author and doctoral candidate Cailean Carter said: “We were interested in understanding which groups of E. coli were responsible for difficult to treat cases of UTIs. By identifying these groups, we can look for a common source of infection and recommend strategies for limiting cases of multi-drug resistant E. coli causing UTIs.”

The study, published in the Journal of Antimicrobial Chemotherapy, used 199 urine samples collected from GP surgeries and hospitals across Norfolk between August 2021 and January 2022. The Norfolk and Norwich University Hospital clinical microbiology laboratory isolated E. coli from the samples which were then screened for AMR. Over 90 per cent of the isolates found were susceptible to multiple antibiotics used in screening.

DNA was extracted from the isolates using RevoluGen Fire Monkey DNA Extractions Kits. This was then sequenced to understand which groups of E. coli are resistant to UTI treatments and to identify the mechanisms enabling these group to resist treatments.

The AMR trends reported suggest current first-line treatment guidelines for antibiotic use are suitable and working well in Norfolk.

The research was supported by funding from the Medical Research Council’s Doctoral Antimicrobial Research Training (DART) Industrial CASE programme and the Biotechnology and Biological Sciences Research Council.

Reference: Uropathogenic Escherichia coli population structure and antimicrobial susceptibility in Norfolk, UK. Cailean Carter, Alexandra Hutchison, Steven Rudder, Elizabeth Trotter, Emma V Waters, Ngozi Elumogo, and Gemma C Langridge published in the Journal of Antimicrobial Chemotherapy, publsihed on June 26 2023. DOI: https://doi.org/10.1093/jac/dkad201