Unveiling ESBL-Producing E. coli: Genetic Markers, Antibiotic Resistance, and Virulence Factors in UTI Patients Exhibiting MDR, XDR, and PDR Phenotypic bacterial isolates
Rusul Mohsen Hashem, May Mohammed Ali, Abeer Thaher Naji Al-Hasnawi
Urinary tract infections (UTIs) are a worldwide issue that affect community and hospitalized individuals resulting in a decrease of the patient’s life quality. Gram-negative bacilli are the most common etiological agents responsible for urinary tract infections. The prevalence of antibiotic resistance in Gram-negative bacilli is increasing at a rapid pace globally, which is constraining the available choices for UTI treatment. This is a case-control study manipulated at City in Holy Karbala, Iraq, the study beginning from October 2023 to the end March 2024. Urine samples from patients suspected to have UTI were collected, and patients with confirmed UTI by laboratory investigations and yielded culture growth were enrolled. Antibiotic sensitivity testing and PCR testing of the EAE, Cnf, bla CTX-M and bla OXA-48 genes were done. The study showed the distribution of extended- spectrum beta-lactamase (ESBL) producing Escherichia coli isolates based on gender, residency, and diabetes status. ESBL E. coli was more prevalent in females than males, more common in isolates from urban areas compared to rural areas, and isolated at a higher percentage in patients with diabetes than those without diabetes, For E. coli isolates, the highest percentage (43.6%) was observed in the (31-41 )years age group, compared to the other age groups. Escherichia coli and Klebsiella pneumoniae were the most commonly isolated uropathogens in this study, and the majority were highly resistant to most of the antimicrobial agents tested. Resistance genes bla CTX-M, EAE , CNF and bla OXA-48 are very common in uropathogens, These results highlight the need for targeted surveillance and control measures, particularly in high-risk populations, to address the spread of ESBL-producing E. coli infections.
Keywords: Urinary tract infections, Antibiotic resistance, Resistance genes, Escherichia coli
