Investigation of virulence factors and their association withantimicrobial resistance among uropathogenic Escherichia coli strainsisolated from patients in Basra city; Iraq

Background and Aim : The aim of present study was to investigate the antimicrobial resistance(AMR) pattern, the frequency of some virulence genes (VGs) in UPEC strains and the associationof AMR with VGs.Methods : Current study was conducted at the AL Zubair Hospital and Dar AL Shifaa InvestmentHospital in Basra- Iraq, during the period from November ۲۰۲۰ to March ۲۰۲۱. A total of ۳۰۰urine samples was collected from patients suspected to have UTI according to the clinicalmanifestations diagnosed by the examining physician. Antimicrobial resistance pattern andvirulence genes (papAH, papC, papEF, papG, fimH, and fyuA) profile of these isolates wereinvestigated by Kirby-Bauer disc diffusion method and polymerase chain reaction, respectively.Results : Among these samples, ۲۰۱ (۶۷%) exhibited a positive growth on culture media. Out ofthese ۲۰۱ isolates, ۳۸ (۱۸.۹%) were Gram-positive, while ۱۶۳ (۸۱.۱ %) were Gram-negativebacteria. In addition, the positive cultures for women and men were ۱۵۲ (۷۵.۶۲%) and ۴۹ (۲۴.۳۷%), respectively. E. coli was found in ۶۰ (۲۹.۸۵ %) specimens compared with Klebsiellapneumonia ۴۲ (۲۰.۸۹%), Staphylococcus aureus ۳۸ (۱۸.۹%), Enterobacter spp ۲۹ (۱۴.۴۲%),Pseudomonas aeruginosa ۱۰ (۴.۹۷%), Proteus mirabilis ۱۵ (۷.۴۶%), others about ۷ (۳.۴۸ %)isolates.Antibiogram results of ۱۵ antibiotics examined showed that all E. coli isolates wereMultidrug resistant (MDR). The frequency of resistance against antimicrobial drugs was as follow:Streptomycin (۱۰۰%), Kanamycin (۹۸.۳%), Ampicillin (۹۶.۷%), Ceftazidime (۹۵.۰%),Amoxicillin-clavulanate (۸۸.۳%), Cefotaxime (۸۶.۷%), Amikacin (۸۵.۰%), Gentamycin (۴۳.۳%),Nalidixic acid (۵۸.۳%), Ciprofloxacin (۵۵.۰%), Tetracycline (۵۸.۳%), Meropenem (۶.۷%),Trimthoprim-sulphametoxazole (۷۱.۷%), Nitrofuranation (۱۵.۰%), and Imipenem (۳۶.۷%). VGsdetected among E. coli isolates were papAH (۸۵%), papC (۸۵%), papEF (۶۰%), papG (۸۰%), fimH(۸۸.۳%), and fyuA (۸۰%). Moreover, these results alleged a no connection between virulencefactors and antimicrobial resistance in E. coli strains. Only, it was found an association betweenfimH gene and antimicrobial resistance against nitrofurantoin (P-value ۰.۰۲۸).Conclusion : The bacterial VFs that were investigated in this study could not serve to predict thepotential for E. coli to cause antibiotic resistance in UTI. However, based on the results of thisstudy virulence genes and antimicrobial resistance are independent properties and can transfer toother bacteria separately.

کلیدواژه ها:

Antimicrobial resistance ، Urinary tract infection ، uropathogenic Escherichia coli ، virulence factors