Frequency of Extensively Drug Resistance and Metallo-Beta-Lactamase Genes among Uropathogenic Escherichia coli Isolates from Nasiriya, Iraq

Background: This study aimed to evaluate the frequency of extensively drug-resistant (XDR) uropathogenic Escherichia coli (UPEC) isolates and to detect their metallo-beta-lactamase (MBL) genes. Materials & Methods: Three hundred urine samples collected from patients with suspected urinary tract infection (UTI) were evaluated for the presence of UPEC isolates. These isolates were subjected to antibiotic susceptibility testing to determine multidrug-resistance (MDR) and XDR profiles. Imipenem or meropenem-resistant isolates were evaluated for MBL production using modified carbapenem inactivation (mCIM) and EDTA-CIM (eCIM) methods. PCR was carried out to identify the presence of MBL genes, including blaGIM, blaSIM, blaVIM-۱, blaVIM-۲, blaSPM-۱, blaIMP-۱, blaIMP-۲, blaNDM, and blaKPC. Findings: Out of ۳۰۰ urine samples, ۲۰۰ (۶۶.۶۶%) were positive for UTI. Among these, ۱۵۰ were caused by UPEC. The highest antimicrobial resistance was against cefepime (۸۸%) and ampicillin (۸۵.۳%), while the highest susceptibility was against imipenem (۹۱.۷%) and fosfomycin (۸۴%). MDR and XDR profiles were detected in ۱۴۵ (۹۶.۶۶%) and ۵ (۳.۳۳%) isolates, respectively.  Overall, five UPEC isolates were XDR and resistant to imipenem and meropenem. All these isolates were positive for mCIM, while four were positive for eCIM. The blaNDM gene was found in all five isolates, while the other MBL genes were not found. Conclusion: The existence of MDR and XDR bacteria poses a significant risk to public health. blaNDM is circulating in UPEC strains at least in Nasiriya province, Iraq. This could lead to increased resistance to carbapenems among Enterobacteriaceae, a serious threat to public health.

کلیدواژه ها:

Uropathogenic Escherichia coli ، Urinary tract infection ، Antibiogram ، Drug resistance ، Beta-lactamases