Abstract
BackgroundUropathogenic Escherichia coli (E. coli) or UPEC is among major nosocomial pathogens causing urinary tract infections (UTIs). The emergence of carbapenem- resistant strains is a major concern regarding the UTI treatment. The subjective of this study included assessment of genetic relation and screening of virulence factors among carbapenemase- producing E. coli from UTI. MethodsThree-hundred E. coli isolates were collected from cystitis and pyelonephritis. Antibiotic susceptibility test was conducted by disk diffusion as provided by clinical and laboratory standards institute (CLSI) version 2017. Carbapenemase production and related genes and virulence factors were screened by polymerase chain reaction (PCR) technique. Genetic relation of isolates was evaluated using phylogrouping and serogrouping. ResultsOf 300 isolates, 11 (3.66%) of them were carbapenemase-producing E. coli (CP-E. coli). Imipenem minimum inhibitory concentration ranged 4-128 μg/ml. The blaOXA-48 and blaIMP genes were co-existed in three (1%) isolates (imipenem MIC: 64-128 μg/ml), but the blaKPC, blaNDM and blaVIM were not amplified. Predominant virulence genes included iutA (n = 293, 97.66%), fyuA (n = 256, 85.33%), inh (n = 249, 83%), traT (n = 247, 82.33%), papП (n = 96, 32%), fimH (n = 93, 31%), csgA (n = 92, 30.66%). All the CP-E. coli contained the iutA, fyuA, traT, papII, fimH and csgA genes. O1 (32%), O16 (15%) and O25 (7%) serogroups were predominant and 6/11, 4/11 and 1/11 of CP-E. coli belonged to O1, O25 and O75 serogroups, respectively. Among eleven CP-E. coli isolates, nine of them were belonged to the B2 phylogroup and two isolates were belonged to B1 phylogroup. ConclusionCP-E. coli (or CP-UPEC) contained the blaIMP and blaOXA-48 genes and belonged to O25/B2. High rate of virulence factors among CP-E. coli from UTI is a concern in Baghdad hospitals. The spread of isolates with resistance to last-line antibiotics must be controlled.
Published Version
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