Phenotypic and Molecular Study of Extended-Spectrum β-lactamases Producing Enterobacteriaceae from Urinary Tract Infection in Zakho city, Kurdistan Region/Iraq.

Abstract


 The prevalence of ESBLs producing Enterobacteriaceae are increasing locally and globally. This study aimed to investigate the antibiotic susceptibility profile of Enterobacteriaceae causing urinary tract infection and to record the prevalence of ESBLs genes among enterobacterial isolates. A total of 454 urine specimens were collected from outpatients with UTIs from two major hospitals in Zakho city; The Zakho General hospital and Emergency hospital. The enterobacterial isolates were identified using the phenotypic and conventional biochemical tests. The antibiotic susceptibility of the isolated organisms was determined using the disk diffusion method, and ESBL production was detected by a double-disk synergy test. The suspected ESBL producers were further confirmed by the amplification of specific primers using PCR assay. Out of 454 specimens, 239 enterobacterial isolates were identified. The most common detected isolates and their rates were: Escherichia coli (65.20 %) and Klebsiella pneumoniae (25.49 %). Imipenem was the most effective antibiotic used while, amoxicillin and ampicillin were the most resistant. The highest level of ESBL production was determined in E. coli (66.3 %) followed by K. pneumoniae (30.43%). The predominant detected gene were both CTX-M and SHV equally followed by TEM. In conclusion, this study indicated that member of Enterobacteriaceae in particular E. coli and K. pneumoniae are the predominant species causing UTI. The isolated bacteria were resistant to most of used antibiotics except imipenem which was effective. These bacteria are becoming multidrug-resistant due to the absence of restriction in antibiotics uses, in addition to their abuse and overuse.