The Incidence of Extended Spectrum β-Lactamase Enzymes and Their Connection to Virulence Genes in Community-Acquired Urinary Tract Infection

Abstract

In community-acquired urinary tract infections, Klebsiella pneumoniae is considered one of the most common etiological agents. Multidrug resistance and virulence are common in Klebsiella pneumoniae populations. In this study, fifty Klebsiella pneumoniae isolates were isolated from urine samples and identified using a vitek 2 compact device. The Kirby–Bauer disk diffusion technique used the antibiotic susceptibility test. According to the findings, approximately [n = 46 (92%)] of Klebsiella pneumoniae isolates are multidrug-resistant (MDR). To detect the production of Extended Spectrum β-lactamase (ESBL) enzymes, the Modified Double Disc Synergy Test (MDDST) was used. The results show that approximately [n=45 (90%)] of the isolates produce ESBLs. The most common ESBL genes (TEM, SHV, and CTX-M) were investigated in isolates. The results show that the SHV gene had the highest prevalence among ESBL genes [n = 34 (68%)], followed by the CTX-M gene [n = 33 (66%)]. while none of the isolates possessed the TEM gene. The virulence factor type 3 fimbriae (MrKD) gene and biofilm (BssS) gene were revealed. The results found that the isolates contain the MrKD gene at [n = 41 (82%)]. At the same time, the results found that the isolates contained the BssS gene at [n =36 (72%)]. The prevalence of Virulence genes within ESBL-producing Klebsiella pneumoniae isolates shows that only [n = 3 (6%)] of isolates that are non-ESBL producers carry one or both virulence genes, while [n=41 (82%)] of ESBL-producing isolates contain one or both virulence genes. The prevalence of ESBL-producing Klebsiella pneumoniae in community patients was high in this research. There may also be a correlation between ESBL production and some virulence factors. Keywords. Klebsiella pneumoniae; Antibiotic Resistance; Virulence Gene; ESBL; Urinary Tract Infection; CTX-M.