The investigation of relationship between adeshins and antibiotic resistance in E.coli induced urinary tract infections by using classic and molecular methods.

The investigation of relationship between adeshins and antibiotic resistance in E.coli induced urinary tract infections by using classic and molecular methods.The urine samples of the patients diagnosed with urethra infection that consulted to polyclinics during the period of August 2006 and September 2007, were analyzed for classical bacterial identification, antibiotic sensitivity and Vitec-32 system and disc diffusion method and the presence of ESBL.The virulence genes and ESBL genes in E.coli strains were studied on a total of 100 patients, 50 with ESBL positive and 50 with ESBL negative for our study.PCR test has been used by making SYBR Green I and Melting Curve analysis for the gene study of bacteria with ESBL negative and bacteria determined as ESBL positive.Of the 50 strains identified as ESBL positive, 50 (100 %) have been identified sensitive to Cefotetan and Imipenem if they were resistant to Ampicilin, Ceftazidime, and Ceftriaxone.Of the 50 E.coli strains with ESBL positive studied for the positivity of ESBL genes, in 45 cases (90 %) TEM gene, in 6 cases (12 %) SHV gene, in 30 cases (60%) CTX-M genes have been found. Furthermore, in 15 of these strains (30 %) pap, in 35 of these strains (70 %) fim-A, and in 3 (6 %) sfa virulence factors have been found positive. In 3 strains used in our study, none of the ESBL genes and E.coli virulence factors have been found.In the cases where ESBL genes exist more than 1 at the same time in 1 strain, of the 50 E.coli strains with ESBL positive; it has been found out that, in 6 (12 %) TEM and SHV gene, in 28 (56 %) TEM and CTX-M gene, in 5 (10 %) SHV and CTX-M gene and in 5 (10 %) TEM, SHV and CTX-M gene co-existed.In the cases where virulence factors exist more than 1 at the same time in 1 strain in E.coli strains found to be ESBL (+), it has been observed that, in 14 (28 %) pap and fimA, in 2 (4 %) pap and sfa, in 2 (4 %) fimA and sfa virulence factors co-existed.In ESBL positive strains, it has been found to be sensitive Ertapeneme to all strains by disc diffusion method. In the cases where ESBL genes of 50 E.coli strains with ESBL positive, it has been observed in 44 (88%) with double disk synergy test, in 45 (90%) with combined disk synergy test.Of the 50 E.coli strains with ESBL negative studied for the positivity of ESBL genes; in 50 (100 %) TEM gene, in 11 (22 %) SHV gene has been found no CTX-M gene has been found in any of the strains. Furthermore, it has been observed that in 37 (74 %) fim-A, in 13 (26 %) sfa virulence factors existed.In the cases where ESBL genes of 50 E.coli strains with ESBL negative exist more than 1 at the same time in 1 strain; TEM and SHV genes have been found in 11 (22 %) cases, but in none of the strains TEM and CTX-M gene, SHV and CTX-M gene and TEM, SHV and CTX-M gene co-existed.In the cases where virulence factors of 50 E.coli strains with EBSL negative exist more than 1 at the same time in 1 strain; it has been observed that in 16 of these (32 %) pap and fimA, in 9 (18%) pap and sfa, in 10 (20%) fimA and sfa and in 8 (16 %) pap, fimA and sfa virulence factors co-existed.The identification of ESBL genes of E.coli strains with ESBL positive has been accomplished by PCR, using SYBR Green, and verification curves have been prepared by using Melting Curve Analysis.Chi-Square test in SPSS 10.0 has been used for the statistical evaluation of the results. Statistical meaningfulness of p<0.05 has been accepted for statistical analysis.In ESBL positive strains, it has been observed that a very meaningful relation (p < 0,003) existed between E.coli virulence factors and ESBL genes.In ESBL positive strains, it has been observed that a very meaningful statistical meaning (p<0,0001) existed in cases where only 1 virulent factor is present in strains when the co-existence of virulence factors and ESBL genes evaluated.In ESBL positive strains, when the relation between each virulence factors and ESBL genes examined one by one, the relation between fimA virulence factors and CTX-M gene has been observed as meaningful (p< 0,002).In ESBL positive strains, the co-existence of pap gene and fimA gene among the virulence factors has been found to be meaningful (p < 0,018)In strains with ESBL negative, the relation between ESBL and virulence factors has been searched with Pearson Correlation, and found that pap and sfa virulence factors co-existed (p<0,012).In the light of all above data, it has been observed that fimA from virulence factors of E.coli strains with CTX-M genes from formation of ESBL genes have a positive effect, and that more than one virulence factors in one strain could be available in the same ESBL positive and negative strain, that has been found meaningful relation with CTX-M gene in ESBL positive strains, but that CTX-M gene has been found in any of the strains of ESBL negative. CTX-M gene in the development of resistance to beta-lactam group of antibiotics is seen as more dominant.