Correlation between some immunological variables and uropathogenic escherichia coli virulence genes, biofilm formation, and antibiotic resistance in urinary tract infection patients

Urinary tract infection is a bacterial disease that usually affects various parts of the urinary tract. A wide variety of species are responsible for urinary tract infections, with Escherichia coli being the leading cause of uncomplicated urinary tract infections. Morning midstream urine and venous blood samples were collected from 200 patients (79 males and 121 females) with clinical and laboratory diagnosis of urinary tract infection by consultant urologists at the Urology Unit of Salah Al-Din General Hospital, Iraq. In addition, mid-morning midstream urine and venous blood samples were collected from 84 healthy controls (29 males and 55 females) to compare with the patients for interleukin testing. The mean ages of the patients and the control group were 42.82±6.22 and 40.65±8.5 years, respectively. The number of females was 55 (65.5%) and 121 (60.5%) in the control and patient groups, respectively, and this number was 29 (34.50%) and 79 (39.5%) higher than the number of males, respectively. Among 200 urine samples, the highest percentage was 157 (78.5%) E. coli isolates. Of the 157 E. coli isolates, only 122 isolates formed a biofilm; 42 isolates (26.75%) were strong, 48 isolates (30.57%) were moderate, 32 isolates (20.38%) were weak, and 35 isolates (22.29%) did not form biofilm. The papC gene was positive in 92 isolates, the fimH was positive in 90 isolates, the sfa gene was positive in 57 isolates and the cnf1 gene was positive in 70 isolates. In conclusion, UPEC are the most common pathogens causing UTIs due to their high virulence frequencies such as biofilm formation and antibiotic resistance. papC, fimH, sfa and cnf1 genes play an important role in the pathogenicity of UPEC and induce high levels of pro-inflammatory cytokines such as IL-8 and IL-17A.