The association between TLR4 gene polymorphism and urinarytract infections caused by multidrug resistant bacteria among Iraqi patients in south regions

The aim of this study was to evaluate the relationship between functional gene polymorphisms (TLR4 rs7873784 and TLR4- rs11536889) and susceptibility to develop multidrug-resistant (MDR) bacteria in urinary tract infections (UTIs). For this purpose, a total of 350 urine samples were collected from men and women aged between 10 and 75 years from Al-Rifai General Hospital in Thi-Qar province in southern Iraq between July 2022 and January 2023. While 150 (42.9%) of the collected samples showed positive results for bacterial growth culture, 200 (57.1%) samples showed negative results for bacterial growth culture. In the frequency distribution of the gender of patients suffering from multidrug-resistant bacteria in urinary tract infections, females (67%) had higher values than males (33%). The MDR bacterial pathogens causing UTI were Escherichia coli (44%), Staphylococcus aureus (33%), Klebsiella pneumoniae (10%) and Proteus mirabilis (13%). In addition, BlaCTX-M gene was 36 (81.8%) in E. coli, 10 (100.0%) in K. pneumonia and 4 (30.8%) in P. mirabilis, BlaSHV gene was 13 (29.5%) in E. coli, 10 (100.0%) in K. pneumonia and 13 (100.0%) in P. mirabilis, BlaAMPC gene was 40 (90.9%) in E. coli, 10 (100%) in K. pneumonia 10 (100.0%) and P. mirabilis 4 (30.8%), BlaTEM gene was found in all gram-negative bacterial isolates and finally mecA, ermA and ermC genes were found in 33 (100.0%) S. aureus isolates. In the comparison of TLR4-rs7873784 SNP and TLR4-rs11536889 SNP genotypes and alleles between patients with urinary tract infections and healthy controls, homozygous CC and heterozygous GC genotypes were found to be significant risk factors. These data showed that patients with homozygous CC and GC genotypes were more likely to develop the disease compared to other genotypes.