Irak'ta COVID-19 olan ve olmayan hastalardan izole edilen üropatojenik Esherichia coli'de karbapenem direncinden sorumlu OXA 48 geninin tespiti

The primary causative agent of infectious diseases in urinary tract infections globally is the pathogenic Escherichia coli (UPEC), Multidrug resistance occurs when carbapenemase genes, regulated by mobile genetic factors that contain additional resistance components. OXA-48 is a significant concern due to its high resistance to therapy and the likelihood of treatment failure. The aim of this research was to determine the occurrence of uropathogenic E. coli co-infection and to identify the prevalence of the OXA-48 carbapenem gene among COVID-19 patients in Iraqi hospitals. This case-control study included 200 patients with and without covid-19. Midstream urine, a nasopharyngeal swab, and 2 ml of venous blood samples were collected from patients in Al-Yarmouk Hospital during November 2022 to February 2023. All urine samples were cultured on Nutrient agar, blood agar, MacConkey agar, and Eosin-methylene blue agar. All nasopharyngeal swabs undergo viral RNA extraction. The percentage of females was higher (57%) and (64%) than in males (43%) and (36%) in both UTIs-patients with and without COVID-19. The Highest incidence rate in femal (54.54%) in age (41-50) with covid-19, while in male (37.5%) in different ages. The antibiotic resistance profile in UTIs-patients with COVID-19 was in lower resistance in amikacine (76.66). While lower resistance was against amikacin (60%) in patient without covid-19. According to minimal inhibitory concentrations, 1024 mg/mL was more effective than 128 mg/mL in both groups. According to the microtiter plate method, among the 30 bacterial isolates, 24 (80%) had strong and 6 (20%) had moderate ability to biofilm formation with respect to UTIs-patients in the COVID-19 group. While, among the 30 bacterial isolates without covid-19 (13.33%) strong, (53.33%) moderate and (33.33%) weak. Among 10 bacterial isolates, the frequency of OXA-48 was positive in 9 (90%) with respect to UTI patients with COVID-19 group and positive in 8 (80%) with respect to UTIs-patients without COVID-19 group. The N and E genes of coronavirus were detected in all patients with COVID-19. According to the hemolysin production of E. coli, among 30 bacterial isolates, 12 (40%) were associated with beta hemolysis, 18 (60%) were associated with gamma hemolysis, 25 (83.33%) were positive for capsule production, and 30 (100%) were positive for gelatinase, swimming motility, and growth in M9 agar. 11 (36.66%) were positive for cell surface hydrophobicity, and according to hemagglutinin, 16 (64.67%) were MRHA and 14 (53.33%) were MSHA with respect to UTIs-patients in the COVID-19 group. Among 60 bacterial isolates from both groups, 28 (46.67%) were resistant to serum, and 32 (53.33%) were sensitive to serum. In conclusion, urinary tract infections were significantly worse in patients with COVID-19 compared to patients without COVID-19. In addition, the higher frequency of the OXA-48 carbapenem gene among E. coli indicated that this gene plays an important role in the emergence of a high rate of antibiotic resistance and the development of multi-drug resistance isolates.