Molecular characterisations of some virulence genes of Escherichia coli isolated from patients with urinary tract infection in the South of Iraq

Acute urinary tract infection (UTI) is a common health concern affecting individuals worldwide. Prompt and accurate diagnosis is crucial for effective treatment, as UTIs can lead to severe complications if left untreated. This study aims to investigate the prevalence of Escherichia coli (E. coli) in UTI patients and assess their antibiotic susceptibility patterns. Additionally, the presence of specific genes associated with antibiotic resistance in E. coli isolates is examined. A total of 80 urine samples were collected from patients with clinical features indicative of UTI who visited Al-Hussein Teaching Hospital from January 2022 to June 2022. Fifty healthy individuals were included as the control group. UTI patients were diagnosed based on clinical criteria, such as dysuria, frequency, urgency, fever, and loin pain. The age and gender distribution of UTI patients was analyzed. Among the UTI patients, females exhibited a significantly higher prevalence, with 49 female patients (61.25%) compared to 31 male patients (38.75%). The percentage of UTI cases was highest in females above 60 years (15.0%) and in females aged 50-59 years (13.75%), while males in these age groups recorded 8.75% infection rate. E. coli was the most prevalent bacterium, accounting for 35.0% of the patient samples, followed by Pseudomonas aeruginosa at 15.0%. All 28 E. coli isolates were identified through standard gram-negative card characteristics, showing positive results for catalase, methyl red, and lactose fermentation tests, but negative results for oxidase, citrate, and vogas-proskauer tests. Antibiotic susceptibility testing revealed that 7 antibiotics displayed resistance to E. coli, 2 antibiotics were sensitive, and 3 antibiotics demonstrated moderate resistance. Furthermore, the prevalence of three genes (hlyA, vat, and mcr-1) associated with antibiotic resistance in E. coli isolates was investigated using Real Time PCR, with positive rates of 26.25%, 23.75%, and 12.50%, respectively. This study provides valuable insights into the prevalence and antibiotic susceptibility of E. coli isolates in UTI patients from Al-Hussein Teaching Hospital. The high occurrence of antibiotic resistance genes highlights the importance of continuous surveillance and appropriate antibiotic stewardship to combat UTI infections effectively.