Molecular Detection of Cephalosporin Resistance Genes in Escherichia coli Isolated from Urinary Tract Infections in Baghdad Hospitals

Abstract

Escherichia coli is a normal flora in the human and animals gut, but also it is pathogenic in the patient with immune system disorder ,is the leading cause of enteritis, urinary tract infection, septicemia and other Medical infections One hundred and eighty (180) midstream urine samples (MSU) were collected from patients with urinary tract infection (UTI) of all age and both sexes. Samples were collected from Al-Karma Teaching Hospital and Al-Yarmouk Teaching Hospital from the beginning of November 2021 until the end of February 2022. All isolates were diagnosed based on microscopic examinations and morphological characteristics using Eosin methylene blue (EMB), Blood agar and MacConkey agar. The diagnosis was confirmed through Vitek system and API E kit. Where the diagnostic results showed that E.coli had the highest percentage, representing 44.7%, followed by Klebsiella pneumonia with 16% and Pseudomonas aeruginosa. 8% and Proteus mirabilis 2.7%, Staphylococcus aureus 14.3%, Enterococcus spp, 6.3% and Fungi 8%. As for age, the age groups of (11-20) years had the highest rate of infection with 29.5%, followed by (21-30) years with a rate of 16.1, while the age groups over 60 and (1-10) were at 12.5% and ( 51-60) and (31-40) were 10.7%, and the lowest percentage of infection was (31-40), representing 8.0% .while was  the injuries, 58% were in women, 42% in men Testing antibiotic sensitivity against 14 different antibiotics showed that E. coli was highest resistance Ceftriaxone (82%), Cefotaxime and Tetracyclic (78%), Cefixime (76%), Ceftazidime and Ampicillin (74%). While there is less resistance at Cefepime (68%) On the other hand, moderate resistance Cephalothin (50%), Cephalexin and Azetrenam (40%) The current study demonstrated that E.coli possessed a low-level resistance against Amikacin (34%), Ciprofloxacin (28%), Imipenem (16%), and Gentamycin (52%). In addition, PCR was used to identify cephalosporin resistance genes. It was concluded  that all isolates were resistant to cephalosporin through the presence of the CTX-M-1 gene by (100%), while the results of the presence of the OXA-48 genes were (23.3%). Three resistant and three intermediate resistant isolates were selected for gene expression study.