Prevalence of Extended-Spectrum B-Lactamase (ESBL) and Quinolone Resistance (qnr) Genes among Cytotoxic Necrotizing Factor-1-Producing Uropathogenic Escherichia coli in Babylon, Iraq

Pathogenic Escherichia coli (E. coli) is usually known as the principal agent of hospital-acquired infections, particularly those related to urinary tract infections (UTIs). The purpose of tThis study aimedwas to determine ESBL (extended-spectrum B-lactamase) production and quinolone resistance (qnr) genes in cytotoxic necrotizing factor 1 (CNF-1)- producing E. coli isolatesd from UTIs in Iraq.

A total of 996 E. coli isolates were obtained from UTIs infections in two general hospitals in Hillah, Babylon, Iraq (during 2014-2022), and 100 uropathogenic E. coli (UPEC) were cnf-1 gene carriers. ESBL production was evaluated using the double-disk synergy -test. The qnr genes were detected using polymerase chain reaction (PCR).

Nalidixic acid and chloramphenicol resistance wasincluded 70% and 30%, respectively. ESBL production was observed among 46% of cnf-1 -carriers isolates. The qnrA, qnrB, and qnrS genes were detected in 18%, 21%, and 11% of the isolates, respectively. ESBL-producing isolates mainly carried the qnrB gene and showedhad the highest resistance levels to quinolones. Major risk factors of pathogenic E. coli isolation included older age (68%, p= 0.031), previous hospitalization (76%, p= 0.021), and urinary catheter (83%, p= 0.018).

Although the prevalenceexistence of the cnf-1 gene was not high among UPEC isolates, its prevalencerate was high among quinolone-resistant and ESBL-producing isolates. The cContinuous investigation of virulence and resistance genes is essential tfor monitoring and controlling the infections and facilitate their control. ItMore investigation is necessary to determine the virulence  traits factors and resistance genes among UPEC in Iraq and to take in timely measures action to hinder the spread of resistance genes from spreading to other nosocomial isolates.