Identification of bacterial isolates in urinary tract infections patients of Basrah province
DOI:
https://doi.org/10.15584/ejcem.2025.1.30Keywords:
antibiotic susceptibility, E. coli, ESBLsAbstract
Introduction and aim. Urinary tract infections (UTIs) are among the most common bacterial diseases worldwide that are caused primarily by members of the Enterobacteriaceae family. This study aimed to identify the most frequent bacterial agents associated with UTIs and analyze their patterns of antibiotic resistance using the Vitek®2 system.
Material and methods. The study included 200 urine samples collected from adult UTI patients of both sexes.
Results. The characterization of bacterial isolates revealed the following distribution: Escherichia coli (35 isolates, 50%), Staphylococcus aureus (18 isolates, 25.7%), Klebsiella pneumoniae (5 isolates, 7.14%), Staphylococcus spp. (4 isolates, 5.7%), Streptococcus spp. (3 isolates, 4.2%), Pseudomonas spp. (3 isolates, 4.2%), and Proteus mirabilis (2 isolates, 2.86%). Antibiotic resistance testing showed that ceftazidime had the highest resistance rate (88.57%), while amikacin had the lowest (17.14%). Additionally, extended-spectrum β-lactamase (ESBL) production was detected in 35 E. coli isolates. Of these, 22 isolates (62.86%) tested positive for ESBL production, while 13 isolates (37.14%) were negative.
Conclusion. This study concluded that E. coli is the most prevalent bacterial species causing UTIs. Furthermore, the E. coli isolates demonstrated a high capacity for ESBL production, highlighting the need for effective antimicrobial management and monitoring.
Downloads
References
Brons JK, Vink SN, de Vos MGJ, Reuter S, Dobrindt U, van Elsas JD. Fast identification of Escherichia coli in urinary tract infections using a virulence gene based PCR approach in a novel thermal cycler. J Microbiol Methods. 2020;169:105799. doi: 10.1016/j.mimet.2019.105799
Nicolle LE, Gupta K, Bradley SF, et al. Clinical Practice Guideline for the Management of Asymptomatic Bacteriuria: 2019 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2019;68(10): 83-110. doi: 10.1093/cid/ciy1121
Wagenlehner FME, Bjerklund Johansen TE, Cai T, et al. Epidemiology, definition and treatment of complicated urinary tract infections. Nat Rev Urol. 2020;17(10):586-600. doi: 10.1038/s41585-020-0362-4
Sudharani M, Basha S M, Saritha Y, et al. Antibiotic resistance and ESBL detection in Escherichia coli strains from cases of urinary tract infections. Inter J Med Pub Health. 2024;14(2):661-664.
Kaur N, Agarwal A, Grover M, Singh S. Uropathogenic Escherichia coli. Enterobacteria. Published online February 23, 2022. doi: 10.5772/intechopen.102525. Accessed February 20, 2023.
Lindblad A, Wu R, Persson K, Isak Demirel. The Role of NLRP3 in Regulation of Antimicrobial Peptides and Estrogen Signaling in UPEC-Infected Bladder Epithelial Cells. Cells. 2023;12(18):2298-2298. doi: 10.3390/cells12182298
Elzouki EM, Eljamay SM, Alshilwi YA. Isolation and Identification of Escherichia Coli in Uropathogenesis. Derna Acad J App Sci. 2024;2(2):95-102.
Ali Albadery A, Shakir Mahdi Al-Amara S, Abd-Al-Ridha Al-Abdullah A. Phenotyping and Genotyping Evaluation of E. coli Produces Carbapenemase Isolated from Cancer Patients in Al-Basrah, Iraq. Arch Razi Inst. 2023;78(3):823-829. doi: 10.22092/ARI.2022.359869.2493
Hardany MJ, Al-Abdullah AA, Al-Amara SM, Makki HM. Detection ESBL enzymes in gram- negative bacteria. J Bas Res. 2019;45(2):53-59.
Bush K, Bradford PA. Epidemiology of β-LactamaseProducing Pathogens. Clin Microbiol Rev. 2020;33(2):1-37. doi: 10.1128/CMR.00047-19 Pincus DH. MICROBIAL IDENTIFICATION USING THE BIOMÉRIEUX VITEK ® 2 SYSTEM. Encyclopedia of Rapid Microbiological Methods Bethesda. MD: Paren Drug Assoc. 2014;2:1-32.
Gamal F, Gadallah F, Zaghloul M, Salama E, Salama S, Khedr A. Differentiation between vaccinal and field strains of E. coli using phenotype and genotype characterization. J Immuno Clin Microbiol. 2017;2(3):48-53. doi: 10.5455/jicm.25-20170707
Choudhary S, Tomar A, Ansari K, et al. Antimicrobial activity of certain drugs against the different isolates found in bovine fecal samples. J Pharma Phytochem. 2022;11(3):186-192.
Kamel HF, Ali GB. Possible Association Between Trichomonas Vaginalis and Recurrent Urinary Tract Infections. Pak J Life Soc Sci. 2024;22(1):2572-2581. doi: 10.57239/pjlss-2024-22.1.00194
Wanja F, Ngugi C, Omwenga E, Maina J, Kiiru J. Urinary Tract Infection among Adults Seeking Medicare at Kiambu Level 5 Hospital, Kenya: Prevalence, Diversity, Antimicrobial Susceptibility Profiles and Possible Risk Factors. Advances in Microbiology. 2021;11(8):360-383. doi: 10.4236/aim.2021.118028
Al-Musawi LR, Al-Husseini RF. Prevalence of Uncomplicated Recurrent Urinary Tract Infection among Adult Females in Babylon Governorate. Med J Bab. 2021;18(1):37-37. doi: 10.4103/mjbl.mjbl_77_20
Alhamedy AJ, Shani WS. Determination of Cathelicidin in UTI patients of Basrah province. Del J. 2020;23(02):182-189. doi: 10.36295/asro.2020.23225
Kline KA, Lewis AL. Gram-Positive Uropathogens, Polymicrobial Urinary Tract Infection, and the Emerging Microbiota of the Urinary Tract. Microbiol Spectr. 2016;4(2): 10.1128/microbiolspec.UTI-0012-2012. doi: 10.1128/microbiolspec.UTI-0012-2012
Al-Hilu SA, Al-Shujairi WH. Characterization of Foodborne Pathogens and Enterotoxigenic Staphylococcus Aureus Isolates with Detection of Antibiotic Resistance from Beef Meat. Syst Rev Pharma. 2020;11(11):464-475. doi: 10.31838/srp.2020.11.68
Abbood, Sanaa A. Isolation and Molecular Identification of Multidrug Resistance Escherichia coli Isolated from Patients with Urinary Tract Infections. Ebscocom. 2024;22(1):36. doi: 10.22578/IJMS.22.1.5
Al.rheem Saad NA, Hussein RH, Al-Shakir NMM. Antibiogram Pattern of Uropathogenic Escherichia Coli in Baghdad Province, Iraq. Journal of Techniques. 2022;4:134-138.
Sneha Kukanur, Meera Meundi, Bajaj A, Subbannayya Kotigadde. Co-Relation between Virulence Factors and Antibiotic Resistance of E. coli, With Special Reference to Uropathogenic E. coli. J Den Med Sci. 2015;14(3):15-21. doi: 10.9790/0853-14351521
Lindblom A, Kiszakiewicz C, Kristiansson E, et al. The impact of the ST131 clone on recurrent ESBL-producing E. Coli urinary tract infection: a prospective comparative study. Sci Rep. 2022;12(1):10048. doi: 10.1038/s41598-022-14177-y
Crowley E, Bird P, Fisher K, et al. Evaluation of the VITEK 2 Gram-Negative (GN) Microbial Identification Test Card: Collaborative Study. J AOAC Inter. 2012;95(3):778-785. doi: 10.5740/jaoacint.cs2011_17
Salumi Z, Abood Z. Phenotypic Diagnosis of Efflux Pump of Escherichia coli Isolated from Urinary Tract Infections. Iraqi J Biotechnotechn. 2022;21(2):21-31.
Ossman A, Hamad M, Ahmed S. Molecular identification of some virulence and antibiotic resistance genes in Pseudomonas aeruginosa isolated from UTI infection. Egypt J Vet Sci. 2024;55(4):1143-1150. doi: 10.21608/ejvs.2023.251833.1692
Maleki D, Honarmand Jahromy S, Zare Karizi S, Eslami P. The Prevalence of acrA and acrB Genes Among Multiple-Drug Resistant Uropathogenic Escherichia coli Isolated From Patients With UTI in Milad Hospital, Tehran. Avic J Clin Microbio Infec. 2016;4(1):39785-39785. doi: 10.17795/ajcmi-39785
Lai K, Ma Y, Guo L, An J, Ye L, Yang J. Molecular characterization of clinical IMP-producing Klebsiella pneumoniae isolates from a Chinese Tertiary Hospital. Ann Clin Microbio Antimicro. 2017;16(1):1-5. doi: 10.1186/s12941-017-0218-9
Jenkins C, Ling CL, Ciesielczuk HL, et al. Detection and identification of bacteria in clinical samples by 16S rRNA gene sequencing: comparison of two different approaches in clinical practice. J Med Microbio. 2011;61(4):483-488. doi: 10.1099/jmm.0.030387-0
Srinivasan R, Karaoz U, Volegova M, et al. Use of 16S rRNA Gene for Identification of a Broad Range of Clinically Relevant Bacterial Pathogens. PLOS ONE. 2015;10(2):1-22. doi: 10.1371/journal.pone.0117617
Hidayat T, Hadibarata T, Farraj D. Phylogenetic Analysis of Microbial Community in Selected Rivers in. J Eng Sci Technol. 2020;15(4):2464-2471.
Shiwk RS. Types of bacteria that cause urinary tract infection and extent resistance to antibiotics in some hospitals of Baghdad. Al-Qad J Pure Sci. 2016;4(21):25-32.
Aboderin OA, Abdu AR, Odetoyin BW, Lamikanra A. Antimicrobial Resistance in Escherichia coli Strains From Urinary Tract Infections. J Nat Med Asso. 2009;101(12):1268-1273. doi: 10.1016/S0027-9684(15)31138-X
Düzgün AÖ, Okumuş F, Saral A, Çiçek AÇ, Cinemre S. Determination of antibiotic resistance genes and virulence factors in Escherichia coli isolated from Turkish patients with urinary tract infection. Rev Soc Bras Med Trop. 2019;52:1-5. doi: 10.1590/0037-8682-0499-2018
Mohamed KG, Aljanaby AAJ. Urinary tract infections in Al-Kufa City Iraq and phenotypic detection of antimicrobial sensitivity pattern of bacterial isolates. Inter J Pharma Res. 2020;12(1):1-5. doi: 10.31838/ijpr/2020.sp1.222
Seyed H, Shahcheraghi, Ayatollahi J, et al. Determination of antibiotic resistance of E. coli isolated from urine culture samples. J Med Res. 2022;8(5):162-164.
Hasan F, Ahmeed HW, Khudair KK. Gentamicin And Ciprofloxacin Sensitivity Against E. Coli Clinically Isolated From Urinary Tract Infection. Med Sci J Advan Res. 2023;4(3):178-182. doi: 10.46966/msjar.v4i3.132
Mujahid F, Rasool MH, Shafiq M, Aslam B, Khurshid M. Emergence of Carbapenem-Resistant Uropathogenic Escherichia coli (ST405 and ST167) Strains Carrying blaCTX-M-15, blaNDM-5 and Diverse Virulence Factors in Hospitalized Patients. Pathogens. 2024;13(11):964-964. doi: 10.3390/pathogens13110964
Jalil MB, Al Atbee MYN. The prevalence of multiple drug resistance Escherichia coli and Klebsiella pneumoniae isolated from patients with urinary tract infections. J Clin Lab Anal. 2022;36(9). doi: 10.1002/jcla.24619
Critchley IA, Cotroneo N, Pucci MJ, Mendes R. The burden of antimicrobial resistance among urinary tract isolates of Escherichia coli in the United States in 2017. PLOS ONE. 2019;14(12):1-11. doi: 10.1371/journal.Pone.0220265
Ahmed GA, Alzubaidy ZM. Enterohemorrhagic escherichia coli isolated from urine samples of women suffering from urinary tract infections. Biochem & Cell Arch . 2021;21(2):3741-3747 .
Andaleeb H, Zia W, Shahid A, et al. Spectrum Of Antimicrobial Susceptibility Pattern of Urinary Tract Infection in In Adults. Pak BioMed J. 2022;5(8):60-66. doi: 10.54393/pbmj.v5i8.751
Paltansing S. Antimicrobial Resistance In Enterobacteriaceae: Characterization and Detection. Leiden University. 2015;155.
Shoyaikh RS, Jasim FAH. Types of bacteria causing urinary tract infections and their antimicrobial resistance magnitude in some hospitals of Baghdad, Iraq. Al Qad J Pure Sci. 2016;21(4):25-32.
Zaman SB, Hussain MA, Nye R, Mehta V, Mamun KT, Hossain N. A Review on Antibiotic Resistance: Alarm Bells are Ringing. Cureus. 2017;9(6):1-9. doi: 10.7759/cureus.1403
Veve MP, Wagner JL, Kenney RM, Grunwald JL, Davis SL. Comparison of fosfomycin to ertapenem for outpatient or step-down therapy of extended-spectrum β-lactamase urinary tract infections. Inter J Antimicro Agents. 2016;48(1): 56-60. doi: 10.1016/j.ijantimicag.2016.04.014
Talan DA, Takhar SS, Krishnadasan A, Abrahamian FM, Mower WR, Moran GJ. Fluoroquinolone-Resistant and Extended-Spectrum β-Lactamase-ProducingEscherichia coliInfections in Patients with Pyelonephritis, United States1. Emer Infect Dis. 2016;22(9):1594-1603. doi: 10.3201/eid2209.160148
Bitew A, Tsige E. High Prevalence of Multidrug-Resistant and Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae: A Cross-Sectional Study at Arsho Advanced Medical Laboratory, Addis Ababa, Ethiopia. J Trop Med. 2020;2020(1):1-7. doi: 10.1155/2020/6167234
Abdullah A, Shazia Shaheen Mir, Fayez Saad Alghamdi, Abdul M, Shaia. Evaluation of Extended-Spectrum Beta-Lactamase Resistance in Uropathogenic Escherichia coli Isolates from Urinary Tract Infection Patients in Al-Baha, Saudi Arabia. Microorganisms. 2023;11(12):1-13. doi: 10.3390/microorganisms11122820
Mohammed AJ, Saad, Hejjaj A. Molecular characterization of blaTEM and blaCTX-M ESBLs genes producing Escherichia coli isolates from urinary tract infections (UTIs) in Al-Basrah province, Iraq. South Eas Eur J Pub Health. 2024;24(4):389-396. doi: 10.70135/seejph.vi.1146
Riaz M, Jadoon S, Khalid H, et al. The abundance of ESBL-expressing, multidrug-resistant Escherichia coli in Pakistani patients with urinary tract infections. Chin J Otorhinolaryngo Head Neck Sur. 2024;55:1347-1356.
Pandit R, Awal B, Shrestha SS, Joshi G, Rijal BP, Parajuli NP. Extended-Spectrum β-Lactamase (ESBL) Genotypes among Multidrug-Resistant Uropathogenic Escherichia coli Clinical Isolates from a Teaching Hospital of Nepal. Interdiscip Perspec Infec Dis. 2020;2020:1-8. doi: 10.1155/2020/6525826
Löhr, IH. Extended-spectrum β-lactamase producing Klebsiella pneumoniae. A neonatal intensive care unit outbreak, long-term colonization in children and plasmid characteristics. https://bora.uib.no/bora-xmlui/handle/1956/9133. Accessed September 20, 2023.
Adamus-Białek W, Baraniak A, Wawszczak M, et al. The genetic background of antibiotic resistance among clinical uropathogenic Escherichia coli strains. Mol Biol Rep. 2018;45(5):1055-1065. doi: 10.1007/s11033-018-4254-0
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 European Journal of Clinical and Experimental Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself.
All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.




