الفهرس 
Escherichia Coli
Antibiotic Resistance in Uropathogenic E. coliOnly 14 pages are availabe for public view
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Abstract
Background: Escherichia coli (E. coli) are found to be the predominant uropathogen (50-90%) in urinary tract infections (UTIs). Uropathogenic E. coli (UPEC) express a multitude of virulence factors, causing UTI and antibiotic resistance against cephalosporins and quinolones. This study aimed to detect the prevalence of CTX-M and Qnr genes (QnrA, B, and S) and the distribution of the most important virulence genes (HlyA, Pap, CNF1, Afa) in UPEC isolates. Methods: In this study, a total of 50 E. coli isolates were collected from random urine samples from patients admitted at Tanta University Hospital with UTI during the period from November 2020 to November 2021. The isolates were cultured, identified, and examined by the disk diffusion method for antibiotic susceptibility test. The antibiotic resistance genes CTX-M and Qnr (QnrA, B, and S) and the virulence genes Pap, CNF1, HlyA, and Afa were detected by polymerase chain reaction (PCR) in UPEC isolates. Results: The mean age of included patients was 44.96 ± 14.17 years, with 28% male and 72% female. Pap, CNF1, HlyA, and Afa genes were positive in 18%, 12%, 10%, and 2% of isolates, respectively. CTX-M and QnrS were positive in 44% and 8% of isolates, while QnrA and B were not detected. The virulence genes were associated with clinical characteristics, mostly upper UTI infections, fever, loin pain, pyuria over 100 WBCs/HPF, and hematuria of 40- 50 RBCs/HPF. Conclusion: The prevalence of virulence and antibiotic resistance genes varies by population. The Pap gene had the highest prevalence among the studied virulence genes at our hospital, and it was strongly associated with severe UTI. CTX-M and QnrS genes were highly prevalent in our studied cohort and related to antibiotic resistance. Our findings, however, should be interpreted with caution due to the small sample size.