?Adnan Kareem Abd Al-Salami

Abstract P_To examine the dissemination of blaTEM and blaSHV genes in Escherichia coli isolate from patients with significant bacteriuria. Methods_ During the study period, antibiotic susceptibility patterns were studied in a total of 38 isolates of E. coli. The isolates also examined to determining the presence of blaTEM and blaSHV genes by PCR assay. Conjugation experiments were performed by using rifampicin resistance E. coli MM294 as the recipient. Results_ All isolates were resistance to at least five of the antibiotics tested (multidrug resistance, MDR) and sensitive to imipenem. PCR assay revealed that 57.1% and 14.3% of the isolates carried blaTEM and blaSHV genes, respectively, additionally 9.5% of the isolates harbored both genes. Conjugation experiments and PCR trials confirmed that the blaTEM positive E. coli isolates tested were able to transfer thisurposgene in transconjugants. Conclusions: There was a high occurrence of MDR isolates in patients with significant bacteriuria and theblaTEM gene was common among isolates.

ABSTRACT Background: Over the past two decades, antibiotic resistance has increased significantly in Gram-negative bacilli (GNB) and in many cases has been linked with increased mortality and health-care costs. The multidrug-resistant (MDR) bacteria such as Pseudomonas aeruginosa (P. aeruginosa) and Acinetobacter baumannii (A. baumannii) and various Enterobacteriaceae including Klebsiella, and Escherichia coli can cause severe and often deadly infections those are frequently reported in the hospitals and clinics. This study aimed to investigate the resistance patterns of GNB commonly encountered in our hospital as well as the outcome of the infection caused by these bacterial agents. Materials and Methods: The samples were processed from a culture and sensitivity test. The isolates were identified primarily by conventional method and then confirmed by Vitek 2 compact system, also antimicrobial sensitivity test was performed using the Vitek 2 compact system. Results: A total of 293 samples were collected from adult patients admitted to AL-Sader Medical City, Najaf, Iraq, from July 1, 2019, to January 7, 2020. The Gram-negative isolates were collected from clinical samples that included urine, wound swab, ear swab, sputum, and pus. Urine specimens accounted for a majority 163 (55.64%) of the clinical samples which yielded GNB, followed by wound swab 75(25.59%), ear swab 29 (9.89%), sputum 22 (7.51%), and pus 4 (1.37%). E. coli was the predominated bacteria 150 (51.19%) followed by P. aeruginosa 59 (20.13%) and Klebsiella pneumoniae 50 (17.06%). The remaining 34 (11.59%) of isolates included Proteus mirabilis 15 (5.11%), A. baumannii 10 (3.41%), and Enterobacter spp. 9 (3.07%). E. coli was leading microorganism isolated from pus 4 (100%) and urine 119 (73.0%); P. aeruginosa was dominant bacteria isolated from ear swab 18 (62.06%) and wound swab 26 (34.66%); and Klebsiella pneumoniae was common microorganism isolated from sputum 9 (40.90%). GNB were showed variable resistant to different types of antibiotics, but E. coli and K. pneumoniae were exhibited high resistance to ceftazidime (CAZ) 119 (58.62%) and 43 (21.18%); cefepime (FEP) 89 (60.13%) and 30 (20.27%); and ceftriaxone (CRO) 74 (62.18%) and 25 (21.00%), respectively. All members of GNB were shown high resistant to CAZ 203 (19.80%), FEP 148 (14.44%), and CRO 119 (11.61%) compared with other types of antibiotics. Out of 293 GNB, 119 (40.61%) isolated were exhibited MDR microorganisms (MDROs). Conclusions: We can conclude from our study that most GNB were isolated from urine samples. E. coli was the predominated bacteria followed by P. aeruginosa. GNB were showed variable resistance to a different type of antibiotics, but all members of GNB were shown high resistance to CAZ 203 (19.80%), FEP 148 (14.44%), and CRO 119 (11.61%). The isolates were exhibit multi-drug resistant microorganisms.