Detection of classⅠintegrons with phenotypic ESBL detection among enterobacteriaceae isolated from patients with urinary tract infection in Sulaimani provenance/ Iraq

Abstract

Objectives: This study aims to evaluate class Ⅰ integrons and ESBL detection in members of Enterobacteriaceae obtained from Urinary tract infection samples. Methods: Four hundred mid-stream urine sample were collected from patients admitting to Shar teaching hospital, Sulaimani teaching hospital, Anwar Shexa medical city hospital with signs and symptoms of UTI, and inoculated on different culture media. Colony morphology, gram staining, and VITEK 2 compact were used for bacterial identification, antibiotic profile and ESBL screened phenotypically by antibiotic profile results and double disk synergy test and confirmed by combined disk test methods. Conventional PCR was used to detect classⅠ Integron by using a specific primer and the result was analyzed, sequenced and uploaded into NCBI. Results: Among four hundred samples the prevalence rate of Enterobacteriaceae was 67.03 which includes 86 E. coli, 32 Klebsiella pneumoniae, and two isolates of Proteus mirabilis, according to the antibiotic profile, the most sensitive antibiotic among all three isolates were Imipenem, meropenem, and nitrofurantoin, while most resistance antibiotic were nalidixic acid and third generation cephalosporin. The prevalence rate of ESBL-producing Enterobacteriaceae was 56.6% by the confirmatory test which was a combined disk test, and the prevalence rate of classⅠintegron was 54.2%. Conclusion: A significant majority of the isolates under study had integrons gene and were ESBL positive. As a result, proactive antibiotic surveillance systems are required in both clinical and community settings in order to stop the occurrence and spread of antibiotic resistance genes among diverse bacterial species.