Background and Objectives: Urinary tract infections are one of the most commonly associated human infectious diseases caused by the bacteria Escherichia coli. Escherichia coli is described as having a large number of virulence genes that enable drug resistance, which is a cause for great concern. Monitoring of antimicrobial susceptibility is critical to determining the scope of the problem and selecting appropriate antimicrobial drugs. The current study aimed to identify the distribution of uropathogenic E. coli (UPEC) based on genetic profiles and to determine resistance patterns among isolates. Materials and Methods: This study employed biological correlations to study the patterns of antibiotic resistance and the distribution of phylogenetic groups of 118 isolates of E. coli and the relationship between them, which were isolated from three hospitals in Baghdad, Iraq. Results: The results of phylogenetic analysis showed that phylogroup F was the most common group among E. coli isolates (37.3%), followed by phylogroups C (20.3%), B2 (15.3%), E (14.4%), UP (4.2%), A and D (3.4%), and B1 (1.7%). The majority of antibiotic resistance patterns were related to penicillin groups (80.5%) and the least to the sulfonamide groups (67.0%). 51.7%, 42.4%, and 1.7% of isolates were Extensive Drug Resistance (XDR), Multi-Drug Resistance (MDR), and Pan Drug Resistance (PDR), respectively. Antibiotic resistance was most commonly detected in group F (35.6%). Conclusion: Our observations revealed that the dominant phylogroup F had the highest prevalence of multi-drug resistance and extensive drug resistance among E. coli isolates. The newly identified phylogroups C, E, and F account for about 72.0% of the E. coli isolates. Such investigations should be conducted in other localities as well, in order to gain a better understand- ing of the pattern of antibiotic resistance patterns and the frequency of distinct phylogenetic groups.

Introduction and Aim: Escherichia coli strains are derived from several phylogenetic groups and have an array of virulence factors such as fimbrial adhesins, which are expressed by the Dr/Afa gene clusters and contribute to overcoming diverse defense mechanisms, resist drugs, and causing disease. The study sought to ascertain the prevalence of the Dr/Afa genes and resistance patterns among E. coli isolated from patients suffering from recurrent urinary tract infections. Materials and Methods:In this prospective cross-sectional study, a maximum of 500 mid-stream urine samples were collected from UTI patients identified at medical centers in Baghdad, Iraq. Antimicrobial susceptibility tests and polymerase chain reaction were used to determine the resistance pattern and gene distribution among isolates, respectively, as well as biochemical tests to diagnose isolates. Results:Research data revealed that recurrent urinary tract infections were associated with the pathogen E. coli (43.88%), followed by Klebsiella pneumoniae (12.82%). The results demonstrated significant antibiotic resistance patterns among isolates associated with recurrent UTIs and the most common antibiotic resistance was observed with penicillin (81.4%), followed by 81 (68.6%) sulfonamides and 63 (53.4%) fluoroquinolones. Molecular studies of the Dr/Afa operon using polymerase chain reaction, revealed several genotypes for genes within the operon. Among isolates studied the prevalence of the gene draA gene was 62 (52.5%), draB 41 (34.7%), draC 66 (55.9%), draD 65 (55.1%), draE 64 (54.2%), and draP 95 (80.5%). Furthermore, XDR and MDR-resistant phenotypes were significantly prevalent in isolates harboring hetero Dr/Afa fimbriae. Conclusion:The results of this study indicate an inverse correlation between the presence of antibiotic resistance patterns and the prevalence of Dr/Afa genes wherein, the isolates with fewer fimbrial adhesion genes were found to be highly resistant. This study implies the Dr/Afa genes involvement in developing UTIs, suggesting that they might be associated with antibiotic resistance and recurrent UTIs.