Citrobacter freundii is one of the most important pathogens that cause urinary tract infection in human because it harbors many types of antimicrobials resistance-associated genes. Therefore, this study aimed to evaluate the prevalence of antimicrobial resistance-associated genes citrobacter freundii isolated from patients with urinary tract infection in Al-Najaf governorate-Iraq. A total of 30 strains of citrobacter freundii isolated from urine samples of patients with urinary tract infection in Al-Najaf central hospital in Al-Najaf City, Iraq, during April to December 2018. Polymers chain reaction technique was used to detect the presence of antimicrobial resistance-associated genes. From the 30 strains of citrobacter freundii, 15 strains (50%) were positive for bla-tem gene, 16 strains (53.3%) were positive for bla-shv gene, 21 strains (70%) were positive for bla-ctxm gene, 3 strains (10%) were positive for bla-ctxm-1 gene, 6 strains (20%) were positive for bla-ctxm-2 gene. Interestingly, it should be noted that no any strain form the 30 we tested was carrying pse1, bla-ctxm-8, bla-ctxm-9 or bla-ctxm-25 genes. Our data showed that 19 strains (63.3%) were positive for cat1 gene, 9 strains (30%) were positive for cat2 gene and 4 strains (13.3%) were positive for cat3 gene. On the other hand, 17 strains (56.6%) were carrying qnrA gene, 11 strains (36.6%) were carrying qnrB gene and aac(6')-Ib-cr gene. Also, the results proved that there were 7 strains (23.3%) being positive for sul1 gene and 11 strains (36.6%) were positive for sul2 gene. We also found 22 strains (73.3%) being positive for strA-strB gene and 4 isolates (13.3%) were positive for aacC1 genes. No strain carrying aacC2, tetA and tetB genes was identified. Citrobacter freundii harbor large numbers of different antimicrobial resistance-associated genes that enable this pathogen to escape the effect of antibiotics which make this bacteria highly resistant causing urinary tract infection.

Citrobacter freundii is one of the most causative agents of urinary tract infection in human due to their high antimicrobials resistance. Therefore, this study aimed to evaluate the ability of Citrobacter freundii to resist to fifteen antimicrobials. A total of 461 urine samples were collected from patients infected with urinary tract infection, females and males, age groups between 18 to 60 years old performed in Al-Najaf central hospital in Al-Najaf City, Iraq, during April to December 2018. Antimicrobials susceptibility testing was performed by disc diffusion method according to the Kirby-Bauer method onto Mueller Hinton agar surface. There were 30 isolates (6.5%) diagnosed as Citrobacter freundii. Antimicrobial resistance rate of the 30 isolates to Amoxicillin and Chloramphenicol were all high (25 isolates 83.4%), Ciprofloxacin, Streptomycin and Sulfonamide (24 isolates 80%). The good resistance rate was observed for Penicillin, Amoxiclav and Ceftazidime (21 isolates 70%). The moderate resistance rate was observed for Cefotaxime (19 isolates 63.3%), Ceftriaxone (20 isolates 66.7%), Gentamicin (15 isolates 50%), Tobramycin (18 isolates 60%) and Erythromycin (20 isolates 66.7%). The lowest resistance rate was observed for Tetracycline (19 isolates 63.3%). While Imipenem provided full antibacterial activity (30 isolates 100%). Of the total 30 isolates, 22 (73.3%) were multi-drug resistance, 8(26.7%) extensive-drug resistance and no isolates were pan-drug resistance. While 19 isolates (63.3%) were extended-spectrum beta-lactamase producing Citrobacter freundii. Citrobacter freundii has highly resistant against most antimicrobials and became more dangerous bacteria cause urinary tract infection.