Background: Intra-intestinal pathogenic strains of Escherichia coli are responsible for mild to severe gastrointestinal lesions, which are mediated by various virulence factors. In this study, we have focused on a comprehensive set of E. coli pathotypes, including STEC, EPEC, EHEC, ETEC, and some hybrid pathotypes including, STEC/ ETEC, EHEC/ ETEC, and EPEC/ ETEC.Methods: Totally, 467 stool samples were obtained from gastrointestinal patients during four years (2016 to 2020). Four pathotypes of E. coli (EPEC, ETEC, EHEC, STEC) were screened due to six virulence genes, including eae, stx1, stx2, st, and lt using the conventional PCR method. Finally, detected E. coli pathotypes were subjected to determine phenotypic and genotypic β-lactam resistance properties.Result: In this study 59/467 (12.63%) strains belonged four pathotypes including STEC (20/59; 50.8%), EPEC (11/59; 18.6%), ETEC (8/59 13.5%), EHEC (5/59; 8.4%) and three novel hybrid pathotypes including STEC/ETEC (3/59; 5%), EHEC/ETEC (1/59; 1.6%), and EPEC/ETEC (1/59; 1.6%). Totally 23/59 (38.9%) isolates were identified as ESBL-producing. Conclusion: Transmission of virulence and antibiotic resistance genes among E. coli strains lead to the emergence of antimicrobial-resistant hybrid pathogenic strains, which is an important health concern. According to food-born and fecal-oral transmission of these E. coli strains, standard methods should be performed to eliminate the possible contamination of food, equipment, and living environment to manure and feces.