Abstract
Background: Uropathogenic Escherichia coli (E. coli) or UPEC is among major nosocomial
pathogens causing urinary tract infections (UTIs). The emergence of carbapenem- resistant
strains is a major concern regarding the UTI treatment. The subjective of this study included
assessment of genetic relation and screening of virulence factors among carbapenemaseproducing E. coli from UTI.
Methods: Three-hundred E. coli isolates were collected from cystitis and pyelonephritis.
Antibiotic susceptibility test was conducted by disk diffusion as provided by clinical and
laboratory standards institute (CLSI) version 2017. Carbapenemase production and related
genes and virulence factors were screened by polymerase chain reaction (PCR) technique.
Genetic relation of isolates was evaluated using phylogrouping and serogrouping.
Results: Of 300 isolates, 11 (3.66%) of them were carbapenemase-producing E. coli (CP-E.
coli). Imipenem minimum inhibitory concentration ranged 4-128µg/ml. The bla OXA-48 and
blaIMP genes were co-existed in three (1%) isolates (imipenem MIC: 64-128µg/ml), but the bla
KPC, bla NDM and bla VIM were not amplified. Predominant virulence genes included iutA
(n=293, 97.66%), fyuA (n=256, 85.33%), inh (n=249, 83%), traT (n=247, 82.33%), pap?
(n=96, 32%), fimH (n=93, 31%), csgA (n=92, 30.66%). All the CP-E. coli contained the iutA,
fyuA, traT, papII, fimH and csgA genes. O1 (32%), O16 (15%) and O25 (7%) serogroups were
predominant and 6/11, 4/11 and 1/11 of CP-E. coli belonged to O1, O25 and O75 serogroups,
respectively. Among eleven CP-E. coli isolates, nine of them were belonged to the B2