Study of Some Virulence Factors and Resistance Patterns in Extended Spectrum β-Lactamases-Producing Uropathogenic Escherichia coli
Abstract
Background: The Enterobacteriaceae family is mostly responsible for infections of urinary tract, which are among the greatest prevalent conditions developed by bacteria in people, including Escherichia coli. Extended-spectrum β-lactamases (ESBLs)-producing Escherichia. Coli are a leading source of community and hospital-acquired infections globally. These bacteria are resistant to both non-β-lactam and β-lactam antibiotics. The capacity of uropathogenic Escherichia coli strains to result in urinary tract infection is associated with the formation of several virulence factors. Aim: This study was performed to isolate and determine ESBLs-producing uropathogenicEscherichia coli then find out the patterns and changes in the antibiotic resistance profile. Methods: The time range for this cross-sectional study was October 2024-January 2025, including 155 midurine samples collected from outpatients at Al-Najaf hospitals. Microscopy and macroscopic tests were performed for identifying E. coli isolates. Phenotypic recognition of ESBLs using the double disc synergy test (DDST), then molecular detection by multiplex polymerase chain reaction of virulence factors. Results: The distribution of 155 isolates showed 78 (50.3%) were UPEC strains, and the other uropathogenic bacteria were 77 (49.7%). The phenotypic method showed that 39 (50%) reported using the DDST were ESBLs-producers. Results of antibiotic susceptibility in this study among 39 ESBLs-producing UPEC isolates revealed that Meropenem had the highest susceptibility, Fosfomycin, Chloramphenicol, and Nitrofurantoin at 36 (92.3%), 38 (97.4%), 37 (94.8%), and 36 (92.3%), respectively. The results revealed that only one gene out of the five types of virulence factors, thepap gene, was observed in 12 (60%) of the isolates. The remaining factors were absent fimH, sfa, pic, aer (0.0%(. Conclusion: Most of the ESBLs-producing UPEC isolates have the pap gene, while other virulence factor genes (sfa, fimH, aer, and pic) were not encoded in the 20 UPEC isolates.
Keywords:
E. coli, ESBLs, Pap Gene, UPEC, UTI
Downloads
Download data is not yet available.
References
Abbas Al-Kadhimi, M. F., Saoudi, M., &Jarullah, B. (2025). Molecular Study of Escherichia coli Urinary Tract Infection Patients in DhiQar Governorate-Iraq. Journal of Pure & Applied Microbiology, 19(4).https://doi.org/10.22207/JPAM.19.4.54
Abubaker, K. T., &Anoar, K. A. (2022). Detection of classⅠintegrons with phenotypic ESBL detection among Enterobacteriaceae isolated from patients with urinary tract infection in Sulaimani provenance/Iraq. Iraq Medical Journal, 6(3), 86-92. https://doi.org/10.22317/imj.v6i3.1190
Ahmed, K. K., &Hawezy, A. A. (2023). Molecular detection of blaTEM, blaSHV,andblaCTX-M genes among uropathogenicEscherichia coli isolated from cases with urinary tract infection in Erbil city-Iraq. Diyala Journal of Medicine, 25(1), 67–78. https://doi.org/10.2650/DJM.25017200102
Ahmed, M. (2021). Genotypic detection of the virulence factors of uropathogenic Escherichia coli (UPEC) strains isolated from pregnant females and their correlation with antibiotic resistance pattern. Al-Azhar Journal of Pharmaceutical Sciences, 63(1), 149-172. https://doi.org/10.21608/ajps.2021.153566
Al Her, H. A. A. M. S., Alazzawi, E. A. H., & Cani, M. M. (2025). Prevalence and Antimicrobial Resistance Patterns of Escherichia Coli in Pediatric Urinary Tract Infections in Karbala, Iraq: A Four-Year Retrospective Study. Karbala Journal of Pharmaceutical Sciences, 16(26), 76-89. https://doi.org/10.62472/kjps.v16.i26.76-89
Al-Gasha’a, F. A. S.,Al-Baker, S. M., Obiad, J. M., Alrobiai, F. A. (2020). Prevalence of urinary tract infections and associated risk factors among patients attending medical city hospital in Baghdad city, Iraq. American Journal of Infectious Diseases, 16(2), 77-84. https://doi.org/10.3844/ajidsp.2020.77.84
Alghamdi, S. A. A., Mir, S. S., Alghamdi, F. S., Al Banghali, M. A. M. M. A., & Almalki, S. S. R. (2023). Evaluation of extended-spectrum beta-lactamase resistance in uropathogenic Escherichia coli isolates from urinary tract infection patients in Al-Baha, Saudi Arabia. Microorganisms, 11(12), 2820. https://doi.org/10.3390/microorganisms11122820
Al-janabi, D. R. A., &Aljanaby, A. A. J. (2024). Comparison of Escherichia coli and Proteus mirabilis in patients infected with chronic pyelonephritis in Al-Najaf Governorate, Iraq. In BIO Web of Conferences (Vol. 139, p. 06006). EDP Sciences. https://doi.org/10.1051/bioconf/202413906006
AL-Khikani, F. H. O., Kadim, B. J., Ayit, A. S., &Abidalali, M. H. (2020). Evaluation cephalosporins resistance in pathogenic bacteria isolated clinically. World News of Natural Sciences, 31, 110-119. https://agro.icm.edu.pl/agro/element/bwmeta1.element.agro-57da8dcb-d70c-4d04-8f0e-67fdcdeb0df9
Alkhudhairy, M. K., & Alshammari, M. M. M. (2019). Extended spectrum β-lactamase-producing Escherichia coli isolated from pregnant women with asymptomatic UTI in Iraq. EurAsian Journal of BioSciences, 13(2), 1881-1889.
Alsamawi, M., Joudeh, A. I., Eldeeb, Y., Al-Dahshan, A., Khan, F., Ghadban, W., ... &Alkhal, A. (2022). Epidemiology of extended-spectrum beta-lactamase producing Enterobacteriaceae in Qatar: A 3-year hospital-based study. Frontiers in Antibiotics, 1, 980686. https://doi.org/10.3389/frabi.2022.980686
Al-Tamimi, M., Albalawi, H., Shalabi, M., Abu-Raideh, J., Khasawneh, A. I., & Alhaj, F. (2022). Cefixime and cefixime-clavulanate for screening and confirmation of extended-spectrum beta-lactamases in Escherichia coli. Annals of Clinical Microbiology and Antimicrobials, 21(1), 20. https://doi.org/10.1186/s12941-022-00508-4
Altayb, H. N., Siddig, M. A., El Amin, N. M., & Mukhtar, M. M. (2021). Prevalence of blaCTX-M, blaTEM, and blaSHV Genes among Extended-spectrum?-lactamases-producing Clinical Isolates of Enterobacteriaceae in Different Regions of Sudan. Sudan Journal of Medical Sciences, 16(1), 5-16. https://doi.org/10.18502/sjms.v16i1.8933
Alwashaish, M. M., Elmeheishi, F. M., & Abbas, A. A. (2026). Clinical Significance of Extended-Spectrum β-Lactamase (ESBL) and AmpC β-Lactamase (AmpC) Coproduction among Uropathogenic Escherichia coli from Diabetic and Nondiabetic Patients: Implications for Antimicrobial Resistance and Treatment Outcomes. Libyan International Medical University Journal, 11(1). https://doi.org/10.1055/s-0045-1814412
Amro, M. M., Güler, E., Süer, K., & Güvenir, M. (2022). Which Phenotypic Method Is the Most Accurate for Detection of Extended–Spectrum β-Lactamases (ESBLs) in Escherichia coli?.Clinical and Experimental Health Sciences, 12(3), 624-628. https://doi.org/10.33808/clinexphealthsci.987433
Ari, M. M., Dashtbin, S., Ghasemi, F., Shahroodian, S., Kiani, P., Bafandeh, E., ... & Darbandi, A. (2023). Nitrofurantoin: properties and potential in treatment of urinary tract infection: A narrative review. Frontiers in Cellular and Infection Microbiology, 13, 1148603. https://doi.org/10.3389/fcimb.2023.1148603
Bahalo, S., Tajbakhsh, E., Tajbakhsh, S., Momeni, M., & Tajbakhsh, F. (2013). Detection of some virulence factors of Escherichia coli isolated from urinary tract infection isolated of children in Shahrekord Iran by multiplex PCR. Middle-East Journal of Scientific Research, 14(1), 29-32. https://doi.org/10.5829/idosi.mejsr.2013.14.1.72136
Barzegar, S., Arzanlou, M., Teimourpour, A., Esmaelizad, M., Yousefipour, M., MohammadShahi, J., &Teimourpour, R. (2022). Prevalence of the Integrons and ESBL Genes in Multidrug-Resistant Strains of Escherichia coli Isolated from Urinary Tract Infections, Ardabil, Iran. Iranian Journal of Medical Microbiology, 16(1), 56-65. https://doi.org/10.30699/ijmm.16.1.56
Başkan, C., Sezgin, F. M., Sırıken, B., Koçyiğit, A., & Ertürk, Ö. (2026). Determination of extended spectrum beta-lactamase production in uropathogen Escherichia coli isolates and in vitro activity of fosfomycin on biofilm. Biologia, 81(1), 4. https://doi.org/10.1007/s11756-025-02117-w
Castanheira, M., Simner, P. J., & Bradford, P. A. (2021). Extended-spectrum β-lactamases: an update on their characteristics, epidemiology and detection. JAC-antimicrobial Resistance, 3(3), dlab092. https://doi.org/10.1093/jacamr/dlab092
Dadi, B. R., Abebe, T., Zhang, L., Mihret, A., Abebe, W., & Amogne, W. (2020). Distribution of virulence genes and phylogenetics of uropathogenic Escherichia coli among urinary tract infection patients in Addis Ababa, Ethiopia. BMC Infectious Diseases, 20(1), 108. https://doi.org/10.1186/s12879-020-4844-z
Das, P., Mahapatra, D., & Mazumder, S. S. (2023). A Guide Towards the Phenotypic Detection of Extended-spectrum β-lactamases Production in Enterobacteriaceae: Alone or in Presence of Other Interfering Enzymes. Journal of Pure and Applied Microbiology, 17(3), 1410-1421. https://doi.org/10.22207/jpam.17.3.31
Ehsan, B., Haque, A., Qasim, M., Ali, A., & Sarwar, Y. (2023). High prevalence of extensively drug resistant and extended spectrum beta lactamases (ESBLs) producing uropathogenic Escherichia coli isolated from Faisalabad, Pakistan. World Journal of Microbiology and Biotechnology, 39, 132. https://doi.org/10.1007/s11274-023-03565-9
El Halfawy, N. M., Gouda, M. K., Elgayar, F. A., & Badran, A. A. (2026). Genomic characterization of multidrug-resistant Escherichia coli strains identified from patients with urinary tract infection in Egypt. Scientific Reports 16, https://doi.org/10.1038/s41598-026-40536-0
Emami, A. (2022). Comparing Tsh and Pic Genes in UPEC strain isolated from urinary and digestive systems infections and examining their relationship in biofilm formation. Tobacco Regulatory Science, 8(2). http://tobreg.org/index.php/journal/article/view/1171
Esfahani, S. N. M., Rostami, S., & Shafiei, A. H. (2023). The causative agents and antibiotic susceptibility patterns of Healthcare-Associated Urinary Tract Infections (HAUTIs) in Isfahan, Iran: the impact on Empiric therapy. Nephro-Urology Monthly, 15(4). https://doi.org/10.5812/numonthly-140033
Firoozeh, F., Zibaei, M., Badmasti, F., & Khaledi, A. (2022). Virulence factors, antimicrobial resistance and the relationship between these characteristics in uropathogenic Escherichia coli. Gene Reports, 27, 101622. https://doi.org/10.1016/j.genrep.2022.101622
Fonseca-Martínez, S. A., Martínez-Vega, R. A., Farfán-García, A. E., González Rugeles, C. I., & Criado-Guerrero, L. Y. (2023). Association between uropathogenic Escherichia coli virulence genes and severity of infection and resistance to antibiotics. Infection and Drug Resistance, 16, 3707-3718. https://doi.org/10.2147/idr.s391378
Ghafer, A., Ghareeb, A. M., &Mohaisen, S. H. (2022). The Prevalence of FimH and TosA Genes in Escherichia coli Isolated from Urinary Tract Infections. Iraqi Journal of Biotechnology, 21(1), 79–88. https://iasj.rdd.edu.iq/journals/uploads/2025/02/02/4fae1e7214609ead52d9006acd0e121b.pdf
Gharavi, M. J., Zarei, J., Roshani-Asl, P., Yazdanyar, Z., Sharif, M., & Rashidi, N. (2021). Comprehensive study of antimicrobial susceptibility pattern and extended spectrum beta-lactamase (ESBL) prevalence in bacteria isolated from urine samples. Scientific Reports, 11(1), 578. https://doi.org/10.1038/s41598-020-79791-0
Ghavidel, M., Gholamhosseini-Moghadam, T., Nourian, K., & Ghazvini, K. (2020). Virulence factors analysis and antibiotic resistance of uropathogenic Escherichia coli isolated from patients in northeast of Iran. Iranian Journal of Microbiology, 12(3), 223 – 230. https://doi.org/10.18502/ijm.v12i3.3240
Göksel, Ş., &Akçelik, M. (2021). Autotransporter Proteins. International Journal of Engineering Research and Development, 13(3), 49-57.https://doi.org/10.29137/umagd.1037361
Hanoon, A. K., Muslim, O. A., Aamer, H., Asfoor, A., & Bakr, H. M. (2022). Epidemiological study of bacterial uropathogens in karbala district. International Journal of Medical Sciences, 2(3), 43-45.
Hasan, S. M., & Ibrahim, K. S. (2022). Molecular characterization of extended spectrum β-lactamase (ESBL) and virulence gene-factors in uropathogenic Escherichia coli (UPEC) in children in Duhok City, Kurdistan Region, Iraq. Antibiotics, 11(9), 1246. https://doi.org/10.3390/antibiotics11091246
Helmy, A. A., Abdel Ghafar, M. T., Okda, H. I., & Abo-Elenein, A. M. (2023). Study of antibiotic resistance and virulence genes in Escherichia coli isolated from urinary tract infection patients in Tanta University Hospitals. Journal of Investigative Medicine, 71(6), 664-673. https://doi.org/10.1177/10815589231172497
Hosoi, Y., Kawanishi, M., Harada, S., Kumakawa, M., Matsuda, M., & Sekiguchi, H. (2024). The prevalence and the underlying mechanisms of fosfomycin resistance of Escherichia coli and Salmonella spp. among cattle in Japan. International Journal of Molecular Sciences, 25(24), 13723. https://doi.org/10.3390/ijms252413723
Husna, A., Rahman, M. M., Badruzzaman, A. T. M., Sikder, M. H., Islam, M. R., Rahman, M. T., ... & Ashour, H. M. (2023). Extended-spectrum β-lactamases (ESBL): challenges and opportunities. Biomedicines, 11(11), 2937. https://doi.org/10.3390/biomedicines11112937
Hussein, F. A. N., &Alwash, M. S. (2022). Molecular detection of extended spectrum ß-lactamase genes in Escherichia coli isolates from urinary tract infected patients. Journal of Applied and Natural Science, 14(4), 1485 – 1492. https://doi.org/10.31018/jans.v14i4.3948
Hussein, N. H. (2025). Molecular detection of blaTEM, blaCTX-M and blaSHV genes in ESβL harboringuropthogenic Escherichia coli (UPEC) isolated from UTIs in Baghdad, Iraq. Reviews and Research in Medical Microbiology, 36(1), 18-27. https://doi.org/10.1097/mrm.0000000000000363
Iseghohi, F., Igwe, J. C., Galadima, M., Kuta, A. F., Abdullahi, A. M., &Chukwunwejim, C. R. (2020). Prevalence of extended spectrum beta-lactamases (ESBLs)-producing Escherichia coli isolated from UTI patients attending some selected hospitals in Minna, Nigeria. Nigerian journal of biotechnology, 37(2), 56-73. https://doi.org/10.4314/njb.v37i2.6
Isidro-Coxca, M. I., Ortiz-Jiménez, S., & Puente, J. L. (2024). Type 1 fimbria and P pili: regulatory mechanisms of the prototypical members of the chaperone-usher fimbrial family. Archives of Microbiology, 206(9), 373.https://doi.org/10.1007/s00203-024-04092-3
Mahmud, Z. H., Kabir, M. H., Ali, S., Moniruzzaman, M., Imran, K. M., Nafiz, T. N., ... & Ahmed, N. (2020). Extended-spectrum beta-lactamase-producing Escherichia coli in drinking water samples from a forcibly displaced, densely populated community setting in Bangladesh. Frontiers in Public Health, 8, 228. https://doi.org/10.3389/fpubh.2020.00228
Mancuso, G., Midiri, A., Gerace, E., Marra, M., Zummo, S., & Biondo, C. (2023). Urinary tract infections: the current scenario and future prospects. Pathogens, 12(4), 623. https://doi.org/10.3390/pathogens12040623
Meena, G. L., Soni, G., & Maheshwari, D. (2021). Prevalence and antimicrobial susceptibility pattern of extended spectrum? -lactamase (esbl) producing gram negative bacilli (klebsiella pneumonia) in a tertiary care teaching hospital, in southern-west kota district of rajasthan (india). International Journal of Medical and Biomedical Studies, 5(4). https://doi.org/10.32553/ijmbs.v5i4.1864
Mhana, S. M. Y., &Aljanaby, A. A. J. (2023, July). Bacteriological investigation of pathogenic bacteria causing urinary tract infections: A Cross-Sectional Study. In IOP Conference Series: Earth and Environmental Science (Vol. 1215, No. 1, p. 012067). IOP Publishing. https://doi.org/10.1088/1755-1315/1215/1/012067
Mohammadzadeh, M., Tavakoli, M., Yaslianifard, S., Asadi, E., Golmohammadi, R., &Mirnejad, R. (2019). Genetic diversity and antibiotic susceptibility of uropathogenic Escherichia coli isolates from kidney transplant recipients. Infection and Drug Resistance, 1795-1803. https://doi.org/10.2147/idr.s200811
Mohammed, E. J., Hasan, K. C., & Allami, M. (2022). Phylogenetic groups, serogroups and virulence factors of uropathogenic Escherichia coli isolated from patients with urinary tract infection in Baghdad, Iraq. Iranian Journal of Microbiology, 14(4), 445-457. https://doi.org/10.18502/ijm.v14i4.10230
Muteeb, G., Rehman, M. T., Shahwan, M., & Aatif, M. (2023). Origin of antibiotics and antibiotic resistance, and their impacts on drug development: A narrative review. Pharmaceuticals, 16(11), 1615. https://doi.org/10.3390/ph16111615
Muthukrishnan, P. D., Mohanakrishnan, A., Ambalavanan, A., Kumar, R., & Ramya, D. V. (2025). Validation of a mobile application for early detection of developmental delays in children aged 0 to 5 years: a prospective observational study. Tpm–Testing, Psychometrics, Methodology in Applied Psychology, 32(S2), 1686-1694. https://tpmap.org/submission/index.php/tpm/article/view/830
Osman, O. M. S., Osman, A., &Abushama, H. M. (2024). Detection of uropathogenicescherichia coli virulence factors’ fimh and flic h7 in urinary tract infections and their association with antibiotics resistance among Sudanese children. International Journal of Scientific Research in Science, Engineering and Technology, 11(6), 74-87. https://doi.org/10.32628/ijsrset24116163
Perera, P. D. V. M., Gamage, S., De Silva, H. S. M., Jayatilleke, S. K., de Silva, N., Aydin, A., ... & Corea, E. M. (2022). Phenotypic and genotypic distribution of ESBL, AmpC β-lactamase and carbapenemase-producing Enterobacteriaceae in community-acquired and hospital-acquired urinary tract infections in Sri Lanka. Journal of Global Antimicrobial Resistance, 30, 115-122. https://doi.org/10.1016/j.jgar.2022.05.024
Quan, J., Dai, H., Liao, W., Zhao, D., Shi, Q., Zhang, L., ... & Yu, Y. (2021). Etiology and prevalence of ESBLs in adult community-onset urinary tract infections in East China: a prospective multicenter study. Journal of Infection, 83(2), 175-181. https://doi.org/10.1016/j.jinf.2021.06.004
Rahman, M. M., Hossain, M. M. K., Rubaya, R., Halder, J., Karim, M. E., Bhuiya, A. A., ... & Alam, J. (2022). Association of antibiotic resistance traits in uropathogenic Escherichia coli (UPEC) isolates. Canadian Journal of Infectious Diseases and Medical Microbiology, 2022(1), 4251486. https://doi.org/10.1155/2022/4251486
Shoaib, M., Hameed, M. F., Aqib, A. I., Wang, W., Wang, Q., Wang, S., & Pu, W. (2025). Emerging threat of antimicrobial resistance determinants and plasmid replicon types acquisition by Escherichia coli of poultry and other food-producing animal origin in China: Local findings with global implications. Poultry Science, 106055. https://doi.org/10.1016/j.psj.2025.106055
Tayh, G., Nagarjuna, D., Sallem, R. B., Verma, V., Yahia, H. B., Gharsa, H., ... & Slama, K. B. (2021). Identification of Virulence Factors Among ESBL-Producing Escherichia coli Clinical Isolates from GAZA Strip, Palestine: Virulence Genes among ESBL-producing E. coli. Journal of Microbiology, Biotechnology and Food Sciences, 11(3), e2865-e2865. https://doi.org/10.15414/jmbfs.2865
Trinh, K. T. L., & Lee, N. Y. (2022). Recent methods for the viability assessment of bacterial pathogens: advances, challenges, and future perspectives. Pathogens, 11(9), 1057. https://doi.org/10.3390/pathogens11091057
Whelan, S., Lucey, B., & Finn, K. (2023). Uropathogenic Escherichia coli (UPEC)-associated urinary tract infections: the molecular basis for challenges to effective treatment. Microorganisms, 11(9), 2169. https://doi.org/10.3390/microorganisms11092169
Yang, X., Chen, H., Zheng, Y., Qu, S., Wang, H., & Yi, F. (2022). Disease burden and long-term trends of urinary tract infections: A worldwide report. Frontiers in Public Health, 10, 888205. https://doi.org/10.3389/fpubh.2022.888205
Zagaglia, C., Ammendolia, M. G., Maurizi, L., Nicoletti, M., & Longhi, C. (2022). Urinary tract infections caused by uropathogenic Escherichia coli strains—new strategies for an old pathogen. Microorganisms, 10(7), 1425.https://doi.org/10.3390/microorganisms10071425
Zhou, Y., Zhou, Z., Zheng, L., Gong, Z., Li, Y., Jin, Y., ... & Chi, M. (2023). Urinary tract infections caused by uropathogenic Escherichia coli: mechanisms of infection and treatment options. International Journal of Molecular Sciences, 24(13), 10537. https://doi.org/10.3390/ijms241310537
Abubaker, K. T., &Anoar, K. A. (2022). Detection of classⅠintegrons with phenotypic ESBL detection among Enterobacteriaceae isolated from patients with urinary tract infection in Sulaimani provenance/Iraq. Iraq Medical Journal, 6(3), 86-92. https://doi.org/10.22317/imj.v6i3.1190
Ahmed, K. K., &Hawezy, A. A. (2023). Molecular detection of blaTEM, blaSHV,andblaCTX-M genes among uropathogenicEscherichia coli isolated from cases with urinary tract infection in Erbil city-Iraq. Diyala Journal of Medicine, 25(1), 67–78. https://doi.org/10.2650/DJM.25017200102
Ahmed, M. (2021). Genotypic detection of the virulence factors of uropathogenic Escherichia coli (UPEC) strains isolated from pregnant females and their correlation with antibiotic resistance pattern. Al-Azhar Journal of Pharmaceutical Sciences, 63(1), 149-172. https://doi.org/10.21608/ajps.2021.153566
Al Her, H. A. A. M. S., Alazzawi, E. A. H., & Cani, M. M. (2025). Prevalence and Antimicrobial Resistance Patterns of Escherichia Coli in Pediatric Urinary Tract Infections in Karbala, Iraq: A Four-Year Retrospective Study. Karbala Journal of Pharmaceutical Sciences, 16(26), 76-89. https://doi.org/10.62472/kjps.v16.i26.76-89
Al-Gasha’a, F. A. S.,Al-Baker, S. M., Obiad, J. M., Alrobiai, F. A. (2020). Prevalence of urinary tract infections and associated risk factors among patients attending medical city hospital in Baghdad city, Iraq. American Journal of Infectious Diseases, 16(2), 77-84. https://doi.org/10.3844/ajidsp.2020.77.84
Alghamdi, S. A. A., Mir, S. S., Alghamdi, F. S., Al Banghali, M. A. M. M. A., & Almalki, S. S. R. (2023). Evaluation of extended-spectrum beta-lactamase resistance in uropathogenic Escherichia coli isolates from urinary tract infection patients in Al-Baha, Saudi Arabia. Microorganisms, 11(12), 2820. https://doi.org/10.3390/microorganisms11122820
Al-janabi, D. R. A., &Aljanaby, A. A. J. (2024). Comparison of Escherichia coli and Proteus mirabilis in patients infected with chronic pyelonephritis in Al-Najaf Governorate, Iraq. In BIO Web of Conferences (Vol. 139, p. 06006). EDP Sciences. https://doi.org/10.1051/bioconf/202413906006
AL-Khikani, F. H. O., Kadim, B. J., Ayit, A. S., &Abidalali, M. H. (2020). Evaluation cephalosporins resistance in pathogenic bacteria isolated clinically. World News of Natural Sciences, 31, 110-119. https://agro.icm.edu.pl/agro/element/bwmeta1.element.agro-57da8dcb-d70c-4d04-8f0e-67fdcdeb0df9
Alkhudhairy, M. K., & Alshammari, M. M. M. (2019). Extended spectrum β-lactamase-producing Escherichia coli isolated from pregnant women with asymptomatic UTI in Iraq. EurAsian Journal of BioSciences, 13(2), 1881-1889.
Alsamawi, M., Joudeh, A. I., Eldeeb, Y., Al-Dahshan, A., Khan, F., Ghadban, W., ... &Alkhal, A. (2022). Epidemiology of extended-spectrum beta-lactamase producing Enterobacteriaceae in Qatar: A 3-year hospital-based study. Frontiers in Antibiotics, 1, 980686. https://doi.org/10.3389/frabi.2022.980686
Al-Tamimi, M., Albalawi, H., Shalabi, M., Abu-Raideh, J., Khasawneh, A. I., & Alhaj, F. (2022). Cefixime and cefixime-clavulanate for screening and confirmation of extended-spectrum beta-lactamases in Escherichia coli. Annals of Clinical Microbiology and Antimicrobials, 21(1), 20. https://doi.org/10.1186/s12941-022-00508-4
Altayb, H. N., Siddig, M. A., El Amin, N. M., & Mukhtar, M. M. (2021). Prevalence of blaCTX-M, blaTEM, and blaSHV Genes among Extended-spectrum?-lactamases-producing Clinical Isolates of Enterobacteriaceae in Different Regions of Sudan. Sudan Journal of Medical Sciences, 16(1), 5-16. https://doi.org/10.18502/sjms.v16i1.8933
Alwashaish, M. M., Elmeheishi, F. M., & Abbas, A. A. (2026). Clinical Significance of Extended-Spectrum β-Lactamase (ESBL) and AmpC β-Lactamase (AmpC) Coproduction among Uropathogenic Escherichia coli from Diabetic and Nondiabetic Patients: Implications for Antimicrobial Resistance and Treatment Outcomes. Libyan International Medical University Journal, 11(1). https://doi.org/10.1055/s-0045-1814412
Amro, M. M., Güler, E., Süer, K., & Güvenir, M. (2022). Which Phenotypic Method Is the Most Accurate for Detection of Extended–Spectrum β-Lactamases (ESBLs) in Escherichia coli?.Clinical and Experimental Health Sciences, 12(3), 624-628. https://doi.org/10.33808/clinexphealthsci.987433
Ari, M. M., Dashtbin, S., Ghasemi, F., Shahroodian, S., Kiani, P., Bafandeh, E., ... & Darbandi, A. (2023). Nitrofurantoin: properties and potential in treatment of urinary tract infection: A narrative review. Frontiers in Cellular and Infection Microbiology, 13, 1148603. https://doi.org/10.3389/fcimb.2023.1148603
Bahalo, S., Tajbakhsh, E., Tajbakhsh, S., Momeni, M., & Tajbakhsh, F. (2013). Detection of some virulence factors of Escherichia coli isolated from urinary tract infection isolated of children in Shahrekord Iran by multiplex PCR. Middle-East Journal of Scientific Research, 14(1), 29-32. https://doi.org/10.5829/idosi.mejsr.2013.14.1.72136
Barzegar, S., Arzanlou, M., Teimourpour, A., Esmaelizad, M., Yousefipour, M., MohammadShahi, J., &Teimourpour, R. (2022). Prevalence of the Integrons and ESBL Genes in Multidrug-Resistant Strains of Escherichia coli Isolated from Urinary Tract Infections, Ardabil, Iran. Iranian Journal of Medical Microbiology, 16(1), 56-65. https://doi.org/10.30699/ijmm.16.1.56
Başkan, C., Sezgin, F. M., Sırıken, B., Koçyiğit, A., & Ertürk, Ö. (2026). Determination of extended spectrum beta-lactamase production in uropathogen Escherichia coli isolates and in vitro activity of fosfomycin on biofilm. Biologia, 81(1), 4. https://doi.org/10.1007/s11756-025-02117-w
Castanheira, M., Simner, P. J., & Bradford, P. A. (2021). Extended-spectrum β-lactamases: an update on their characteristics, epidemiology and detection. JAC-antimicrobial Resistance, 3(3), dlab092. https://doi.org/10.1093/jacamr/dlab092
Dadi, B. R., Abebe, T., Zhang, L., Mihret, A., Abebe, W., & Amogne, W. (2020). Distribution of virulence genes and phylogenetics of uropathogenic Escherichia coli among urinary tract infection patients in Addis Ababa, Ethiopia. BMC Infectious Diseases, 20(1), 108. https://doi.org/10.1186/s12879-020-4844-z
Das, P., Mahapatra, D., & Mazumder, S. S. (2023). A Guide Towards the Phenotypic Detection of Extended-spectrum β-lactamases Production in Enterobacteriaceae: Alone or in Presence of Other Interfering Enzymes. Journal of Pure and Applied Microbiology, 17(3), 1410-1421. https://doi.org/10.22207/jpam.17.3.31
Ehsan, B., Haque, A., Qasim, M., Ali, A., & Sarwar, Y. (2023). High prevalence of extensively drug resistant and extended spectrum beta lactamases (ESBLs) producing uropathogenic Escherichia coli isolated from Faisalabad, Pakistan. World Journal of Microbiology and Biotechnology, 39, 132. https://doi.org/10.1007/s11274-023-03565-9
El Halfawy, N. M., Gouda, M. K., Elgayar, F. A., & Badran, A. A. (2026). Genomic characterization of multidrug-resistant Escherichia coli strains identified from patients with urinary tract infection in Egypt. Scientific Reports 16, https://doi.org/10.1038/s41598-026-40536-0
Emami, A. (2022). Comparing Tsh and Pic Genes in UPEC strain isolated from urinary and digestive systems infections and examining their relationship in biofilm formation. Tobacco Regulatory Science, 8(2). http://tobreg.org/index.php/journal/article/view/1171
Esfahani, S. N. M., Rostami, S., & Shafiei, A. H. (2023). The causative agents and antibiotic susceptibility patterns of Healthcare-Associated Urinary Tract Infections (HAUTIs) in Isfahan, Iran: the impact on Empiric therapy. Nephro-Urology Monthly, 15(4). https://doi.org/10.5812/numonthly-140033
Firoozeh, F., Zibaei, M., Badmasti, F., & Khaledi, A. (2022). Virulence factors, antimicrobial resistance and the relationship between these characteristics in uropathogenic Escherichia coli. Gene Reports, 27, 101622. https://doi.org/10.1016/j.genrep.2022.101622
Fonseca-Martínez, S. A., Martínez-Vega, R. A., Farfán-García, A. E., González Rugeles, C. I., & Criado-Guerrero, L. Y. (2023). Association between uropathogenic Escherichia coli virulence genes and severity of infection and resistance to antibiotics. Infection and Drug Resistance, 16, 3707-3718. https://doi.org/10.2147/idr.s391378
Ghafer, A., Ghareeb, A. M., &Mohaisen, S. H. (2022). The Prevalence of FimH and TosA Genes in Escherichia coli Isolated from Urinary Tract Infections. Iraqi Journal of Biotechnology, 21(1), 79–88. https://iasj.rdd.edu.iq/journals/uploads/2025/02/02/4fae1e7214609ead52d9006acd0e121b.pdf
Gharavi, M. J., Zarei, J., Roshani-Asl, P., Yazdanyar, Z., Sharif, M., & Rashidi, N. (2021). Comprehensive study of antimicrobial susceptibility pattern and extended spectrum beta-lactamase (ESBL) prevalence in bacteria isolated from urine samples. Scientific Reports, 11(1), 578. https://doi.org/10.1038/s41598-020-79791-0
Ghavidel, M., Gholamhosseini-Moghadam, T., Nourian, K., & Ghazvini, K. (2020). Virulence factors analysis and antibiotic resistance of uropathogenic Escherichia coli isolated from patients in northeast of Iran. Iranian Journal of Microbiology, 12(3), 223 – 230. https://doi.org/10.18502/ijm.v12i3.3240
Göksel, Ş., &Akçelik, M. (2021). Autotransporter Proteins. International Journal of Engineering Research and Development, 13(3), 49-57.https://doi.org/10.29137/umagd.1037361
Hanoon, A. K., Muslim, O. A., Aamer, H., Asfoor, A., & Bakr, H. M. (2022). Epidemiological study of bacterial uropathogens in karbala district. International Journal of Medical Sciences, 2(3), 43-45.
Hasan, S. M., & Ibrahim, K. S. (2022). Molecular characterization of extended spectrum β-lactamase (ESBL) and virulence gene-factors in uropathogenic Escherichia coli (UPEC) in children in Duhok City, Kurdistan Region, Iraq. Antibiotics, 11(9), 1246. https://doi.org/10.3390/antibiotics11091246
Helmy, A. A., Abdel Ghafar, M. T., Okda, H. I., & Abo-Elenein, A. M. (2023). Study of antibiotic resistance and virulence genes in Escherichia coli isolated from urinary tract infection patients in Tanta University Hospitals. Journal of Investigative Medicine, 71(6), 664-673. https://doi.org/10.1177/10815589231172497
Hosoi, Y., Kawanishi, M., Harada, S., Kumakawa, M., Matsuda, M., & Sekiguchi, H. (2024). The prevalence and the underlying mechanisms of fosfomycin resistance of Escherichia coli and Salmonella spp. among cattle in Japan. International Journal of Molecular Sciences, 25(24), 13723. https://doi.org/10.3390/ijms252413723
Husna, A., Rahman, M. M., Badruzzaman, A. T. M., Sikder, M. H., Islam, M. R., Rahman, M. T., ... & Ashour, H. M. (2023). Extended-spectrum β-lactamases (ESBL): challenges and opportunities. Biomedicines, 11(11), 2937. https://doi.org/10.3390/biomedicines11112937
Hussein, F. A. N., &Alwash, M. S. (2022). Molecular detection of extended spectrum ß-lactamase genes in Escherichia coli isolates from urinary tract infected patients. Journal of Applied and Natural Science, 14(4), 1485 – 1492. https://doi.org/10.31018/jans.v14i4.3948
Hussein, N. H. (2025). Molecular detection of blaTEM, blaCTX-M and blaSHV genes in ESβL harboringuropthogenic Escherichia coli (UPEC) isolated from UTIs in Baghdad, Iraq. Reviews and Research in Medical Microbiology, 36(1), 18-27. https://doi.org/10.1097/mrm.0000000000000363
Iseghohi, F., Igwe, J. C., Galadima, M., Kuta, A. F., Abdullahi, A. M., &Chukwunwejim, C. R. (2020). Prevalence of extended spectrum beta-lactamases (ESBLs)-producing Escherichia coli isolated from UTI patients attending some selected hospitals in Minna, Nigeria. Nigerian journal of biotechnology, 37(2), 56-73. https://doi.org/10.4314/njb.v37i2.6
Isidro-Coxca, M. I., Ortiz-Jiménez, S., & Puente, J. L. (2024). Type 1 fimbria and P pili: regulatory mechanisms of the prototypical members of the chaperone-usher fimbrial family. Archives of Microbiology, 206(9), 373.https://doi.org/10.1007/s00203-024-04092-3
Mahmud, Z. H., Kabir, M. H., Ali, S., Moniruzzaman, M., Imran, K. M., Nafiz, T. N., ... & Ahmed, N. (2020). Extended-spectrum beta-lactamase-producing Escherichia coli in drinking water samples from a forcibly displaced, densely populated community setting in Bangladesh. Frontiers in Public Health, 8, 228. https://doi.org/10.3389/fpubh.2020.00228
Mancuso, G., Midiri, A., Gerace, E., Marra, M., Zummo, S., & Biondo, C. (2023). Urinary tract infections: the current scenario and future prospects. Pathogens, 12(4), 623. https://doi.org/10.3390/pathogens12040623
Meena, G. L., Soni, G., & Maheshwari, D. (2021). Prevalence and antimicrobial susceptibility pattern of extended spectrum? -lactamase (esbl) producing gram negative bacilli (klebsiella pneumonia) in a tertiary care teaching hospital, in southern-west kota district of rajasthan (india). International Journal of Medical and Biomedical Studies, 5(4). https://doi.org/10.32553/ijmbs.v5i4.1864
Mhana, S. M. Y., &Aljanaby, A. A. J. (2023, July). Bacteriological investigation of pathogenic bacteria causing urinary tract infections: A Cross-Sectional Study. In IOP Conference Series: Earth and Environmental Science (Vol. 1215, No. 1, p. 012067). IOP Publishing. https://doi.org/10.1088/1755-1315/1215/1/012067
Mohammadzadeh, M., Tavakoli, M., Yaslianifard, S., Asadi, E., Golmohammadi, R., &Mirnejad, R. (2019). Genetic diversity and antibiotic susceptibility of uropathogenic Escherichia coli isolates from kidney transplant recipients. Infection and Drug Resistance, 1795-1803. https://doi.org/10.2147/idr.s200811
Mohammed, E. J., Hasan, K. C., & Allami, M. (2022). Phylogenetic groups, serogroups and virulence factors of uropathogenic Escherichia coli isolated from patients with urinary tract infection in Baghdad, Iraq. Iranian Journal of Microbiology, 14(4), 445-457. https://doi.org/10.18502/ijm.v14i4.10230
Muteeb, G., Rehman, M. T., Shahwan, M., & Aatif, M. (2023). Origin of antibiotics and antibiotic resistance, and their impacts on drug development: A narrative review. Pharmaceuticals, 16(11), 1615. https://doi.org/10.3390/ph16111615
Muthukrishnan, P. D., Mohanakrishnan, A., Ambalavanan, A., Kumar, R., & Ramya, D. V. (2025). Validation of a mobile application for early detection of developmental delays in children aged 0 to 5 years: a prospective observational study. Tpm–Testing, Psychometrics, Methodology in Applied Psychology, 32(S2), 1686-1694. https://tpmap.org/submission/index.php/tpm/article/view/830
Osman, O. M. S., Osman, A., &Abushama, H. M. (2024). Detection of uropathogenicescherichia coli virulence factors’ fimh and flic h7 in urinary tract infections and their association with antibiotics resistance among Sudanese children. International Journal of Scientific Research in Science, Engineering and Technology, 11(6), 74-87. https://doi.org/10.32628/ijsrset24116163
Perera, P. D. V. M., Gamage, S., De Silva, H. S. M., Jayatilleke, S. K., de Silva, N., Aydin, A., ... & Corea, E. M. (2022). Phenotypic and genotypic distribution of ESBL, AmpC β-lactamase and carbapenemase-producing Enterobacteriaceae in community-acquired and hospital-acquired urinary tract infections in Sri Lanka. Journal of Global Antimicrobial Resistance, 30, 115-122. https://doi.org/10.1016/j.jgar.2022.05.024
Quan, J., Dai, H., Liao, W., Zhao, D., Shi, Q., Zhang, L., ... & Yu, Y. (2021). Etiology and prevalence of ESBLs in adult community-onset urinary tract infections in East China: a prospective multicenter study. Journal of Infection, 83(2), 175-181. https://doi.org/10.1016/j.jinf.2021.06.004
Rahman, M. M., Hossain, M. M. K., Rubaya, R., Halder, J., Karim, M. E., Bhuiya, A. A., ... & Alam, J. (2022). Association of antibiotic resistance traits in uropathogenic Escherichia coli (UPEC) isolates. Canadian Journal of Infectious Diseases and Medical Microbiology, 2022(1), 4251486. https://doi.org/10.1155/2022/4251486
Shoaib, M., Hameed, M. F., Aqib, A. I., Wang, W., Wang, Q., Wang, S., & Pu, W. (2025). Emerging threat of antimicrobial resistance determinants and plasmid replicon types acquisition by Escherichia coli of poultry and other food-producing animal origin in China: Local findings with global implications. Poultry Science, 106055. https://doi.org/10.1016/j.psj.2025.106055
Tayh, G., Nagarjuna, D., Sallem, R. B., Verma, V., Yahia, H. B., Gharsa, H., ... & Slama, K. B. (2021). Identification of Virulence Factors Among ESBL-Producing Escherichia coli Clinical Isolates from GAZA Strip, Palestine: Virulence Genes among ESBL-producing E. coli. Journal of Microbiology, Biotechnology and Food Sciences, 11(3), e2865-e2865. https://doi.org/10.15414/jmbfs.2865
Trinh, K. T. L., & Lee, N. Y. (2022). Recent methods for the viability assessment of bacterial pathogens: advances, challenges, and future perspectives. Pathogens, 11(9), 1057. https://doi.org/10.3390/pathogens11091057
Whelan, S., Lucey, B., & Finn, K. (2023). Uropathogenic Escherichia coli (UPEC)-associated urinary tract infections: the molecular basis for challenges to effective treatment. Microorganisms, 11(9), 2169. https://doi.org/10.3390/microorganisms11092169
Yang, X., Chen, H., Zheng, Y., Qu, S., Wang, H., & Yi, F. (2022). Disease burden and long-term trends of urinary tract infections: A worldwide report. Frontiers in Public Health, 10, 888205. https://doi.org/10.3389/fpubh.2022.888205
Zagaglia, C., Ammendolia, M. G., Maurizi, L., Nicoletti, M., & Longhi, C. (2022). Urinary tract infections caused by uropathogenic Escherichia coli strains—new strategies for an old pathogen. Microorganisms, 10(7), 1425.https://doi.org/10.3390/microorganisms10071425
Zhou, Y., Zhou, Z., Zheng, L., Gong, Z., Li, Y., Jin, Y., ... & Chi, M. (2023). Urinary tract infections caused by uropathogenic Escherichia coli: mechanisms of infection and treatment options. International Journal of Molecular Sciences, 24(13), 10537. https://doi.org/10.3390/ijms241310537
Statistics
0 Views | 0 Downloads
How to Cite
Alkhudhairy, M. and Alkurdi, B. (2026) “Study of Some Virulence Factors and Resistance Patterns in Extended Spectrum β-Lactamases-Producing Uropathogenic Escherichia coli”, International Journal of Advancement in Life Sciences Research, 9(2), pp. 174-185. doi: https://doi.org/10.31632/ijalsr.2026.v09i02.013.
Section
Research Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
.