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Extended-spectrum β-lactamase-producing Escherichia coli and Virulence Genes in Pediatric Patients with Health- care Urinary Tract Infections.

Introduction Health care associated urinary tract infection (UTI) represents a major health problem especially in infants and young children. The most common pathogen associated with this infection is Escherichia coli (E.coli). Objective Therefore, the present study aimed to detect the frequency of virulence genes among clinical isolates of E.coli isolated from health care associated urinary tract infections in children and the correlation between these virulence genes and the presence of the bla-CTX gene Methods The study included one hundred clinical isolates of E.coli isolated from health care associated urinary tract infections in children in intensive care units. The isolates were subjected to antibiotics sensitivity by disc diffusion method, detection of extended spectrum beta-lactamase by double discs diffusion method. In addition, multiplex polymerase chain reaction (PCR) was used for detection of some virulence genes and PCR was used to detect bla-ctx-M gene. Results E.coli producing ESBL by double discs method was identified in 74 isolates. bla-ctx-M gene detection by PCR was identified among 38 isolates representing 51.4% of ESBL producing E.coli. There was significant association between ESBL and bla-ctx-M Gene, P=0.0001. The frequency of the studied virulence genes by multiplex PCR in the isolated E.coli were 66% for Fim gene, 75% for Aer gene, 68% for FliC gene, 53% for each of IucD gene and Usp gene, 40% for pap gene, 35% for each of afa and ironN genes and 17% for sfa gene. None of the isolated E.coli had Cdt gene. There was significant association between the presence of FimH gene (P=0.0001), Pap gene (P=0.05), sfa (P=0.026), Afa gene (P=0.018) and aer gene (P=0.035) and the presence of bla-ctx-M gene in the isolated E.coli. Conclusion The present study highlights the presence of virulence genes and bla-ctx-M gene in uropathogenic E.coli isolated from pediatric patients with health care associated urinary tract infection. There were various distributions of the studied genes with high frequency of fimbria, aer flic genes. Moreover, the ESBL had high frequency in E.coli with the presence of bla-ctx-M in about one third of the isolates. There was association between the presence of bla-ctx-M gene and virulence genes FimH, pap, sfa , Afa and aer.