Evaluation of the Relationship Between Integrons and Class A and B Carbapenem Resistance Genes in Escherichia coli Isolated from Patients with Urinary Tract Infections

Abstract

Recently Carbapenem resistant reports increased among E.coli isolates from patients with urinary tract infection. Otherwise integrons are genetic elements with ability of integration of resistance gene cassettes in their structure facilitating the dissemination of antibiotic resistance genes. The study highlighting the detection of carbapenem resistance genes in Escherichia coli and how they are affected by the bacterial integron from 200 patients with Urinary tract infection. This cross-sectional study was conducted in Al-Sadder Medical City in Al-Najaf from the first of September to end of December 2024. E .coli isolates were identified using conventional biochemical tests and VITEK-2®System, while biofilm formation tested by Congo red agar. Antimicrobial susceptibility and phenotypic detection of carbapenemase were done using VITEK-2 AST card with disk diffusion and mCIM methods respectively. The presence of carbapenemase gene (bla-KPC, bla-GES, bla-NDM, bla-VIM and bla-IMP), Int-1and Int-2 were examined by polymerase chain reaction. Approximately 49 (24.5%) isolates of Eschericichia coli were identified from which 38(78%) were biofilm producers. Antibiotic resistant recorded  in low rate to imipenem (20.4%), meropenem (22% (and ertapenem (24%). All E.coli isolates were MDR 46(94%) except 3(6%) were XDR. The positive results of Modified Carbapenem inactivation method (mCIM) recorded in 13 isolates. The gene bla-KPC found in 6(46%) isolates, bla-NDM in 11(85%) isolates and bla-VIM in 3(23%) isolates. Neither bla-GES nor bla-IMP genes were found. All isolate have Int-1 while only 1 isolate have Int-2. The presence of integrons mainly class-1 encourage Carbapenem and multi-drug resistant, indicating their role in enhancing and spreading resistant genes.