Molecular Prevalence of E. coli and Enterobacter cloacae Caused Urinary Tract Infections in Iraqi Patients

The prevalence of antibiotic resistance in Enterobacteriaceae has increased sharply in recent years. Extended-spectrum -lactamase-producing Enterobacteriaceae include E. coli and E. coli and Enterobacter cloacae have become especially common. Although traditionally linked to risk factors such as prior hospitalization and antibiotic use, these bacteria have become increasingly recognized in the community, especially as pathogens in urinary tract infections (UTIs). This pattern of community-acquired resistance is concerning, as it may dictate a need for use of broader-spectrum antibiotics when initiating empiric therapy for routine infections. Aims of present study were to review the impact of E. coli and Enterobacter cloacae in urinary tract infections, and study the role of chuA and yjaA genes and anonymous DNA fragment TspE4C2 in the molecular detection of E. coli and Enterobacter cloacae in the Iraqi patients clinically diagnosed with urinary tract infection. In this study urine samples from 75 patients clinically diagnosed with urinary tract infection were used for Gram staining, culture, API 20 E, singleplex PCR and multiplex PCR methods. Singleplex and multiplex PCR were performed with primers targeted to chuA and yjaA genes and anonymous DNA fragment TspE4C2 of E. coli and Enterobacter cloacae. The results of the singleplex and multiplex PCR were compared with conventional methods of Gram staining, culture and API 20E test. The positive singleplex and multiplex PCR products were identified by presence of ~279 bp, ~211 bp and ~152 bp amplicons of chuA and yjaA genes and anonymous DNA fragment TspE4C2 for both of E. coli and Enterobacter cloacae. Conventional methods of Gram staining, culture and API 20E test showed positive result for E. coli in 14 (18.6 %) out of 75 patients clinically diagnosed with urinary tract infection and positive result for Enterobacter cloacae in 10 (13.3 %) out of 75 patients. PCR detected 13 (17.3 %) out of the 14 (18.6 %) samples that were positive for E. coli and detected 9 (12 %) out of the 10 (13.3 %) samples that were positive for Enterobacter cloacae by using these conventional methods. The majority of urinary tract infections (UTIs) caused by spectrum -lactamase-producing Enterobacteriaceae include E. coli and Enterobacter cloacae were acquired in the community, so rapid, specific and sensitive molecular method such as multiplex PCR method is urgently needed to better prevalence, prevent and treat these infections in Iraq.