MOLECULAR STUDY OF EXTEND SPECTRUM β -LACTAMASES AMONG EXTRAINTESTINAL ENTEROBACTER CLOACAE RECOVERED FROM PATIENTS WITH CAUTI, HILLA-IRAQ

Background: Enterobacter cloaca is important nosocomial pathogens responsible for various infections including catheter associated urinary tract infections (CAUTIs) and lower respiratory tract infections. It can be assigned to one of main four phylogenetic groups including intestinal (A and B1) groups and extraintestinal (B2 and D) groups. Many (ESBLs) can be found in E. cloacae like blaTEM, blaCTX-M, blaSHV and blaOXA. It was also have the ability to form biofilm and rendering them resistant to antimicrobials and host defenses. Material: Uriscan test (using urine strip) was used to detect pyuria among urine samples. All samples were cultured on routine culture medium and the suspected isolates confirmed with automated diagnosis with Viteck 2 Compact system and then by conventional PCR for 16s rRNA gene for E. cloacae. The confirmed E. cloacae isolates investigated genotepically to identify the phylogenetic group and only extraintestinal E. cloacae isolates will screened for ESBLs phenotypes (using DDST) and the confirmed by genotypic assessments for ESBLs production. Results: Among 120 urine samples only 53 (44.16%) of samples positive for culture (Bacteriuria) among which 7 (13.20%) isolates (from different urine samples), were phenotypically and genotepically identified as E. cloacae. Five isolates of E. cloacae were biofilm former. The results of phylogenetic analysis revealed that only two isolates belong to intestinal phylogenetic groups (group A and B1) while the rest, five isolates, belongs to extra intestinal groups (four isolates belong to group B2 and single isolates belong to group D). The phenotypic investigation of ESBLs display that, two isolates were negative for of ESBLs while five isolates were positive. The genotypic investigation of ESBLs results revealed that (3/7) E. cloacae isolates carrying blaTEM, blaSHV, blaCTX-M genes. Conclusions: Although E. cloacae was intestinal opportunistic pathogen, but can cause serious extraintestinal infections like CAUTI which may be still untreatable due to their possessing of differ types of ESBLs like blaTEM, blaSHV, blaCTX-M.