The investigation of p fimbriae presence in escherichia coli strains isolated from urine samples and their antibacterial resistance

The most important virulence factor of Escherichia coli that it's commonly isolated from urinary tract infections (UTI) is pyelonephritis associated P fimbriae (pap). In this study, after the isolation of E. coli from patients with UTI, the investigation of the presence of P fimbriae, extended spectrum β-lactamase (ESBL) enzymes, and antimicrobial resistance of isolates were aimed. The material of the study was consisted of 133 E. coli strains isolated from urine samples in a one year period. After the isolation of microorganisms with conventional methods, identification was performed with polymerase chain reaction (PCR). The presence of ESBL enzyme and antibiotic resistance profiles to 20 antibiotics as which phenotypically belong to 7 antimicrobial families were investigated with disc diffusion test (DDT) and double disc synergy test (DDST), respectively. The presence of ESBL genes (blaTEM, blaCTX, blaOXA, blaSHV) and P fimbriae genes (papA, papG) were also investigated. Chi-square test was used to compare the antibiotic resistance and sensitivities of i) ESBL producing and non-producing and ii) papA and papG bearing and non-bearing isolates. It was determined that 50.30%, 41.90% and 13.80% of isolates were resistant to ciprofloxacine, trimethoprime sulphamethoxazole, cefazoline, respectively, while antibiotic resistances for other 17 antibiotics varying between 0.75% and 9.80% according to DDT. It was determined that 49.7% of isolates were found as ESBL positive as phenotypically, while 59.4% were genetically positive. The percentages of genes detected with PCR were 32.3%, 31.6%, 21.0%, 2.3% for blaTEM, blaCTX, blaOXA, blaSHV, respectively. A total of 51 pap genes (12.0% papA, 26.3% papG) were detected in the 27.0% of total isolates. The statistically significance was found between i)ESBL producing and non-producing isolates for ciprofloxacine, trimethoprime sulphamethoxazole ii) between ciprofloxacin resistance and the presence of papG in Chi-square test. Further studies should be designed to investigate the plasmids of ESBL positive E. coli stains isolated from UTI and whether plasmids are responsible for ESBL production.