Detection of ESBL/AmpC-producing Escherichia coli and Klebsiella pneumoniae from urinary tract infections in Al-Hilla, Iraq | ||
Microbes and Infectious Diseases | ||
Articles in Press, Accepted Manuscript, Available Online from 27 September 2025 | ||
Document Type: Original Article | ||
DOI: 10.21608/mid.2025.420583.3177 | ||
Authors | ||
Noorhan Ameer Khaleel* 1; Mourouge Saadi Abbas2; Liqaa Yahya Mohsen Mohsen2 | ||
1Department of Biology, College of Science, University of Babylon, Iraq. | ||
2Department of Biology, College of Science, University of Babylon, Iraq | ||
Abstract | ||
Background: Antimicrobial resistance (AMR) is a critical public health threat, particularly in regions with a high prevalence of extended-spectrum β-lactamase (ESBL)and AmpC β-lactamase-producing Enterobacteriaceae. Data from Iraq remain limited despite the escalating burden of multidrug-resistant infections. Objective: This study aimed to determine the prevalence and genetic profiles of ESBL and AmpC β-lactamases among Escherichia coli and Klebsiella pneumoniae isolates from urinary tract infections (UTIs) in Al-Hilla, Babylon Province, Iraq. Methods: A total of 215 urine samples were collected from hospitalized and non-hospitalized patients across seven healthcare facilities. Bacterial identification was performed using culture, Gram staining, biochemical tests, and VITEK-2 system. Phenotypic detection of ESBL and AmpC was performed using the combined disk tests. Genotypic characterization was carried out via multiplex PCR for the major ESBL (blaTEM, blaSHV, blaCTX-M, blaOXA) and plasmid-mediated AmpC genes. Results: E. coli (53%) and K. pneumoniae (28%) were predominant pathogens. Phenotypic ESBL production was confirmed in 100% of the isolates. The most prevalent ESBL gene was blaOXA (80%), followed by blaCTX-M (70%), blaTEM (52%) and blaSHV (48%). The predominant AmpC gene is blaDHA (62%). Co-production of multiple β-lactamase genes was common, with 15 distinct genotypic profiles identified in E. coli and 10 in K. pneumoniae. Conclusion: This study revealed an alarmingly high prevalence of ESBL and AmpC β-lactamase genes among uropathogens in Iraq, indicating a serious public health concern. The high rate of co-production underscores the need for enhanced antimicrobial stewardship, robust surveillance, and alternative treatment strategies to combat multidrug-resistant infections. | ||
Keywords | ||
Extended-Spectrum β -Lactamases; AmpC β -Lactamases; Urinary Tract Infections; Drug Resistance; Iraq | ||
Statistics Article View: 57 |