Investigation of Some Virulence Genes of Uropathogenic Escherichia coli isolated from patients with Urinary Tract Infection in Mosul City, Iraq

Approximately 150 million people are infected (UTIs) affect up to 150 million people worldwide, and Escherichia coli (E. coli) is the leading cause of these infections globally. This study investigated the morphological, biochemical, and antibiotic susceptibility profiles of these bacteria using the VETIK2 system. The study also identified the virulence and antiviral gene profiles of E. coli strains identified in the GenBank database and discovered a new gene (FamsAh LC842012.1) that is a major cause of UTIs in patients in Mosul, Iraq.

Materials and Methods: 37 urine samples were collected from Al-Hayat International Hospital in Mosul from September 1 to November 31, 2025. Bacterial isolation was done by MacConkey, Eosin Methylene Blue (EMB) and blood agar. Confirmation was done by Gram staining, IMViC tests, catalase and urease tests, TSI (Triple Sugar Iron) agar reactions, and 16S rRNA sequencing. Antimicrobial susceptibility tests were conducted by the Vitek-2 system with 15 antibiotics. Virulence genes were detected by PCR in a reference strain registered as a new isolate (FaMsAh LC842012.1) in NCBI (National Center for Biotechnology Information).

Results: Out of 37 uropathogens, E. coli (14, 37.8%) was the most commonly identified organism. All the isolates were Gram-negative bacilli. They showed pink colonies on MacConkey agar and a metallic green sheen on EMB agar, and an IMViC profile of (++−−). Molecular identification through 16S rRNA, identified the isolates as E. coli. Most isolates showed extensive multidrug resistance (MDR Uropathogenic E. coli) among 9 of the 15 antibiotics tested, including amoxicillin-clavulanate, piperacillin-tazobactam, and several cephalosporins. However, the isolates were susceptible to the carbapenems (imipenem, meropenem) and to gentamicin, fosfomycin, nitrofurantoin and trimethoprim-sulfamethoxazole. The positive PCR revealed the presence of all virulence factors, (fimH, stx1, eae, hlyA), and then, the first hybrid UPEC/STEC/EPEC of its kind. 

Conclusions: The first emerging strain of multidrug-resistant Uropathogenic E. coli (UPEC) with the unprecedented presence of virulence genes associated with diarrheal disease was identified in Iraq. Monitoring the emerging UPEC strains in Iraq is of utmost importance.