A Study on The Pathogenicity of Escherichia Coli Producing Extended-Spectrum Β Isolated from Urological Patients and its Association With Some Immunological Biomarkers from Hospitalized Adult Patients

Abstract

Objective: The objective of this research is to discover Escherichia coli bacteria that produce the broad
spectrum beta-lactamase enzyme and assess their resistance to antibiotics, as well as their toxicity in animals. 
A total of 40 clinical samples were obtained from inpatient individuals diagnosed with urinary tract infections. 
These samples were collected from both serum and urine sources, and the collection process was overseen by 
a specialist doctor from Balad General Hospital, Al-Dujail Surgical Hospital, as well as several well-known 
clinics. The data collection period spanned from January 2, 2023, to March 1, 2023. 
Methodology: The identification of the isolates involved a two-step process. Initially, selective media were 
employed to detect the bacteria responsible for urinary tract infections and differentiate them from other 
bacterial species. This was achieved by cultivating the isolates on UTI ChromoSelect Agar medium. 
Subsequently, the isolates were cultured on ESBL Chrome Agar medium, which specifically targets bacteria that produce the broad-spectrum beta-lactamase enzyme. The distinctive characteristics of the resulting 
colonies were utilised for further identification. In terms of morphology, the analysis revealed that 10 out of 
the total isolates, accounting for 25%, were identified as Escherichia coli, a bacterium known for its production 
of the broad-spectrum beta-lactamase enzyme. 
Results: All bacterial isolates exhibited resistance to multiple drug-resistant (MDR) antibiotics. Specifically, 
all isolates shown resistance to Cefepime, Cefotaxime, Ceftazidime, Ceftriaxone, and Pipracillin. Additionally, 
30% of the isolates displayed resistance to Ciprofloxacin, while 40% of the isolates were resistant to 
Gentamycin and Nitrofurantoin. All specimens exhibited sensitivity to Imipenem. 
Conclusion :The results obtained from the enzyme-linked immunosorbent assay revealed that all samples that 
secreted broad-spectrum beta-lactamase exhibited elevated serum concentrations of interleukin IL-17. Notably, 
the minimum serum concentration (QTA = 135.2 pg/ml) surpassed the median serum concentration standard 
X ̅ = 59.158 pg/ml by a factor greater than two. A statistically significant difference was observed with a 99% 
confidence level (p = 0.000 < 0.01) in the serum concentrations of interleukin between samples exhibiting 
urinary system infection without detectable growth of ESBL E.Coli on the appropriate culture media, and 
samples exhibiting urinary system infection with visible growth. The enzyme-linked immunosorbent test 
(ELISA) revealed a statistically significant distinction, with a 99% confidence level (p = 0.000 < 0.01), in the 
serum amounts of lipopolysaccharide (LPS) between samples exhibiting ESBL E.Coli infection on the suitable 
culture conditions. In cases where there is no observable proliferation of ESBL E. Coli on suitable culture 
medium, the urinary tract exhibits no discernible growth. Conversely, when samples from individuals with 
urinary tract infections are cultured on proper media, the presence of apparent ESBL E. Coli growth is seen.