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Prevalence of pks-positive Escherichia coli in Iraqi Patients with Urinary Tract Infections or Bladder Cancer

Medical Laboratory Techniques, College of Health and Medical Technology, Southern Technical University,
Basra, Iraq
*(e-mail:; Mobile: 964 0 77233 54137)
(Received: January 4, 2023; Accepted: February 11, 2023)


Escherichia coli has been considered as one of the most common microorganisms associated with UTIs. Colibactin is a bacterial toxin encoded by pks pathogenicity island which is composed of clbA-Sgenes. The aim of this study was to investigate the prevalence of pks+E. coli among patients with urinary tract infections and bladder cancer. E. coli isolates were identified by routine microbiological methods. PCR with specific primers were used to confirm the E. coli identification and for phylogenetic grouping and pks genes. clbB gene was used as a main marker in addition to clbQ and clbA genes, which are closely located near to the 5′ and 3′ ends of the pks island. Antibiotics susceptibility tests were performed by using disc diffusion and VITEC methods. One hundred & thirty six E. coli isolates were identified containing 50, 25.5, 23.5 and 1% belonging to B2, A, B1 and D phylo-groups, respectively. Out of 94 E. coli strains showed 100% resistance to ceftizoxime, cefsulodin, cefuroxime and norfloxan, followed by piperacillin (94.73%), ticarcillin (94.63%), trimethoprim (91.13%) and tetracycline (90% ) and high susceptibility (> 85%) to Ceftazidime/Avibactam, Amikacin, Imipenem, Meropenem and gentamycin. Out of 84 strains, 12 E. coli strains (8.82%) showed positive results for all tested genes (ClbA, ClbB, ClbQ), of which 9 (75%) strains were isolated from UTIs and 3 (25%) strains from patients with bladder cancer. Most of the pks+ strains (75%) belonged to phylogenic B2 group. These findings provided essential baseline data, which would contribute to understanding facts of the epidemiology of possibly genotoxic phenotypes of E. coli and their clinical consequence.
Key words : E. coli, clbB, clbA, clbQ, B2 phylogroup