التحري عن بعض عوامل الضراوة لبكتريا Escherichia coli المرافقة لمرضى الفشل الكلوي والتهاب المسالك البولية

Investigation of some Virulence Factors of Escherichia Coli Associated with Renal Failure and Urinary Tract Patients

ABSTRACT

This study included the collection of 130 urine samples It included 30 samples each from patients with kidney failure, patients with kidney failure accompanied by urinary tract infection, and patients with urinary tract infection who were attending the Imam Hussein medical city / dialysis unit and a urology consultant for age groups between (20-70) years for both sexes, As well as 40 samples from healthy people. The samples were cultured on the medium of blood agars and MacConkey ⸲ then the growing bacterial cultures were subjected to microscopic and biochemical examinations.
This study also included collecting blood samples from the same patients described above to determine the concentration of the Toll-like immune receptor TLR4 as well as to estimate the activity of the enzyme Superoxide Dismutase (SOD) and the concentration of glutathione. The results showed the following:
The collection of 57 bacterial isolates and after treatment with a potassium hydroxide solution (3%), they were distributed as 47 negative isolates for Gram stain from the total number of isolated bacteria, and 10 positive isolates for this stain. After diagnosing the bacterial isolates by culture and biochemical methods, it became clear that E.coli bacteria are dominant, With 22 isolates. as their diagnosis was molecularly confirmed using the Pho A gene.
By testing the sensitivity of E.coli isolates to antibiotics using the Vitec system, it was found that all isolates were 100% sensitive to Imipenem, 95.4% to Amikacin, 72.7% to Gentamicin and Cefepime, while the isolates were 90.9% resistant to Ticarcillin and Piperacillin, and 63.6% to Sulfamethoxazole and 50% for the antibiotics Ticarcillin-Clavulanic acid, Aztreonam and Tobramycin.
Molecular detection of some virulence and antibiotic resistance genes in E.coli bacteria, as it was found that 11 (50%) isolates possess the hemolysin gene hly A, 12 (54%) isolates possess the fim H gene, and 7 (31.81%) bacterial isolates possess the ctx-M gene.
Through the results of estimating the toll -like immune receptor TLR4, it became clear that the age group between (40-59) years showed the highest immune response, as the concentration of this immune receptor reached 1.115 ng / ml. The results of the statistical analysis confirmed the presence of significant differences p<0.05 in the concentration of this receptor in the age group between (20-39) years, while the remaining two age groups did not show any significant differences.
By estimating the effectiveness of the Automatic antioxidants in patients with kidney failure and patients with kidney failure who have urinary tract injuries as well as people with urinary tract infection and compare them with the effectiveness of the enzyme in healthy people, it became clear from the results that the highest effectiveness of the SOD enzyme was recorded in healthy people, which amounted to 15.353 units /ml ⸲ while it was noted that there is a moral decrease in the effectiveness of this in both patients with kidney failure and patients with kidney failure accompanied by urinary tract infections.
The results of estimating the concentration of glutathione in the groups under study showed a high concentration of this compound in healthy people (6.697 µm/ml), while a significant decrease in its concentration was observed in both patients with renal failure and patients with renal failure who had urinary tract injuries.