Background: Antibiotic resistance is an increasing phenomenon in many bacterial pathogens including uropathogenic Escherichia coli. Hypothetical anti-virulent agents could be a solution, but first clear virulence associated gene-pool of antibiotic resistant isolates have to be determined. The aim of this study is to investigate the significant associations between genes encoding VFs with antibiotic resistance and phylogenetic groups in UPEC isolates. Results: The majority of 248 UPEC isolates belonged to phylogenetic group B2 (67.3%). The maximum and minimum resistance was attributed to amoxicillin (90.3%) and both fosfomycin and imipenem (1.6%) respectively. 11.3% of isolates were resistant to all antibiotic agents except that of imipenem, nitrofurantoin and fosfomycin. These highly resistant isolates were placed only in group B2 and D. The most prevalent virulence gene was ompA (93.5%). The hlyA was the only virulence gene that was significantly more prevalent in the highly resistant isolates. The ompA, malX and hlyA genes were obviously more abundant in the antibiotic resistant isolates in comparison to susceptible isolates. The papC gene was associated with amoxicillin resistance (p-value = 0.006, odds ratio: 26.00). Conclusions: Increased resistance to first line drugs prescribed for UTIs were detected in CA-UPEC isolates in our study.. Minimal resistance was observed against nitrofurantoin, fosfomycin and imipenem. Therefore, they are introduced for application in empirical therapy of UTIs. Fosfomycin may be the most effective antibiotic agent against highly resistant UPEC isolates. The presence of the ompA, malX and hlyA genes were significantly associated with resistance to different antibiotic agents. We assume that the ability of UPEC isolates to upgrade their antibiotic resistance capacity may occurs in compliance with the preliminary existence of specific virulence associated genes. But, more investigation with higher number of bacterial isolates, further virulence associated genes and comparison of gene pools from CA-UPEC isolates with HA-UPEC are proposed to confirm these finding and discovering new aspects of this association.

Background: Enterobacter cloacae complex (ECC) including different species are isolated from different human clinical samples. ECC is armed by many different virulence genes (VGs) and they were also classified among ESKAPE group by WHO recently. The present study was designed to find probable association between VGs and antibiotic susceptibility in different ECC species. Methods: Forty-five Enterobacter isolates that were harvested from different clinical samples were classified in four different species. Seven VGs were screened by PCR technique and antibiotic susceptibility assessment was performed by disk-diffusion assay. Result: Four Enterobacter species; Enterobacter cloacae (33.3%), Enterobacter hormaechei (55.6%), Enterobacter kobei (6.7%) and Enterobacter roggenkampii (4.4%) were detected. Minimum antibiotic resistance was against carbapenem agents and amikacin even in MDR isolates. 33.3% and 13.3% of isolates were MDR and XDR respectively. The rpoS (97.8%) and csgD (11.1%) showed maximum and minimum frequency respectively. Blood sample isolated were highly virulent but less resistant in comparison to the other sample isolates. The csgA, csgD and iutA genes were associated with cefepime sensitivity. Conclusion: The fepA showed a predictory role for differentiating of E. hormaechei from other species. More evolved iron acquisition system in E. hormaechei was hypothesized. The fepA gene introduced as a suitable target for designing novel anti-virulence/antibiotic agents against E. hormaechei. Complementary studies on other VGs and ARGs and with bigger study population is recommended.

Proteus mirabilis (P. mirabilis) is one of the frequent causes of urinary tract infection in humans. This pathogen armed by diverse virulence associated factors. Biofilm formation and swarming motility are two surface living behaviors of P. mirabilis and their association with virulence associated genes was investigated in the present study. Biofilm formation ability and swarming motility were evaluated by microtiter plate assay and top-agar travel tracking in 91 P. mirabilis isolates respectively. The polymerase chain reaction method was used for screening of 10 virulence associated genes. Association of virulence associated genes with biofilm formation ability and also swarming motility was analyzed statistically. The zapA (100%) and hlyA (41.8%) genes had maximum and minimum frequency respectively. Forty-one, 35 and 15 isolates were categorized as weak, intermediate and strong biofilm producers respectively. While, 11%, 38.5% and 50.5% of isolates were grouped as weak, intermediate and strong swarmers respectively. Adhesin encoding genes such as mrpA were more prevalent in strong biofilm producers in comparison to the other isolates. Reversal association of rsmA gene with swarming motility was detected. The frequency of hlyA gene was associated directly with swarming motility and in opposite way with biofilm formation. Reverse correlation of biofilm formation ability and swarming motility was estimated. Based on the study findings it is hypothesized that P. mirabilis benefited from adhesins such as MR/P fimbriae for production of biofilm and successful colonization and then they shift from biofilm formers to strong swarmers in order to reach deeper urinary organs and HlyA toxin is used to overcome the immune system cells. However, it has to confirmed trough future studies.

Motility plays a major role in pathogenicity of Helicobacter pylori, yet there is scarce data regarding its chemotactic behaviour. The present study was designed to investigate the chemotactic responses of local isolates of H. pylori towards various sugars, amino acids, as well as some other chemical substances. Chemotaxis was assayed by a modified Adler's method. We used solutions of sugars, amino acids as well as urea, sodium chloride, sodium and potassium bicarbonate, sodium deoxycholate and keratin at 10 mM concentrations. Despite some small differences, tested H. pylori isolates generally had a positive chemotaxis towards the tested sugars (P< 0.05). Among amino acids, phenylalanine, aspartic acid, glutamic acid, isoleucine and leucine showed a positive chemotaxis (P< 0.05) ; however, tyrosine showed negative chemotaxis (repellent) (P< 0.15). Urea, sodium chloride, sodium and potassium bicarbonate showed to be attractants (P< 0.05), but sodium deoxycholate was repellent (P< 0.05). It seems that, sugars and many amino acids by their attraction for H.pylori, many amino acids, may enhance the activity of this bacterium and probably aggravate the symptoms of its infection. However, those like L-tyrosine, may possibly be employed as deterrents for H. pylori and thus can control its infections. However, we suggest that further investigations on chemotactic behaviour of many more strains of H. pylori should be carried out before a final conclusion.