Abstract

Background Antibiotic resistance is an increasing phenomenon in many bacterial pathogens including uropathogenicEscherichia 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 wasompA(93.5). ThehlyAwas the only virulence gene that was significantly more prevalent in the highly resistant isolates. TheompA,malXandhlyAgenes were obviously more abundant in the antibiotic resistant isolates in comparison to susceptible isolates. ThepapCgene 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 theompA,malXandhlyAgenes 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.