Background: Antimicrobial resistance (AMR) is a critical public health threat, particularly in regions with a high prevalence of extended-spectrum β-lactamase (ESBL)and AmpC β-lactamase-producing Enterobacteriaceae. Data from Iraq remain limited despite the escalating burden of multidrug-resistant infections. Objective: This study aimed to determine the prevalence and genetic profiles of ESBL and AmpC β-lactamases among Escherichia coli and Klebsiella pneumoniae isolates from urinary tract infections (UTIs) in Al-Hilla, Babylon Province, Iraq. Methods: A total of 215 urine samples were collected from hospitalized and non-hospitalized patients across seven healthcare facilities. Bacterial identification was performed using culture, Gram staining, biochemical tests, and VITEK-2 system. Phenotypic detection of ESBL and AmpC was performed using the combined disk tests. Genotypic characterization was carried out via multiplex PCR for the major ESBL (blaTEM, blaSHV, blaCTX-M, blaOXA) and plasmid-mediated AmpC genes. Results: E. coli (53%) and K. pneumoniae (28%) were predominant pathogens. Phenotypic ESBL production was confirmed in 100% of the isolates. The most prevalent ESBL gene was blaOXA (80%), followed by blaCTX-M (70%), blaTEM (52%) and blaSHV (48%). The predominant AmpC gene is blaDHA (62%). Co-production of multiple β-lactamase genes was common, with 15 distinct genotypic profiles identified in E. coli and 10 in K. pneumoniae. Conclusion: This study revealed an alarmingly high prevalence of ESBL and AmpC β-lactamase genes among uropathogens in Iraq, indicating a serious public health concern. The high rate of co-production underscores the need for enhanced antimicrobial stewardship, robust surveillance, and alternative treatment strategies to combat multidrug-resistant infections.
Khaleel et al. (Sat,) studied this question.