MOLECULAR DETECTION AND CHARACTERIZATION OF PAPGII, HLYA, AND IUCC VIRULENCE GENES AMONG UROPATHOGENIC ESCHERICHIA COLI ISOLATES FROM ACUTE PYELONEPHRITIS AND CYSTITIS

Abstract

Background:
Uropathogenic Escherichia coli (UPEC) remains the principal cause of urinary tract infections (UTIs), displaying a wide spectrum of disease from cystitis to severe pyelonephritis. Molecular virulence determinants such as P-fimbrial adhesin (papGII), α-hemolysin (hlyA), and aerobactin (iucC) facilitate colonization, immune evasion, and tissue injury.

Objectives:
To determine the prevalence of papGII, hlyA, and iucC genes among E. coli isolates from cystitis and pyelonephritis patients and to correlate molecular findings with clinical outcomes and antimicrobial resistance.

Methods:
Ninety UPEC isolates (45 from acute pyelonephritis, 45 from cystitis) were identified by conventional methods. DNA was extracted via heat-lysis and amplified for papGII, hlyA, and iucC using SYBR Green PCR. Statistical comparison was performed with χ² test using SPSS v25.

Results:
papGII, hlyA, and iucC were detected in 40 %, 17.7 %, and 40 % of pyelonephritis isolates, and 28.9 %, 22.2 %, and 31.1 % of cystitis isolates, respectively. Co-occurrence of papGII and iucC was strongly associated with upper-tract infection (p < 0.05). Presence of hlyA correlated with hematuria and elevated CRP. No isolate contained all three genes simultaneously.

Conclusion:
The study highlights a higher prevalence of papGII and iucC genes in pyelonephritis strains, implying their synergistic role in renal invasion. Integration of molecular profiling with clinical data may improve diagnostic accuracy and guide future vaccine or anti-adhesion strategies.