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چکیده
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Introduction: Urinary tract infections (UTIs) are among the most common bacterial infections affecting postmenopausal women, a population that is particularly exhibition to hormonal changes, alterations in the urogenital microbiota, and increased prevalence of comorbidities. This study aimed to investigate the bacteriological profile, antimicrobial resistance patterns, and molecular characteristics of extended-spectrum β-lactamase (ESBL)-producing uropathogenic Escherichia coli (UPEC) isolated from postmenopausal women with UTIs in Kut City. Material and Methods: A total of 162 midstream urine samples were collected from symptomatic patients attending healthcare facilities between March and October 2025. Bacterial identification using conventional techniques, supported by API and Vitek 2 systems, confirmed species-level accuracy. The biochemical and morphological characteristics of the isolates were consistent with standard diagnostic profiles described in the literature. Molecular analysis was carried out by PCR method and bonds were visualized by gel electrophoresis. Results: Of the 162 samples examined, 105 (65%) showed significant bacterial growth. E. coli emerged as the predominant pathogen, accounting for 37.1% of the isolates, followed by Staphylococcus aureus (24.4%), Pseudomonas aeruginosa (13.3%), Klebsiella pneumoniae (9.5%), and Proteus mirabilis (8.5%). Antibiotic susceptibility testing showed concerning levels of resistance among the detected uropathogens, particularly E. coli. Extremely high resistance rates were recorded for commonly prescribed β-lactam antibiotics, including ampicillin (99%) and amoxicillin–clavulanic acid (97%). Resistance to cephalosporins was also substantial, reflecting the growing burden of ESBL producers in community-acquired UTIs. In contrast, nitrofurantoin and carbapenems (meropenem and imipenem) retained strong efficacy, with sensitivity rates ranging from 85% to 95%. Molecular analysis showed the E. coli isolates, 93.3% were confirmed as ESBL producers. The most frequently detected ESBL genes were blaCTX-M particularly the CTX-M-1 group (73.8%), followed by blaTEM (65.5%). Several isolates carried more than one ESBL gene. Conclusion: This study provides comprehensive bacteriological, phenotypic, and genotypic data on UTI pathogens in postmenopausal women in Kut City. The high prevalence of ESBL-producing UPEC in postmenopausal women in Kut City has significant clinical implications. The results emphasize the urgent need for antimicrobial supervision programs, routine screening for ESBL production, and carrying out of local antibiotic prescribing guidelines designed specifically for resistance patterns observed in the region.
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