Molecular study of some virulence genes in Proteus mirabilis isolated from urinary tract infection patients in Sulaymaniyah, Kurdistan region/Iraq

Abstract
Urinary tract infections (UTIs) are a severe public health issue that are caused by a variety of pathogens, including Proteus mirabilis, it is the main bacterium which causes complicated (UTIs), mainly catheter-associated UTIs (CAUTIs). This study aimed to identify genes that regulate pathogenic virulence factors such as hemolysin, urease, protease enzyme activity, biofilm formation and fimbriae of P. mirabilis isolated from clinical samples in Sulaymaniyah hospitals. (117) urine samples collected from five hospitals were studied. Gender characteristics revealed that the majority of samples were from female patients (70, 59.8%); meanwhile, 47 (40.1%) were from male patients. No statistically significant correlation was found between gender and the incidence of urinary tract infections (UTIs) (Fisher’s Exact Test, p = 0.56). Although, Females had a marginally greater prevalence of UTI (92.9%, 65/70) than males (89.4%, 42/47), however this difference lacked statistical significance. Results showed that E. coli was present in 17 (14.5%), S. hemolyticus in 11 (9.4%) isolates, and P. mirabilis in 10 (8.5%). Molecular diagnosis was confirmed using PCR targeting (16S rRNA) gene, followed by DNA sequencing, and then registered in Gene Bank-NCBI; also, accession numbers were gained. Specific primers were chosen for genes (UreC, MrpA, ZapA, HpmA, LuxS). Results demonstrated that all ten isolates possessed five mentioned genes, with the exception of HpmA, which was lacking in two isolates. All Proteus mirabilis isolates demonstrated multidrug resistance (MDR), indicating a potential correlation between MDR and the expression of virulence factors, such as hemolysin synthesis and biofilm formation, among the isolates. Sequencing for the virulence genes was performed and compared to NCBI database registered sequences.