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Background  Urinary tract infection (UTI) is a common cause of morbidity worldwide. Uropathogenic  Escherichia coli  (UPEC) bacteria are the major cause of urinary tract infections. UPEC strains derive from different phylogenetic groups and possess an arsenal of virulence factors that contribute to their ability to overcome different defense mechanisms and cause disease. The objective of this study was to identify phylogroup and virulence genes of UPEC among urinary tract infection patients.    Methods  A cross sectional study was conducted from January 1, 2017 to October 9, 2017.  E. coli  bacteria were isolated from UTI patients using culture and conventional biochemical tests. Identification of phylogroup and genes that encodes for virulence factors was done using multiplex polymerase chain reaction (PCR). Data was processed and analyzed with SPSS version16.0 and Epi-info version 3.4.1 software.    Results  The most common urologic clinical manifestation combinations in this study were dysuria, urine urgency and urgency incontinence. The frequent UPEC virulence gene identified was fimH 164 (82%), followed by aer 109 (54.5%), hly 103 (51.5%), pap 59 (29.5%), cnf 58 (29%), sfa 50 (25%) and afa 24 (12%).There was significant association between pap gene and urine urgency ( p -0.016); sfa and dysuria and urine urgency ( p -0.019 and  p -0.043 respectively); hly and suprapubic pain ( p -0.002); aer and suprapubic pain, flank pain and fever ( p -0.017,  p -0.040,  p -0.029 respectively). Majority of  E. coli  isolates were phylogroup B2 60(30%) followed by D 55(27.5%), B1 48(24%) and A 37(18.5%). There was significant association between  E. coli  phylogroup B2 and three virulence genes namely afa, pap, and sfa ( p -0.014,  p -0.002,  p -0.004 respectively).    Conclusion  In this study the most frequent  E. coli  virulence gene was fimH, followed by aer, hly, pap, cnf, sfa and afa respectively. There was significant association between  E. coli  virulence genes and clinical symptoms of UTI. The phylogenetic analysis indicates majority of uropathogenic  E. coli  isolates were phylogroup B2 followed by phylogroup D. Phylogroup B2 carries more virulence genes. Hence, targeting major UPEC phylogroup and virulence genes for potential vaccine candidates is essential for better management of UTI and further research has to be conducted in this area.

Distribution of virulence genes and phylogenetics of uropathogenic Escherichia coli among urinary tract infection patients in Addis Ababa, Ethiopia