Molecular Detection of Cytotoxic Necrotizing Factor Type 1 Gene (CNF1) of Uropathogenic E. coli Isolated from Bladder and Prostate Cancer Patients

Abstract

Uropathogenic Escherichia coli (E. coli) produces cytotoxic necrotizing factor 1 (CNF-1). This factor influences epithelial cells and is a key virulence factor of uropathogenic E. coli, playing an essential role in bladder and prostate cancers.

Molecular identification of the cnf1 gene in uropathogenic E. coli isolated from patients with bladder and prostate cancer was performed using polymerase chain reaction (PCR). This cross-sectional study included 150 urine samples obtained from patients with prostate and bladder cancer attending various hospitals in Baghdad, Iraq, from November 2024 to February 2025. All urine samples were analyzed both microscopically and macroscopically, cultured on blood agar and MacConkey agar, subjected to biochemical testing, and validated using the VITEK-2 system. Antibiotic susceptibility testing and molecular identification of isolated E. coli were performed by PCR targeting the cnf1 gene.

Of 150 urine samples, only 59.3% showed growth, with several bacterial species identified. Just 16% of samples were identified as E. coli and were obtained from prostate and bladder cancers. PCR analysis revealed that only 8 isolates contained the cnf1 gene. The antibiotic susceptibility test demonstrated varying levels of sensitivity and resistance. All 8 isolates containing the cnf1 gene showed elevated resistance to cefclidine (100%). The remaining 16 isolates lacking the cnf1 gene exhibited greater resistance to loracarbef (100%).

The research found that the cnf1 gene is genotoxic and can influence cellular differentiation, apoptosis, and proliferation. These findings underscore the importance of the cnf1 gene in urological infections and highlight the need for further studies on its association with antimicrobial resistance.