Molecular Detection of FimH and FimA Adhesion Genes in Enterobacter Species Isolated from Clinical Samples in Thi-Qar Province

Background: Enterobacter spp. is opportunistic pathogens frequently implicated in healthcare-associated infections, particularly among immunocompromised individuals. Their virulence is closely associated with adhesion genes such as FimH and FimA, which promote biofilm formation, host cell colonization, and contribute to antibiotic resistance. Objective: This study aimed to determine the prevalence of Enterobacter spp. in clinical samples and to detect the adhesion genes FimH and FimA using molecular techniques. Methods: A total of 120 clinical specimens including 67 urine samples, 32 wound swabs, and 21 burn swabs were collected from Al-Hussein Teaching and Al-Shatrah Hospitals (Thi-Qar, Iraq) between November 2024 and March 2025. Bacterial identification was conducted using biochemical tests, the VITEK-2 system, and PCR targeting the 16S rDNA gene. The FimH and FimA genes were detected using PCR with gene-specific primers. Ethical approval for this study was obtained (Approval No. 1778) on December 16, 2024, in accordance with the Helsinki Declaration. Results: Forty Enterobacter isolates were identified: 28 from urine, nine from wounds, and three from burns. E. cloacae (57.5%) were the most prevalent species, especially in urine samples (71.4%), followed by E. sakazakii (42.5%), which was more common in wound and burn isolates. PCR analysis revealed the presence of FimH in 12 isolates (30%) and FimA in eight isolates (20%). All isolates showed positive amplification of the 16S rDNA gene (1500 bp). Conclusion: E.cloacae was the predominant species in urinary infections, whereas E. sakazakii was more frequently associated with wound and burn infections. The moderate prevalence of FimH and FimA genes underscores their potential roles in adhesion, biofilm formation, and pathogenicity. Molecular detection of these genes provides valuable insight into Enterobacter virulence and may inform future clinical and therapeutic strategies.