<p>Background: Urinary Tract Infection (UTI) in patients with Chronic Kidney Disease (CKD) caused by multi-drug resistance and Extended Spectrum Beta Lactamase (ESBL)-producing gram-negative bacteria has been increased in different countries. The aim of the present study was to detect the antibiotic susceptibility patterns and the distribution of <em>Bla-TEM, Bla-SHV </em>and<em> Bla-CTX-M</em> genes in gram-negative bacteria isolated from outpatients infected with UTI, with and without CKD in Al-Najaf city, Iraq.&nbsp;<br /> Methods: A total of 120 non-duplicate urine samples were collected from outpatients (37 male and 83 female) infected with UTI in Al-Najaf city, Iraq; 60 samples from patients Without Kidney Disease (WKD) and 60 samples from patients with CKD. The antibiotic susceptibility testing was done according to Kirby-Bauer method. PCR technique was performed to investigate the prevalence of <em>Bla-TEM</em>, <em>Bla-SHV</em> and<em> Bla-CTX-M </em>genes.<br /> Results: A total of 126 different gram-negative bacterial strains were isolated. <em>Escherichia coli (E. coli)</em> was the most prevalent bacterium (49 isolates) followed by <em>Idebsiella pneumonia (K. pneumonia) </em>(35 isolates), <em>Pseudomonas aeruginosa (P. aeruginosa)</em> (18 isolates), <em>Citrobacter freundii (C. freundii) </em>(12 isolates), <em>Enterobocter aerogenes (E. aerogenes)</em> (8 isolates) and <em>Proteus mirabilis (P. mirabilis)</em> (4 isolates). All bacterial isolates from UTI patients with CKD were resistant to antibiotics and carried <em>Bla-TEM</em>, <em>Bla-SHV </em>and <em>Bla-CTX-M</em> genes more than isolates from UTI patients with WKD.<br /> Conclusion: This study demonstrated that all bacterial isolates from UTI patients with CKD were more virulent than isolates from UTI patients with WKD.</p>