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Introduction: Since its discovery in 1961, methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as a significant healthcare-associated pathogen (HA-MRSA) and a notorious 'superbug'. Typing is crucial for surveillance, epidemiology analysis, infection control of MRSA and sequencing of the spa gene is one of the most common methods used for determining the origin of this bacterium in humans and animals. This research aimed to determine the antibiotic resistance and spa type of S. aureus strains collected from outpatients in two hospitals in the Wasit province of Iraq. Material & Methods: The study analyzed 200 outpatient MRSA isolates by collecting nasal and sputum samples from patients. Standard biochemical and molecular methods based on the nuc gene were used to identify S. aureus bacteria and amplify the mecA and spa genes. The Kirby-Bauer disc diffusion method was employed to determine the antibiotic sensitivity of the isolates using penicillin, cefoxitin, vancomycin, gentamicin, erythromycin, tetracycline, imipenem, clindamycin, chloramphenicol and rifampicin. Results: Methods. The prevalence of MRSA was more common in women than in men. Antibiogram results showed that most of the isolates were resistant to penicillin (94.2%) and sensitive to imipenem (100%), clindamycin (100%), and chloramphenicol (100%). Of these 35 isolates, 30 (87.5%) and 26 strains (74.3%) were positive for the mecA and spa genes. Typing based on spa gene sequencing revealed four different patterns: t386, t3579, U0002 and U0234. Conclusion: Variations in the spa gene among different S. aureus isolates may he of clinical importance when treating staphylococcal infections. In this study, spa typing revealed four different patterns in Iraq, representing diagnostic and therapeutic implications. [ABSTRACT FROM AUTHOR]

About 100 C. luteus were examined to determine the extent of the presence of diseasecausing bacteria in the Diwaniyah River from April 2021 to March 2022. The bacteria were isolated using the VITEK2 system, and vital tests identified the species Aeromonas hydrophila and Sphingobacterium thalpophilum. Aeromonas hydrophila and S. thalpophilum were tested in vitro, revealing noticeable antibiotic susceptibility. Levofloxacin (=0.22 µg/ml for A. hydrophila and =0.20 µg/ml for S. thalpophilum), as well as Ciprofloxacin (=0.10 µg/ml) and Imipenem (=0.23 µg/ml), demonstrated notable effectiveness. Resistance to Cefazolin was observed in A. hydrophila (=69 µg/ml) and S. thalpophilum (=70 µg/ml). The study highlights the presence of harmful bacteria in C. luteus from the river, specifically A. hydrophila and S. thalpophilum. The findings emphasize the critical importance of prudent antibiotic use and ongoing monitoring in aquaculture practices to mitigate risks and safeguard public health. [ABSTRACT FROM AUTHOR]

Pyelonephritis is a common pediatric infection with high risk of renal injury in children less than 5 years. Prompt diagnosis and treatment is mandatory to minimize the risk of renal scarring. To investigate the causative pathogen of pediatric pyelonephritis and to assess antibiotic resistance among these patients. The study conducted from the 1st of April 2019 to the 30th of December 2019 at Al-Diwaniya maternity and children teaching hospital and at outpatient clinic. Total number of patients involved was 130 children. We classified them in to two groups. Group 1(3 months -12 months) while Group 2 were (1-5 years old). Total number of patients involved in this study was 130 patients. 54 of them were (3-12 months) termed as group 1 and 76 of them (1-5 years) were group 2. From 130 urine samples, we get 186 bacterial isolate, majority was with one bacterial isolate (67.1%), multiple bacterial isolate also seen but in less number (32.9%). Regarding the causative bacterial pathogen. E. coli was the commonest microorganism isolated (73.07%), then Proteus mirabilis (16.92%), enterococcus (6.15%) and staphylococcus aureus (3.84%). On evaluating antibiotic sensitivity, we found that Imipenem, Nalidxic acid, Nitrofurantoin and Ciprofloxacin are highly sensitive antibiotics in vitro. Gentamycin show less sensitivity than amikacin. Cephalosporin, Penicillin and Trimethoprim-sulfamethoxazole show no valuable sensitivity (very high resistance). [ABSTRACT FROM AUTHOR]

Background: Carbapenems-resistant Pseudomonas aeruginosa mutants are disseminating around the globe. 90%-100% of P. aeruginosa isolates became Carbapenems-resistant mutants in some countries like Thailand and Brazil respectively. Finding alternative therapeutic options instead of carbapenems is the global duty of researchers and institutions. The OprD gene mutation/s has the main role in carbapenems resistance appearance in P. aeruginosa due to the decrease in the outer membrane permeability for carbapenems. Aim: This study aims to assess the antimicrobial activity of carbapenems (imipenem, and meropenem) against Pseudomonas aeruginosa isolated from hospitalized burn patients in Al-Najaf/Iraq, and the role of OprD gene mutations in the resistance. Methods and materials: 76 samples were collected from hospitalized burn patients suffering from burn wounds infections, and the identity of each cultivated microbe was confirmed by VITEK compact system 2 and further confirmation for P. aeruginosa isolates via performing molecular identification by OprD gene detection, 10/12 carbapenems resistant isolates, 1/12 sensitive, and 1/12 intermediate resistant were submitted to OprD gene sequencing by Sanger method. Result: P. aeruginosa is the major cause of burn wound infection in the burn center of Al-Najaf city, 61/76 (80%) of samples shows positive growth, 20/61 (32%) were P. aeruginosa, 13/20 of P. aeruginosa isolates (65%) were imipenem-resistant the rest 6/20 (30%) imipenem-sensitive and 1/20 (1.5%) was imipenem-intermediate-resistant, also 17/20 of P. aeruginosa isolates (85%) were meropenem-resistant the remain 3/20 (15%) were meropenem-sensitive, all carbapenems resistant sequenced isolates contained OprD gene mutations, likely the main factor of resistance appearance and dissemination was antibiotics misuse Conclusion: Carbapenems-resistant Pseudomonas aeruginosa mutants are prevalent in the Al-Najaf burn center; a new drug is required, also more restrictions on antibiotics usage need to be applied. [ABSTRACT FROM AUTHOR]

Background and Aim: Acinetobacter has been considered an important nosocomial pathogen since 1970. This study aims to investigate the prevalence of Acinetobacter infection during 2017-2021, study the antibiogram of these bacteria, and study the impact of gender on infection. Materials and Methods: This is a retrospective study in which data of the clinical samples received in Al-Kafeel Hospital, Kerbala, Iraq, between April 2017 and February 2021 were searched for Acinetobacter infection and their antibiotic susceptibility testing. Results: The prevalence of Acinetobacter infection was 9.2% of cases. Male to Female ratio was 3:1, and there was a significant difference in Acinetobacter infection regarding gender. There were high resistance rates to major antibiotic classes. Maximum resistance was recorded for Amoxicillin (100%), followed by 3rd generation cephalosporins, including Cefotaxime (92.3%), Ceftriaxone (91.6%), Ceftazidime (91.3%), Cefixime (80%); in addition to growing resistance to carbapenems, Imipenem (42.8%) and Meropenem (62.2%). The lowest resistance rates were found to colistin sulfate (10%). There 80.7% of the isolates were multidrug-resistant MDR. Conclusion: Acinetobacter spp., is considered as fast emerging opportunistic agents with evolving drug resistance. Rationale use of antibiotics is important and necessary to prevent microbial resistance. Gender is considered a risk factor for Acinetobacter infection. [ABSTRACT FROM AUTHOR]

This study aimed to synthesize new iron nanoparticles (FeNPs) using Beta Vulgaris (beet) extract as a reducing agent and test its bioactivity against Pseudomonas aeruginosa. In total, five grams of beet were ground and dissolved in 50 ml of distilled water and filtered with filter paper. The filtrate was then isolated. Different concentrations, including 25%, 50%, 100%, and 150% of the isolated filtrated substances were prepared from the stock solution. FeNPs were prepared from 0.5 moles of iron nitrate salt (Fe(NO3)3.9H2O which was mixed with the aqueous solution of beet extract. Moreover, two aqueous solutions were mixed thoroughly with continuous stirring at 60°C. The FeNPs were isolated, separated, identified, and characterized using different physicochemical techniques (i.e., X-Ray Diffraction, Ultraviolet-visible Spectroscopy, and Atomic Force Microscope). Subsequently, the bioactivity of the NPs against P. aeruginosa was tested. The Vitek antibiotic test for P. aeruginosa showed resistant activity against Piperacillin/Tazobactam, Cefazolin, Ceftazidime, Cefepime, Imipenem, Cefepime, Ceftazidime, Cefazolin, and Piperacillin/Tazobactam; in addition, it revealed high sensitivity toward Tobramycin, Levofloxacin, Trimethoprim, Gentamicin, Nitrofurantoin, and Ciprofloxacin. The FeNPs at 50% concentration showed the best inhibition activity against P. aeruginosa. In the current study, novel FeNPs were synthesized which showed activity toward P. aeruginosa that could be used to replace certain antibiotics as a green medicine. [ABSTRACT FROM AUTHOR]

Introduction: Resistance to antibiotics has emerged recently due to the misuse of antibiotics and is a threat to the health-care system, especially in developing countries like Iraq where there are no antimicrobial stewardship programs in most intensive care units (ICU). Materials and Method: This was an observational, cross-sectional study done in the ICU of Ghazi AL Hariri hospital, Medical City/Iraq. All patients getting admitted to ICU from both genders were included in the study.Samples taken for culture and sensitivity tests included blood, urine, tracheostomy tube, sputum, cerebrospinal fuid, central venous line, and bedsore swab. Results: 43 patients satisfied the inclusion and exclusion criteria and were included in the study. The most common isolated pathogens were pseudomonas in sputum and blood samples, Acinetobacter in wounds and operation skin site infection, Klebsiella in central venous line, and bedsore swab, while Candida in the urine. Klebsiella was the most frequently isolated in overall culture results, it was most sensitive to imipenem, meropenem, and amikacin. Conclusion: Ceftriaxone was the most commonly used antibiotic as an empiric treatment followed by meropenem and amikacin. Most of the isolated pathogens (> 90%) had resistance to ceftriaxone. ICU-acquired Klebsiella, P. aeruginosa, and Acinetobacter predominate hospital-acquired infections. [ABSTRACT FROM AUTHOR]

Carbapenems are the drugs of choice against serious infections caused by Gram-negative bacteria Carbapenem-resistant. Acinetobacterbaumannii (CRAB) represents one of the important causing agents of nosocomial infections especially in immunocompromised and Intensive Care Units (ICUs) patients. The aim of this work was to identify the Carbapenem-Resistant genes in Acinetobacterbaumannii isolated from Baghdad and Ramadi hospitals. Among 48A. baumannii isolates, 33 isolates (68.75%) were resistant to imipenem and meropenem. One gene for carbapenem resistance (blaOXA-51 like) were amplified by PCR. The presence of blaOXA-51-like genes in 100% of CRAB isolates indicated that the blaOXA-51-like genes are the predominant mechanism for imipenem resistance in our isolates. [ABSTRACT FROM AUTHOR]

Background: Chronic rhinosinusitis (CRS) considered one of the common diseases, affecting nearly 10% of the general population, defined as an inflammatory disorder of the paranasal sinuses and linings of the nasal passages that last more than 12 weeks. The aim of the study is the determination of more predominant bacteria in patients' complaints from CRS in Wasit Province. Materials and Methods: One hundred and fifty patients were included in the present study with a case history of CRS. Isolated bacteria were identified by API system and confirmed by polymerase chain reaction (PCR) using speciesspecific primer pairs for 16S rRNA gene. Biofilm-related gene, icaA, icaD, and PpyR, was detected by PCR. Furthermore, antibiogram was performed according to the Clinical and Laboratory Standards Institute. Results: The results showed that 140 samples were positive for bacterial growth while only 10 were negative culture. The more predominant bacteria Staphylococcus aureus compile 41 (27.33%), 34 (22.66%) for Pseudomonas aeruginosa, 33(22%) for Staphylococcus epidermidis, 12 (8%) for Streptococcus pneumonia, 9 (6%) for Klebsiella pneumonia, 8 (5.33%) for Proteus mirabilis, 3 (2%) for Enterobacter aerogenes. According to gender, female was more affected than male, the age groups (15-24 years and 35-44 years) were the highest affected among others. Most of the infected patients were students. The biofilm-related genes were diagnosed among most three predominant species, icaA for S. aureus, icaD for S. epidermidis, and PpyR for P. aeruginosa. The results revealed that 38 (92.68%) of S. aureus, 33 (100%) of S. epidermidis, and 34 (100%) of P. aeruginosa have icaA, icaD, and PpyR, respectively. The highest resistance of isolates for antibiotics was S. aureus for erythromycin (82.92%), S. epidermidis for cefpodoxime (90.90%), S. pneumonia for erythromycin (41.66%), P. aeruginosa for cefpodoxime (100%), K. pneumonia for ceftazidime (100%), P. mirabilis for ceftriaxone (100%), and E. aerogenes for erythromycin (100%). The results revealed that the most effective antibiotics were ciprofloxacin and imipenem for all Gram-positive and Gram-negative bacteria. Conclusion: The study concludes that the predominant causative agents of CRS in Wasit Province were bacterial with capacity to form biofilm formation accompanied by antibiotic resistance. [ABSTRACT FROM AUTHOR]

Introduction: Acinetobacter baumannii (A. baumannii) is an opportunistic pathogenic bacterium mainly associated with hospital acquired infections and in immunocompromised individuals who stay in hospitals for a long time. In recent years, it has become increasingly resistant to many different types of antibiotics. The production of the metallo-beta-lactamase (MBL) enzyme is one of the primary causes of this resistance. This study aimed to detect the presence of MBL genes that belong to the verona integrin metallo-β-lactamase (bla-VIM) and imipenemase (bla-IMP) groups in the isolates of Acinetobacter baumannii from burn patients., Methodology: One hundred and seventeen (117) isolates of A. baumannii were obtained from patient specimens using traditional methods followed by using the VITEK 2 (BioMérieux, Les Pennes-Mirabeau, France) identification system. Metallo β-lactamases were detected in the imipenem-resistant strains by using imipenem disks on Muller-Hinton agar. The polymerase chain reaction (PCR) technique was utilized to examine 117 isolates for the detection of MBLs encoding genes such as bla-VIM, and bla-IMP., Results: Imipenem resistance was detected in 78.6% of the patients. The PCR assays of the isolates identified bla-VIM-1, bla-VIM-2, bla-IMP-1 and bla-IMP-2 genes at the rates of 17%, 40.1%, 29.9% and 4.2%, respectively., Conclusions: The findings suggest that the majority of A. baumannii isolates harbour one or more of the detected genes, signifying that the production of MBLs plays a pivotal role in resistance mechanisms., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Haval Mohammed Khalid.)

Introduction: this study aimed to isolate P. aeruginosa and S. aureus, investigate the antimicrobial resistance of collected isolates, and investigate the distribution of exoU and mecA genes in P. aeruginosa and S. aureus isolates., Methodology: Out of 150 samples, 32 isolates were identified as P. aeruginosa, 48 isolates were identified as S. aureus. All isolates were checked for AST. Then, a PCR was applied to detect exoU and mecA genes in P. aeruginosa and S. aureus., Results: 12.0% and 29.3% of the samples showed co-isolates and single isolates of studied pathogens, respectively. Regarding burn samples, S. aureus was the most prevalent pathogen (38.0%, 38/100) among males (41.8%, 23/55), followed by P. aeruginosa (27.0%, 27/100) among females (28.9%, 13/45). The highest burn infection rates of S. aureus (50.0%) and P. aeruginosa (32.7%) were recorded among age groups (≥ 50) and (18-49), respectively. Comparatively, wound samples were less infected with these pathogens. P. aeruginosa isolates usually exhibited high resistance to gentamicin, tobramycin, and netilmicin, whereas, imipenem showed low resistance at 46.87%. S. aureus isolates were susceptible to trimethoprim-sulphamethoxazole and rifampin. 56.25% of P. aeruginosa isolates were exoU positive and 37.5% of S. aureus isolates were mecA positive. Results of the cefoxitin inhibition zone with mecA gene amplification, 33.3% isolates were MRSA, 4.2% isolates were nmrMRSA, and 62.5% isolates were MSSA. Most of the resistant isolates of P. aeruginosa carried the exoU gene, 80% resistant isolates to imipenem were exoU positive., Conclusions: S. aureus was more predominant than P. aeruginosa in burns and wounds infections., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2024 Samir Ali, Mahde Assafi.)

Urinary tract infections and their complications causing serious health problems especially in diabetic patients in Misan province, it is essential to determine the causative agent for appropriate treatment of this disease. One hundred and fifty urine samples were taken from adult patients with diabetes. The microbial growth appeared in 106 (70.6%) samples. Axenic culture was 83% versus 17% mixed growth. UTI prevalence was 65% with females comparing 35% of males and it was 56.6% in age group 35-49 years. Furthermore, UTIs were more incident in patients without antibiotics use and diabetic period 5-10 years (82% and 64%) respectively. Escherichia coli was identified as the most common causative agent of UTIs (52.9%), followed by Klebsiella pneumoniae and Enterococcus faecalis (9,1% and 6.6%, respectively). Streptococcus agalactiae and Klebsiella aerugenes were (4.2%, for each). Moreover, Pseudomonas aeruginosa, Klebsiella oxytoca and Staphylococcus haemolyticus were 2.48% for each. Additionally, the frequency of Proteus mirablis, Staphylococcus aureus, Streptococcus pyogenes, Serratia marcessens, Staphylococcus epidermidis and Staphylococcus warnerii was 1.65% for each, while Acinetobacter baumani and Bacillus subtilis were 0.82% for each. Most bacterial isolates had a high sensitivity to imipenem (78.8%) followed by amikacin (61.9%), but low sensitivity to ceftriaxone, tetracycline and Co-trimaxazole (36.4%, 29.7% and 26.3%, respectively) whereas, highly resistance to ampiclox and nitrofurantoin (98.3% and 87.3%, respectively). High rate of multidrug resistance observed among bacterial isolates. [ABSTRACT FROM AUTHOR]

Toxin Antitoxin (TA) systems have recently received much attention as one of the most promising antimicrobial targets. This study was designed to evaluate the presence of type II toxin antitoxin system and biofilm formation among imipenem resistant Klebsiella pneumoniae isolates in Baghdad. A total of 39(22.94%) Klebsiella pneumoniae isolates were collected from patients. Antimicrobial susceptibility test was performed and the biofilm formation was assayed by micro titer plate, then PCR was performed for detection of Toxin Antitoxin -Type II, Biofilm and Quorum sensing genes. The results show that the imipenem resistance was seen in 23(58.97%) of K.pneumoniae isolates. Then, the isolates showed levels of resistance percentage to antibiotic, with a highest resistance rate reached to (100%) for ampicillin and recorded lowest resistance rate to ciprofloxacin and levofloxacin reached to (10.26%) and (7.69%), respectively. Among these isolates, 22(56.41%) were biofilm producers. All 39 K.pneumoniae isolates showed different results for ompA and bap genes when were found by 9(23.08%) isolates for ompA, while, all isolates didn't have bap gene. Further, TA system genes were found by 15(38.46%), 15(38. 46%), three (7.69%) and five (12.82%) for mazEF, ccdAB, relBEand mqsR. On the contrary, all isolates didn't have QS system genes as lasIRandrhlIR genes. [ABSTRACT FROM AUTHOR]

Background: The serine carbapenemase enzymes (KPC) which produce from bacteria klebsiella pneumoniae today have been emerged as one of the β-lactamase enzymes that is capable to inactivating the last line of carbapenems. The gene encoding the K. pneumonia (bla KPC ) belongs to gene carried on plasmid among Enterobacteriaceae family, which has modulation for the infections control so this study is aimed to spot the presence and evaluate bla KPC gene expression by real-time PCR in local isolates of K. pneumonia., Methods: Forty-seven of K. pneumonia isolates were isolated from different clinical samples (blood, sputum, urine, wounds and burns) from patients in separate hospitals in Baghdad., Antimicrobial sensitivity test was carried out by vitik-2 system and Kirby- Bauer method. The PCR was employed to detect carbapenemase gene., Results: The results of this study showed that all explored isolates were resistant to Ertapenem, Meropenem and imipenem 47(100%). Phenotypically, all the isolates had carbapenemase which hydrolyzed the carbapenem antibiotics. Furthermore, the isolates showed (100%) resistance to Cefazolin, Ampicillin and Amoxicillin/ Clavulic acid. However, the most effective antibiotic was Levofloxacin (91.5%). The results of conventional PCR technique for the detection of bla KPC gene showed that 38 (80.9%) isolates of carbapenem-resistant K. pneumoniae harboured bla KPC gene (1010 bp), while none carried other carbapenemase genes including bla NDM1 , bla VIM and bla IMP genes. High levels of carbapenem resistance was clarified by the imipenem and meropenem MICs determination. All 38 isolates were positive in CNPT. Furthermore, the 38 isolates showed over expression of bla KPC gene compared with housekeeping rpo gene in Real-Time PCR., Conclusions: According to these results, the resistant isolates to carbapenem were belong to the present and high level expression of bla KPC gene in our local isolates., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)