Proteus mirabilis is a Gram-negative rod-shaped bacterium most noted for its swarming motility and urease activity. It is recognized as one of considerable uropathogens. It is particularly common among patients with chronic inflammatory conditions. One of these conditions is rheumatoid arthritis, an immune-mediated inflammatory disorder that primarily affects and damages joints. This study aimed to investigate the prevalence of P. mirabilis along with its virulence gene (hpmA) in urinary tract infections and determine its association with key inflammatory biomarkers among rheumatoid arthritis patients. Eighty urine samples were collected from clinics and laboratories in Zakho city from September to December 2024. Phenotypic tests were used to identify P. mirabilis in patients’ urine, and PCR assays were performed to investigate the hpmA gene. In addition, Blood samples were analyzed for Erythrocyte sedimentation rate (ESR), Rheumatoid Factor (RF), and C- Reactive protein (CRP) from the same RA suspected patients to confirm Rheumatoid Arthritis and evaluate inflammation level. Cultural and biochemical tests identified P. mirabilis in 15 samples (18.75%). Molecular analysis revealed that all 15 isolates (100%) of P. mirabilis samples had hpmA gene. Notably, patients with P. mirabilis–positive UTIs, especially those carrying hpmA, showed elevated ESR and CRP levels. This indicates an association between hpmA-mediated pathogenicity and inflammatory responses in RA. These results suggest the importance of screening P. mirabilis and its virulence factors in RA patients with UTIs. The presence of hpmA which is responsible for hemolysin production, may be associated with increased levels of inflammation in these patients.

Proteus mirabilis is the most common species among the genus Proteus that has been associated with various infections in humans. In this study, the prevalence of P. mirabilis among outpatients with UTIs, ear, burns, wounds, respiratory tract infections, and vaginitis who attended the major hospitals and clinics in Zakho city has been investigated. Four hundred specimens were collected from both genders at different ages (≤1 year to over 50 years), from July 2021 to January 2022. All specimens were analyzed according to conventional bacteriological methods for detecting the presence of P. mirabilis. Also, a molecular method was used using species-specific ureR primer to confirm the presence of P. mirabilis among the isolates. From all collected specimens, 23.75% (95/400) were identified as P. mirabilis with a higher rate in males than females (52.63% vs 47.37). Among both genders, the age group ≤ 1-10 years showed the highest rate of infection (61.90%). Married patients had a higher rate (27%) than unmarried ones (16.92%). In terms of residency, rural inhabitants had the highest rate (31.25%) among other inhabitants. Furthermore, infections during the months of the year were at their maximum rate during August (52.27%), while reduced to 11.67% in October. ureR primer gives a precise and specific detection of P. mirabilis. This study highlights that; P. mirabilis is one of the remarkable bacteria that cause various infections in humans through various risk factors like anatomical abnormalities, gender, age, and chronic diseases that facilitate its spreading in the community

Proteus mirabilis is one of the important causative agents of bacterial infections in humans. This study involved the prevalence of the virulence genes among P. mirabilis from urine, ear, sputum, burn, wound, and vagina specimens in Zakho city during the period of July 2021 until January 2022 and their susceptibility to different commonly used antimicrobial agents. Isolates were identified by traditional phenotypic and biochemical tests. Out of 400 cultures, 95 (23.75%) were P. mirabilis. The antibiotic susceptibility toward different antibiotics varied among the isolates. The results showed that ceftriaxone was the most potent antibiotic with a susceptibility rate of 90.28 %. The isolates were resistant to many screened antibiotics, with the highest rate of 88.42% to imipenem. Whereas, the resistant proportion was slightly lower toward other antibiotics at rates varied from 74.68 % and 77.89% for Ampicillin and Amoxicillin/clavulanic acid, respectively. Fifty-two P. mirabilis isolates were selected for PCR analysis, according to their multiple antimicrobial resistance to the used antibiotics. The selected samples were amplified for P. mirabilis identification by producing a single band of the ureR gene. The prevalence of the virulence genes (flaA, rsbA, zapA, and mrpA) among these isolates were 96.15%, 88.46%, 80.77%, and 69.23%, respectively. This study demonstrates that multidrug resistance P. mirabilis harbors multiple virulence genes.

Otitis media define as infection of middle ear that causes inflammation (swelling and redness) and fluid build-up behind the eardrum. Anyone can develop an infection of the middle ear. It is either acute or chronic in two forms, the chronic may be associated with effusion (intact tympanic membrane, eardrum perforation) which is an inflammation of the middle ear mucosa and mastoid air cells for more than 3 months. This inflammation is either a sequel to acute suppuratve otitis media (tubo tympanic disease) or can be caused by cholesteatoma .In the acute otitis media, which is always associated with ear pain and sometimes associated with effusion. Analysis of acute otitis infection by diagnosis of the highest bacterial species in the sample of swabs from university ear students. In the biology department, we took 298 patients, including students at different stages. First, the student asked whether he had ear pain, effusion, or past doctor or hospital visits to treat this infection. Samples are collected from the infected ear and then sent to the laboratory for bacteria analysis, bacteriological study and biochemical tests performed to determine staphylococcus aureus resistance to methicillin and Pseudomonas aeruginosa (MDR). Staphylococcus aureus biochemical test such as: mannitol fermentation, gram stain, positive catalase and essentially negative oxidase, coagulate all positive. On the other hand, all biochemical tests including: pigment production at nutrient agar and positive catalase, Simon citrate positive, for pseudomonas aeruginosa. In our cases of acute otitis media, Pseudomonas aeruginosa considered the one of the most common microorganism, followed by Staphylococcus aureus, methicillin resistance. Pseudomonas aeruginosa trend showed resistance of about 5 case of students resistance to these antibiotics to specific drugs called ciprofloxacin, but the other antibiotics were sensitive, such as amikacin, ceftazidime, gentamycin, etc. Conclusion : 1. The most prevalent pathogen was Pseudomonas aeruginosa followed by isolated Staphylococcus aureus from ear of students. 2. Ciprofloxacillin has been found to be the most appropriate antibiotic despite some cases of students having resistance to this drug, but the highest cases of Pseudomonas aeruginosa are sensitive to the same drugs followed by amikacin and ceftazidime.