Background Helicobacter pylori infection affects over 50% of the global population. Individuals acquire this infection in early childhood that persists throughout life if not treated. The degree of the outbreak severity varied from one region to another, causing long-term clinical consequences such as gastritis, peptic ulcer disease, and cancer of the stomach. The primary objective of this investigation was to estimate the prevalence of Helicobacter pylori among the population in Duhok City via the implementation of non-invasive methods. Methods From January 2021 to December 2022, 2313 cases were studied using ELISA assays for immunoglobulins, IgG, IgM, and IgA, a stool antigen test (SAT), and a urea breath test (UBT) to identify Helicobacter pylori. Results Among 2313 patients of both genders, 61.7% (1427/2313) were females and 38.3% (886/2313) were males. The prevalence of H. pylori infection was 35.28% among them, with a high significant difference in infection rate in females than males (60.78% vs 39.22%), and among various ages with the highest being at ages of 31 to 40 years. The serological and the SAT tests are commonly used diagnostic tests that yield the most significant number of posi tive results. Furthermore, a notable correlation was observed between the prevalence of infection and age, especially for IgA and UBT where males exhibited higher significant levels than females; moreover, for UBT, highly significant variations were observed among ages also. Conclusions Over half of the performed tests detected H. pylori antibodies with the peak at 49.3% for the IgG test, indicating the body elicits an immune response against this bacterium. Both gender and age were linked to this infec tion. For more clarification of the prevalence of H. pylori, we recommend conducting more in-depth investigations.

Objective: Virulence factors are substances produced by pathogenic Pseudomonas aeruginosa that contribute significantly to the etiologyof disease. Virulence genes encode these virulence factors on the Pseudomonas aeruginosa chromosome.Methods: Between July 2021 and June 2022, at the Burn and Plastic Surgery Hospital in Duhok city, Iraq, seventy-one isolates ofPseudomonasaeruginosa were isolated from infected burns. The lasB and toxA genes were identified using Polymerase Chain Reaction (PCR).Results: P. aeruginosa was isolated from 64.55% (71/110) of the specimens, with non-significantly higher rate from females than males(38.18% vs 26.36%), but the differences between various ages were significant (P < 0.04). About 38.18% of burns were due to flame andthe highest rate (45.4%) of infected burns were second-degree burns. Furthermore, 76.06% (54/71) of the isolates were multidrug resistant.They demonstrated greater resistance to Piperacillin; the resistance was 98.59%. Of the isolates examined, 35 (64.81%) were positive fortoxA and 27 (50%) were positive for lasB genes.Conclusion: Due to the limited number of effective medications against this bacterium that are currently available, testing for antimicrobialsusceptibility must be performed on all isolates. By doing this, you can help manage the treatment plan and stop the emergence ofresistance in burn units.

Pseudomonas aeruginosa is resistant to a wide range of extended spectrum-lactamases (ESBLs) antibiotics because it produces several kinds of ESBLs. The goal of the current investigation was to identify the bacteria that produce extended spectrum -lactamases and the genes that encode three different ESBLs, such as blaOXA-10, blaPER-1 and blaSHV genes in Pseudomonas aeruginosa isolated from burn patients. In this investigation, 71 Pseudomonas aeruginosa isolates were isolated from burn wounds in Burn and Plastic Surgery Hospital, Duhok City between July 2021 to June 2022. For the purpose of finding the blaOXA-10, blaPER-1, and blaSHV ESBL expressing genes, Polymerase Chain Reaction (PCR) was used. Among 71 Pseudomonas aeruginosa isolates, 26.36% (29/71) were isolated from males and 38.18% (42/71) from females, and 76.06% (54/71) of the isolates were multidrug resistant. They exhibited higher resistance against Piperacillin with resistance rates of 98.59%. Among the ESBL-producing isolates tested, blaOXA-10 was found in 59.26% (32), blaPER-1 was found in 44.44% (24), and blaSHV was found in 11.11% (6). All isolates must undergo antimicrobial susceptibility testing because only a few numbers of the available antibiotics are effective for the treatment of this bacterium. This will prevent the development of resistance in burn units and aids in the management of the treatment plan.

Uropathogenic E. coli (UPEC) is problematic and still the leading cause of urinary tract infections worldwide. It is developed resistance against most antibiotics. The investigation, surveillance system, and efficient strategy will facilitate selecting an appropriate treatment that could control the bacterial distribution. The present study aims to investigate the epidemiology and associated risk factors of uropathogenic E. coli and to study their antibiotic resistance patterns. 1585 midstream urine specimens were collected from symptomatic urinary tract infections (UTI) patients (225 males and 1360 females) admitted to Zakho emergency hospital, Zakho, Kurdistan Region, Iraq from January 2016 until the end of December 2018. Specimens were inoculated on blood and MacConkey plates and incubated at 37оC for 24 hours. Uropathogenic E. coli was diagnosed based on gram staining, colony characteristics, and standard biochemical tests in accordance with local standards and guidelines. All isolates were screened for their antibiogram pattern using the disk diffusion method based on the Clinical and Laboratory Standards Institute guidelines. The results showed that out of 1585 urine specimens, 1026 (64.7%) were UTIs positive with a statistically higher rate in 2016 (83.6%) (P< 0.0001). The UTIs frequency in females was significantly higher than males (P< 0.0001). Generally, the uropathogenic E. coli represented 21.1% with the highest level in 2016 (22.9%). The uropathogenic E. coli rate was higher, statistically not significant, in females (21.4%) than males (18.5%) (P=0.4946). Additionally, through the three years of study, uropathogenic E. coli (UPEC) was in high frequency in February and May 2016. The female’s age group from 20 to 39 years was the most vulnerable (46%) form total infected females, while those from 70-74 years (1%) were the least susceptible in males and females. A high percentage (80.56 %) of multidrug resistance E. coli isolates was observed with high resistance against 𝛽-lactamase and macrolides antibiotics. However, higher sensitivity was towards imipenem and meropenem. In conclusion, the wrong and overuse of antibiotics will ncrease the resistance rate of E. coli. For this reason, proper use of available antibiotics is necessary. Also, the educational programs and periodic monitoring of antimicrobial susceptibility are essential for reducing the antibiotic resistance rate.

Uropathogenic Klebsiella pneumoniae is considered the most important causes of urinary tract infection, and recently the antibiotic resistance of this pathogen has increased dramatically. The study aims at investigating the prevalence and antibiotic sensitivity of uropathogenic K. pneumoniae among different ages of groups at both genders. 1737 urine specimens were collected from individuals admitted to Zakho emergency hospital from January 2016 until December 2018. K. pneumoniae was identified based on Gram stain, colony characteristics and biochemical tests, and then it was tested for their antibiotic sensitivity. Out of all samples, 1076 (61.9%) showed significant bacterial yield. The UTIs among females (64.3%) were statistically higher than males (46.5%) (P<0.001). The age group of 20-29 years was highly susceptible to UTIs (43%). Among the total UTIs, K. pneumoniae represented 16.2%. K. pneumoniae in males (23.4%)was significantly higher than females (15.4%) (P=0.03).The age group 40-49 years (32.2%) was the highest group that at risk for K. pneumoniae infection. K. pneumoniae was highly susceptible to imipenem (100%) and was highly resistant against cephalothin (90.8%). A high prevalence of UTIs were observed among the age group of 20-29 years and the females had more risk of having UTIs. The males were more susceptible to K. pneumoniae with higher prevalence in the age group of 40-49 years. K. pneumoniae showed high sensitivity toward imipenem and high resistance to cephalothin. More awareness is required in all healthcare sectors for regular surveillance of the use of antimicrobial agents to reduce the resistance rates and to eradicate the pathogens.

Typhoid fever is still recognized as one of the most important global health problem. Salmonella species are the main cause of typhoid fever that causes health threat in developing countries. The purpose of this study was to find out the prevalence and the risk factors of Salmonella Typhi from people presenting with fever to Azadi general hospital, Duhok, Iraq. A total of 2323 patient blood samples (992 males and 1331 females) were collected through the period January 2017 to December 2017. Serologic-proved typhoid fever for Salmonella Typhi was diagnosed by Widal test. Out of 2323 blood samples, 824 (35.47%) were diagnosed as serologic-proved typhoid fever. The highest percentage (37.3%) of typhoid fever was recorded at age group 21–30 years and the less prevalence was at age group more than 51 years (29%) (p=0.4036). No significant differences was found in frequency of typhoid fever in males (35.4%) and females (35.5%) (p=0.9387). The incidence of typhoid fever in June (39%) was significantly higher than the incidence rate in other months of the year (p=0.0086). Typhoid fever has a considerable challenge to public health. The age group 21-30 years is the vulnerable group for typhoid fever. The typhoid fever is independent of sex and it is a seasonal disease with the majority of cases occurring is the June. Awareness should be created in young generation related to polluted water and hygienic food to eradicate this particular infection. Hence, health education classes play an important role in to reduce the infection rate.

Staphylococcus aureus is one of the most adaptable human pathogens. Nasal Staphylococcus aureus is the main cause of community associated staphylococcal infections. This project aimed to study the prevalence of nasal carriage of Staphylococcus aureus and community-associated methicillin resistant Staphylococcus aureus (CA-MRSA) and evaluate their antibiotic susceptibility tests among primary school children at Zakho city, Kurdistan region, Iraq. Nasal swabs were taken from a total of 300 primary school pupils aged 8-12 years. Collected nasal swabs were processed according to the standard bacteriological culture and isolates were identified using mannitol fermentation, gram stain, catalase test and coagulase test. Antimicrobial susceptibility test was carried out on Muller-Hinton agar (MHA) to determine the susceptibility of S. aureus and CA-MRSA towards antibiotics. 30% (90/300) of the primary school children carried S. aureus. The nasal carriage of MRSA was 4% (12/300) among participants. All MRSA isolates were sensitive to vancomycin, doxycycline, amikacin and ciprofloxacin. This study showed that the incidence of S. aureus and CA-MRSA is comparable with reports from elsewhere. Measures are needed to keep the emergence and transmission of these pathogens to a lowest. Antimicrobial susceptibility testing of all S. aureus isolates is crucial for treatment of MRSA. Further studies are required to detect the risk factors of the acquisition of MRSA.

Uropathogenic Escherichia coli are the most important group of microorganisms responsible for urinary tract infection. A high percentage of uropathogenic E. coli over the world are detected to be ESBLs producers, which is now a problem that limits therapeutic options. The aim of this study is to determine the prevalence of ESBLs E. coli and study the prevalence of different ESBLs genotype patterns among the ESBLs producing isolates. Methods: One hundred and six uropathogenic E. coli isolates were analyzed for their ESBL production by molecular methods. Results: 55 (52%) isolates were detected as extended spectrum β-lactamases (ESBLs) producers. Based on the PCR results, all E. coli isolates possessed one or more ESBL gene. CTX-M type ESBL was the most dominant ESBL (87.2%) among the isolates. While those for TEM-type and SHV-type were 54.5% and 21.8% respectively. Six genotype patterns were detected (TEM, CTX-M, TEM+SHV, TEM+CTX-M, SHV+CTX-M and TEM+SHV+CTX-M). The genotype CTX-M was the most prevalent genotype (40%) followed by the genotype TEM+CTX-M combination (30.9%). The occurrences of the genotypes (TEM, TEM+SHV, SHV+CTX-M and TEM+SHV+CTX-M) were 7.3%, 5.5%, 5.4%, 10.9%, respectively.

Antimicrobial resistance in uropathogenic E. coli is of major concern worldwide due to its increasing resistance to several commonly prescribed antibiotics. The aims of this study were to determine the prevalence and to evaluate the presence and antibiogram pattern of uropathogenic E. coli among people in Zakho city, Iraq. Methods: 1120 urine samples were collected from people. Samples were screened for E. coli isolates and their susceptibility to different antibiotics was analyzed. Results: Diagnoses tests showed that only 106 (9.4%) isolates were E. coli. Females (90, 85%) were more susceptible to urinary tract infections (UTIs) than males (16, 15%) (p <0.05). The age 11-21 years old (23, 21.7%) was the most affected group (p <0.05). All isolates were resistant to penicillin, ampicillin and aztreonam. While, all these isolates were sensitive to imipenem and meropenem. Conclusions: The incidence of uropathogenic E. coli among people is comparable with reports from elsewhere. E. coli isolates are highly susceptible towards imipenem, and meropenem antibiotics, and highly resistant towards β-lactam and cephalosporins antibiotics. Education programs and improving the hygienic measures are necessary to prevent contaminations with E. coli and minimize the use of β-lactam and cephalosporin antibiotics. Keywords: Uropathogens, E. coli, Antimicrobial resistance, Iraq.