2024-02

Journal of Infection in Developing Countries (Issue : 1) (Volume : 18)

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.

2024-02

journal of contemporary medical sciences (Issue : 1) (Volume : 10)

Objective: Virulence factors are substances produced by pathogenic Pseudomonas aeruginosa that contribute significantly to the etiology of 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 of Pseudomonas aeruginosa 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 and the 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 for toxA 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 antimicrobial susceptibility must be performed on all isolates. By doing this, you can help manage the treatment plan and stop the emergence of resistance in burn units.

2023-11

Journal of University of Duhok (Issue : 2) (Volume : 6)

Infection of healthcare workers with methicillin resistant Staphylococcus aureus (HA-MRSA) occurs by direct contact with infected wounds, through hand contamination from asymptomatic people or medical devices. While Community-associated MRSA (CA-MRSA) infections arise in healthy non-hospitalized people or in those having medical procedure within the past year. The study was conducted from April 2021 to March 2022 to determine the rates of S. aureus and MRSA isolates, their antibiotic resistance and virulence factors among 712 specimens (308 out-patients and 404 healthcare workers) of Azadi and Bedari hospitals/ Duhok province. Staphylococcus aureus isolated at rates of 28.57% and 16.83%, among out-patients and healthcare workers, respectively. Male outpatients’, and patients with ages of >40-50 years showed higher isolate rate than healthcare worker (46.15% vs 35.38% and 85.71% vs 46.42 %) respectively. CA-MRSA showed higher resistance to beta lactam antibiotics, while HA-MRSA showed higher multidrug resistance. Males of both MRSA types (CA-MRSA and HA-MRSA) carried higher isolate rates than females (38.46% and 15.87%) respectively. The higher rates of CA-MRSA and HC-MRSA isolates were 64.29% and 22.54% at ages of >40-50 and >20-30 years, respectively. PCR analysis detected nuc and mecA genes in 100% of both MRSA types, also, the genes arcA lukS/F-pvl and lukE-lukD were detected at high rates (30.3%, 42.42% and 33.33%), respectively.

2023-11

Journal of Wildlife and Biodiversity (Issue : 1) (Volume : 7)

Methicillin-resistant Staphylococcus aureus (MRSA) is considered a serious public health problem. This study aimed to estimate the rate of MRSA among Staphylococcus aureus isolates of inpatients and to determine their susceptibility to antibiotics and some of the virulence genes. The study was conducted from April 2021 to March 2022 and involved specimens from 302 inpatients admitted to Azadi and Bedari teaching hospitals in Duhok province. Staphylococcus aureus was detected in 20.53% (62/302) of the examined specimens with the highest rate (37,50%) from surgical swabs. Antibiotics sensitivity tests showed that all isolates were resistant to penicillin G. Methicillin-resistant S. aureus was detected in 77.42% (48/62) of S. aureus isolates with a higher rate from skin swabs (85.71%). According to gender, a significantly (P<=0.005) higher rate of S. aureus and MRSA isolates was recorded in Males (21.52%). As regards age, ages > 40-50 years showed the highest rate of MRSA isolate (24.62%). Among MRSA, 77.08% (37/48) were multidrug resistant. Molecular analysis revealed the presence of nuc, mecA, pvl and eta genes at rates of 100%, 66.6%, 31.2% and 22.9%, respectively among the analyzed isolates.

2023-10

ACTA MICROBIOLOGICA BULGARICA (Issue : 3) (Volume : 39)

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.

2023-10

Scientific reports (Issue : 18402) (Volume : 13)

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 ESBLproducing 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.

2023-10

Journal of Contemporary Medical Sciences (Issue : 5) (Volume : 9)

Abstract Objectives: Pseudomonas aeruginosa is opportunistic gram-negative bacillus and a major human pathogen belongs to family Pseudomonadaceae, it causes several nosocomial infections including pneumonia, urinary tract, surgical sites, otitis externa, and soft tissues. Methods: The study was conducted from April 2021 to January 2022 and involved the prevalence of Pseudomonas aeruginosa isolates and their susceptibility to different antimicrobial agents among patients and healthcare workers specimens in three hospitals of Duhok city. The collected specimens were examined and cultured on different media in the Advanced Microbiology Laboratory, Azadi teaching hospital. The isolated bacteria were identified according to their morphological and biochemical properties. Results: Out of 324 specimens, 29.32% (95/324) of the isolates were identified as Pseudomonas aeruginosa, isolated from 26.89% patients and 40% healthcare workers. Regarding isolate rates among specimens, the highest rate (48.78%) was from sputum, with a highly significant (P < 0.001) difference from other sources. Females had a non-significantly higher isolate rate than males (28.19% vs 25.22%), ages, > 50 years had the highest isolate rate (72.88%), while the lowest rate 6.25% was among ages > 10–20 years, with highly significant (P < 0.001) differences among them. Specimens from Heevi hospital showed a non-significantly higher isolate rate (28.57%) than other hospitals. Isolates highest susceptibility was to Colistin (88.7%)-followed by Imipenem (78.9%), while they were 98.6% resistant to ampicillin and 100% resistant to Amoxicillin, Erythromycin and Trimethoprim/Sulfamethoxazole. A high rate of extensively drug-resistant (19.72%) Pseudomonas aeruginosa isolates was documented among patients who attended these hospitals with the highest (31.25%) from wounds. Conclusion: These findings will be helpful to advise treatment with appropriate antibiotic strategy against multi- and extensively drugresistant P. aeruginosa to cope with the chances of evolving resistant pathogens.

2023-07

Journal of Infection in Developing Countries (Issue : 4) (Volume : 13)

Background: Acinetobacter baumannii (A. baumannii) is an opportunistic pathogenic bacterium mainly related with hospital acquired infections and in immunocompromised individual who stay for long time in hospitals. It has become increasingly resistant to many different types of antibiotics in recent years. The production of the metallo-beta-lactamase enzyme is one of the important causes of this resistance (MBLs). Methodology: This study aimed to detect the presence of metallo-beta-lactamase genes that belongs to the Verona Integrin Metallo- β-lactamase (bla-VIM) and the types of Imipenemase (bla-IMP) in the isolates of Acinetobacter baumannii from burn patients Methods: One hundred seventeen (117) isolates of A. baumannii were obtained from patient specimens using traditional methods followed by using VITEK 2 identification system. Metallo β-lactamases were detected in the imipenem-resistant strains that used imipenem disks on Muller-Hinton agar. The PCR technique was utilized to examine 117 isolates for the detection of MBLs encoding genes like as bla-VIM, and bla-IMP. Result: The rate of imipenem resistance was detected in 78.6% of the patients. The PCR assays of bla-VIM-1, bla-VIM-2, bla-IMP-1 and bla-IMP-2 genes were revealed at rates of 17%, 40.1%, 29.9% and 4.2%, respectively in these isolates.

2023-05

Infection and Drug Resistance (Volume : 16)

Purpose: Brucellosis is a zoonotic disease that contributes to severe global health and economic issues. In this study, the Rose Bengal Test (RBT), a crucial diagnostic tool for brucellosis in Duhok city, was evaluated in order to offer updated epidemiological data on this disease. Patients and Methods: A total of 339 patients suffered from fever and seeking medical attention in the private medical health center in Duhok city, Iraq, were enrolled after taking ethical approval from committee at Faculty of Sciences, University of Zakho and a verbal consent from each enrolled patient for using his/her blood and data. The blood specimens were tested for Brucella spp. Antibodies using the RBT and blood cultures, followed by spp. determination. A questionnaire form was designed to detect the associated risk factors. Results: Prevalence of brucellosis was 12.6% among participants with a probable diagnosis and 10.3% among those with a confirmed diagnosis (positive blood culture). Most of the positive cases were between the ages of 20 to 40 years. A highly significant (P < 0.0001) association was found between brucellosis with both consuming raw milk and having contact with cattle. The most common species identified were Brucella melitensis (57.1%) and Brucella abortus (42.7%). Conclusion: Brucellosis is a significant cause of fever in the current study and can be detected using the RBT. Human brucellosis can be reduced by minimizing the chances of contact with cattle and consuming boiled or pasteurized milk.

2022-11

Academic Journal of Nawroz University (Issue : 4) (Volume : 11)

Intestinal parasites and bacteria especially enteropathogenic Escherichia coli (EPEC) are important causative agents responsible for persistent diarrhea in infants and children worldwide due to their high occurrence in both the hospitals and community settings. However, sporadic outbreaks by these microorganisms occur globally. This study was conducted from August 2021 to January 2022, during which 500 diarrheic stool samples were collected from both genders and various ages (6 month to 12 years) from outpatient in Zakho hospital. In this study the total rate of infection was 64.2%(321/500), considerable number of samples were positive for more than one species of microorganisms, elevating the rate to 89%, with the highest rate (62%) being with bacteria among which E. coli was the dominant species (74.84%), while the rate with parasites was 27%, with E. histolytica being the dominant species (45.93%). Other recorded bacterial species with their rates are: Klebsiella (15.16%) Pseudomonas spp. and Shigella spp. at rates of 6.13% and 3.87%, respectively. While other parasites included: Cryptosporidium spp.(34.07%), Blastocystis spp.(13.33%), G. lamblia (5.93%) and H. nana (0.74%). Single infections were reported in 61.68%(198/321) of the positive cases with the highest rate (49.53%) of bacteria and only 12.15% with parasites. The dominant organisms in single infections were E. coli and the oocysts of Cryptosporidium spp. at rates of 81.13% and 61.54%, respectively. The mixed infections were documented in 38.32%(123/321). Among these, 67.48%(83/123) showed a combination between bacteria and parasites.

2022-11

Academic Journal of Nawroz University (Issue : 4) (Volume : 11)

Intestinal parasites and bacteria especially enteropathogenic Escherichia coli (EPEC) are important causative agents responsible for persistent diarrhea in infants and children worldwide due to their high occurrence in both the hospitals and community settings. However, sporadic outbreaks by these microorganisms occur globally. This study was conducted from August 2021 to January 2022, during which 500 diarrheic stool samples were collected from both genders and various ages (6 month to 12 years) from outpatient in Zakho hospital. In this study the total rate of infection was 64.2%(321/500), considerable number of samples were positive for more than one species of microorganisms, elevating the rate to 89%, with the highest rate (62%) being with bacteria among which E. coli was the dominant species (74.84%), while the rate with parasites was 27%, with E. histolytica being the dominant species (45.93%). Other recorded bacterial species with their rates are: Klebsiella (15.16%) Pseudomonas spp. and Shigella spp. at rates of 6.13% and 3.87%, respectively. While other parasites included: Cryptosporidium spp.(34.07%), Blastocystis spp.(13.33%), G. lamblia (5.93%) and H. nana (0.74%). Single infections were reported in 61.68%(198/321) of the positive cases with the highest rate (49.53%) of bacteria and only 12.15% with parasites. The dominant organisms in single infections were E. coli and the oocysts of Cryptosporidium spp. at rates of 81.13% and 61.54%, respectively. The mixed infections were documented in 38.32%(123/321). Among these, 67.48%(83/123) showed a combination between bacteria and parasites.

2022-10

ZANCO Journal of Pure and Applied Sciences (Issue : 5) (Volume : 34)

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.

2022-09

Academic Journal of Nawroz University (AJNU) (Issue : 3) (Volume : 11)

The prevalence of ESBLs producing Enterobacteriaceae are increasing locally and globally. This study aimed to investigate the antibiotic susceptibility profile of Enterobacteriaceae causing urinary tract infection and to record the prevalence of ESBLs genes among enterobacterial isolates. A total of 454 urine specimens were collected from outpatients with UTIs from two major hospitals in Zakho city; The Zakho General hospital and Emergency hospital. The enterobacterial isolates were identified using the phenotypic and conventional biochemical tests. The antibiotic susceptibility of the isolated organisms was determined using the disk diffusion method, and ESBL production was detected by a double-disk synergy test. The suspected ESBL producers were further confirmed by the amplification of specific primers using PCR assay. Out of 454 specimens, 239 enterobacterial isolates were identified. The most common detected isolates and their rates were: Escherichia coli (65.20 %) and Klebsiella pneumoniae (25.49 %). Imipenem was the most effective antibiotic used while, amoxicillin and ampicillin were the most resistant. The highest level of ESBL production was determined in E. coli (66.3 %) followed by K. pneumoniae (30.43%). The predominant detected gene were both CTX-M and SHV equally followed by TEM. In conclusion, this study indicated that member of Enterobacteriaceae in particular E. coli and K. pneumoniae are the predominant species causing UTI. The isolated bacteria were resistant to most of used antibiotics except imipenem which was effective. These bacteria are becoming multidrug-resistant due to the absence of restriction in antibiotics uses, in addition to their abuse and overuse.

2022-06

JOURNAL OF LIFE AND BIO-SCIENCES RESEARCH (Issue : 1) (Volume : 3)

Klebsiella pneumoniae is a common cause of infections, particularly urinary tract infections (UTIs). Urine samples were taken from 800 patients with clinical indications of UTI who visited the inpatient and outpatient clinics from governorate hospitals and private clinics, namely, Azadi Teaching hospital, Duhok Emergency hospital, Heevi Pediatrics Teaching hospital and Vajeen Private hospital in Duhok city. Standard bacteriological methods were used to identify isolated colonies from urine samples cultured on bacterial media. A speciesspecific PCR assay was used to identify K. pneumoneae isolates at molecular level PCR assays and capsular type counting of the K1 and K2 genes were detected among 50 K. pneumoniae isolates. The furthermost predominant genes amongst all isolates were K1 gene (12%) followed by K2 gene (8%). This study emphasized on K. pneumoniae as sources of UTIs that displayed to harboring K1 and K2 genes. The goal of this work was to investigate the mucoviscosity of K. pneumoniae isolated from a urinary tract infection and to screen for certain virulence factor genes such as K1 and K2 genes.

2021-10

Al-Qadisiyah Journal of Pure Science (Issue : 5) (Volume : 26)

This study involved the prevalence of uropathogenic Escherichia coli (UPEC) among outpatients of UTI attending three major hospitals in Zakho city. Four hundred urine samples were collected from patients of UTI of both sexes and different ages (≤ 1 year to over 50 years), during the period from July 2018 until January 2019. All urine samples were analyzed by conventional bacteriological method for the presence of Escherichia coli (E. coli), while molecular method was used for the presence of species-specific uidA gene in the isolated E. coli. Out of 400 samples, 141 (35.25%) were infected with UPEC from enrolled patients. The rate was higher in females than males (90.78% vs 9.22%), respectively. In both sexes, the age group 41-50 years in both sexes showed the highest rate (46.67%) of infection, and statistically this rate of infection was significant (p< 0.013) among both sexes and various age groups. Furthermore, in all ages, married patients showed slightly higher prevalence than un-married one (38% vs 32.5%), but this difference was statistically non-significant (p> 0.05%). The rate of UTI was higher among urban inhabitants (40.56%) than others. During the months of the year, the peak (90.48%) in both sexes was during December while the lowest rates (13.64%) was during January.

2021-08

International Journal of Research in Medical Sciences (IJRMS) (Issue : 4) (Volume : 4)

Background: Pseudomonas aeruginosa is common pathogen causing nosocomial infection. Acquired drug resistance and Metallo-β-lactamases (MBL) production have recently emerged as one of the most worrisome resistance mechanism that hydrolyze all beta-lactam antibiotics including penicillins, cephalosporins and carbapenems, with the exception of aztreonam. The aim was to find out the prevalence of multi drug resistant (MDR) and Metallo-β-lactamase (MBL) positive isolates of P. aeruginosa in wounds samples which are a serious concern. Methods: Pseudomonas aeruginosa strains were obtained by standard isolation and identification techniques from 307 wound samples of hospital. Strains were then subjected to susceptibility testing for anti-pseudomonas drugs as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Carbapenems resistant strains were selected for the detection of MBL enzyme production by disc potentiation test. Production of MBL was confirmed by enhancement of inhibition zone around imipenem and meropenem discs impregnated with EDTA, as compared to discs without EDTA. Results: Amongst the 71 isolates of P. aeruginosa, 62(87.3%) isolate were imipenem-sensitive, while 9(12.7%) isolates were found to be imipenem resistant and MBL producers. Very high resistance to antibiotics was recorded amongst MBL producers’ P. aeruginosa compared with non-MBL imipenem-sensitive strains. Conclusion: Study indicates that, surveillance for the detection of MBL is necessary. The rapid dissemination of MBL producers is worrisome and necessitates the implementation of proper and judicious selection of antibiotics especially carbapenem.

2019-08

zanco journal of pure and applied sciences (Issue : 32) (Volume : 2)

Uropathogenic Escherichia coli (UPEC) is one of the most causative agents which causing urinary tract infections (UTIs) in humans. This study involved the prevalence of the virulence genes among UPEC isolated from patients in various hospitals in Zakho city from July 2018 until January 2019 and their susceptibility to different commonly used antimicrobial agent against UPEC. The different culture media were used for the identification of Escherichia coli (E. coli). Out of 400 samples, 141 (35.25%) strains of UPEC were isolated from enrolled patients. The antibiotic susceptibility toward different antibiotics was varied among the isolates. Imipenem was the most potent antibiotic with a resistant rate of only 2.84%. While the isolates were resistant to most screened antibiotics, with the highest rate 96.45% to Amoxicillin/ clavulanic. The resistant rates decreased toward other antibiotics at rates varied from 93.62% for Amoxicillin to 43.97% for Norfloxacin. Fifty-seven isolates were selected for PCR analysis, according to the resistance of E.coli to various antibiotics. The selected samples were successfully amplified for E. coli identification by producing a single band of a target uidA gene. In this study, the virulence related genes were detected in only 35 (61.40%) isolates out of 57 isolates. The distribution of the virulence related genes that included; afa, sfa, hly, cnf and pai were 28.07%, 17.54%, 26.32%, 22.81% and 22.81%, respectively. The study highlight that multidrug resistance UPEC harbors multiple virulence genes circulating in this settin

2018-08

Zanco Journal of Medical Sciences (Issue : 22) (Volume : 2)

Background and objective: Pseudomonas aeruginosa is very a well-documented nosocomial and opportunistic microorganism, a little challenge is being present with the identification of such pathogen. This study aimed to identify Pseudomonas on genus and species levels by conventional PCR and determine multi-drug resistant isolates.

2017-08

Science Journal of University of Zakho (Issue : 5) (Volume : 1)

Extended Spectrum Beta Lactamase-among Proteus mirabilis strains recorded high incidence leaving few therapeutic options of potential infections. The purpose of current study was to assess the prevalence of antibiotic resistance among Extended Spectrum Beta-Lactamases (ESBL) producing P. mirabilis, in addition to molecular characterization of the ESBL gene-types using PCR. All isolates were fully identified, checked for antibiotic susceptibility and ESBL production using double disk synergy phenotypic method. Positive ESBL-producing isolates were subjected to PCR assay using specific primers for detection of CTX-M, TEM, and SHV genes. The majority of the isolates exhibited absolute susceptibility (100%) to both meropenem and ertapenem and high susceptibility (95%) to imipenem, while co-resistance were expressed toward cefotaxime, ceftazidime, ceftriaxone and other non-lactam antibiotics. Out of 37 isolates, 21 (57%) were ESBL-producers and using a double-disc synergy test (DDST). Using molecular-based PCR, CTX-M (81%), TEM (57%) and SHV (24%) were determined among ESBL-positive. CTX-M was predominant and circulating among phenotypic multiple resistant strains. Moreover, the coexistence of CTX-M and TEM gene was a more frequent combination. The study highlighted the increasing levels of low antibiotic susceptibility among P. mirabilis harbored ESBL genes at Duhok city and also confirms that a high level of blaCTX-M-positive ESBL isolates is circulating in this area.

2016-08

Science Journal of University of Zakho (Issue : 4) (Volume : 1)

Enterococcus faecalis is one of the leading causes of many infections and mainly urinary tract infections. This pathogen developed high resistance to multiple antibiotics and it harbor many virulence factors genes. This study aimed to determine the antibiotic resistance patterns and screening for some virulence factor genes of E. faecalis isolated from urinary tract infection. Urine samples were collected from 788 outpatient’s clinic having clinical signs of UTI that visited Azadi Teaching Hospital in Duhok city. Urine samples were cultured on bacteriological media and isolated colonies identified using standard bacteriological methods. Antibiotic susceptibility was performed by Kirby Bauer test. All isolates were subjected to species-specific PCR assay for confirmatory identification followed by targeting virulence genes. Twenty five isolates of E. faecalis were detected and confirmed by species-specific PCR assay that expressed high antibiotic-resistance to many selected drugs except norfloxacin, penicillin and ampicillin. The most prevalent genes among all isolates were cpd genes followed by asa1, ace, esp, and gelE. Bearing of virulence genes combination were more frequent among multiple-antibiotic resistant strains. This study highlighted on E. faecalis as causes of UTI in Duhok city that showed multiple resistances to common antibiotics and harboring more than one virulence gene.

2016-08

International Journal of Chemical and Biomolecular Science (Issue : 2) (Volume : 2)

Twenty five isolates of Enterococcus faecalis have been previously identified and characterized were subjected to ERIC-PCR analysis in order to study the genetic relationship with regarding to their virulence profile. Nine virulence profiles were identified according to the presence/absence of five virulence factors; asa1, gelE, esp, cpd and ace. Most isolates (28%) were belonged to Virprofile1 asa1+, gelE+, esp+, cpd+, ace+ followed by Virprofile3 asa1+, gelE-, esp+, cpd+, ace+(20%), Virprofile4 asa1+, gelE+, esp-, cpd+, ace-accounting 16%, while virprofiles5 asa1+, gelE-, esp-, cpd+, ace+, virprofile6 asa1-, gelE+, esp+, cpd+, ace+ and virprofile8 asa1+, gelE-, esp+, cpd+, ace-representing 8%, virprofile2 asa1-, gelE-, esp-, cpd-, ace+, virprofile7 asa1+, gelE+, esp+, cpd+, ace-and virprofile9 asa1+, gelE+, esp-, cpd+, ace+ were 4%. ERIC-PCR analysis divided isolates into two main clusters named; cluster A accounting 28% which further classified into groups; 8% isolates were belonged to A1 and 20% were belonged to A2. Most isolates were belonged to cluster B accounting 72%. This cluster was involved two groups; six isolates (33.3%) were belonged to B1 while 66.6% of isolates were assigned as B2. However, no relationship was found between virulence profiles with phylogentic groups of the isolates.

2016-08

International Journal of Chemical and Biomolecular Science (Issue : 2) (Volume : 2)

Molecular characterization of ESBL-related bla genes including blaTEM, blaSHV, and blaCTX-M has been performed for Escherichia coli isolated from urine and collected from three cities in Kurdistan/region/Iraq (Erbil, Sulymani and Duhok). One hundred sixty nine isolates of E. coli have been identified and their production of ESBLs enzymes have been determined using phenotypic methods. All these isolates were successfully amplified producing a single band of the uidA locus in all strains with a molecular weight of about 670bp in order to confirm at molecular level that all these isolates were E. coli. One hundred sixty ESBL E. coli isolates out of 169 appeared to have one or more ESBLs genes accounting for 94.7%. CTX-M constituted the high prevalent type of ESBLs genes compared to the others represented by 94.1% of all isolates in all the three cities of Kurdistan region followed by TEM and SHV in a percentages of 43.8% and 2.5%, respectively. In Duhok, TEM showed the higher prevalence (60.8%) in comparison to the other two cities in percentages of 36.2% for Sulaimania while Erbil represented by 25%. Furthermore, it was clear that SHV type of ESBLs had the lower prevalence of all types and there were only four isolates out of 160 appeared to carry this type of gene representing 2.5%. The presence and/or absence of the three genes in all isolates were also investigated and it was shown that 86/160 isolates (53.75%) had the CTX-M gene only while the rest of genes were lacking. Moreover, 69/160 isolates had both CTXM and TEM. Interestingly, 3/160 harbored all three involved genes. The isolates characterized by the presence only TEM gene and those that had both CTX-M and SHV, shared the same percentage (0.6%). after taking sequencing of the PCR product of studied genes for 12 E coli isolates into consideration, it was obvious that all the PCR products of CTX-M were belonged to type CTXM-15; while TEM-1 type appeared predominant among all sequences PCR product for TEM gene.. Finally, from the three isolates which revealed positive PCR amplification for the SHV gene, two isolates showed 100% similarity to the SHV-12 genome type while the rest single isolate was similar (99%) to SHV11.

2014-08

Science Journal of University of Zakho (Issue : 2) (Volume : 2)

This study was purposed to sequence analysis of ESBLs genotype of K pneumoniae using partial sequence and Multilocus sequence typing (MLST). A total of 275 K. pneumoniae isolatesinvolved three general hospitals in Duhok, Erbil, and Sulymania, from September 2010 to June 2011. The Minimum Inhibitory Concentration (MIC) was measured by Phoenix system that confirmed 187 ESBL producing isolates followed by the Double Disk Synergy Test (DDST). Then, 12 isolates were selectedaccording to sample diversity, high resistancy to β-lactam and cephalosporins and harboring combination of three genes (TEM, SHV, and CTX-M). Partial sequence analysis of TEM; showed two different genotypes regarding blaTEM as 9 isolates (75%) from different samples (wound, sputum and blood) from three provinces harbor TEM-1 gene and 3 isolates (25%) only from urine in three provinces harbor TEM-198 gene. SHV analysis revealed characterization of selected isolates into six different genotypes. The common genotype was blaSHV-11 involved five isolates from sputum and blood in Erbil and Sulymania provinces, and wound in Duhok province. Only one genotype as all 12 isolates (100%) from different samples and different provinces was found harbored CTX-M-15 gene. Multilocus sequence typing (MLST) study performed using seven housekeeping genes (gapA, infB, mdh, pgi, phoE, rpoB and tonB). A total of 8 different sequence types (STs) were identified; ST11 was dominant sequence type, accounting 41.6%(5 isolates) and was harboring combination of TEM-1, SHV-11 and CTX-15 genes.

2013-08

Science Journal of University of Zakho (Issue : 1) (Volume : 1)

A total of 275 clinical isolates of Klebsiella pneumoniae were collected from three general hospitals in Duhok, Erbil, and Sulymania, during the period September 2010 to June 2011. The Minimum Inhibitory Concentration (MIC) of these isolates was measured using the Gram-negative susceptibility card (GNC) of Phoenix system. Only 187 ESBL producing K. pneumoniae isolates were detected by this system. These isolates were confirmed as 100% ESBLs producers by the Double Disk Synergy Test (DDST). All 187 K. pneumoniae isolates were 100% resistant to ampicillin, cefazolin, cefepime, ceftriaxone, cefotaxime, cefuroxime, ceftazidime, and aztreonam. These isolates showed different percentages of resistance 81.8%, 68.5%, 65.8%, 52.4%, 50.3%, 34.2%, 25.2%, and 12.3% towards, ampicillin/sulbactam, gentamicin, trimethoprime-sulfamethoxazole, ciprofloxacin, piperacillin-tazobactam, amikacin, amoxicillin-clavulanate, and levofloxacin respectively. Molecular characterization by PCR was employed using specific primers for three different ESBLs (TEM, SHV, and CTX-M). Results obtained revealed that SHV-type ESBLs were the most common ESBL occurring in 87% of the isolates with phenotypic evidence of ESBLs production. While those for TEM-type and CTX-M-type were 60% and 58% respectively.