Background and Aim Recently, the extensive use of quinolones led to increased resistance to these antimicrobial agents, with different rates according to the organism and the geographical region. The aim of this study was to detect the resistance rate of Klebsiella pneumoniae Iraqi isolates toward quinolone antimicrobial agents, to determine genetic mutations in gyrA and parC , to screen for efflux-pump activity, and to screen the presence of plasmid-mediated quinolone resistance (PMQR) genes. Methods Forty-three K. pneumoniae isolates were confirmed phenotypically and genotypically by Vitek 2 system and species specific primers by PCR using the targeting rpo gene followed by sequencing. Antibiotic susceptibility test was carried out using disc diffusion method. Quinolone resistant isolates were subjected to ciprofloxacin MIC testing, and cartwheel method to screen for efflux pump activity. The presence of the plasmid mediated quinolone resistance genes qepA, qnrB, qnrS , and aac(6)Ib was tested by PCR. Sequencing of gyr A and par C was performed. Results We observed a high rate of resistance to ceftriaxone, gentamicin ciprofloxacin, and levofloxacin. Low rate of resistance was detected against amikacin and azithromycin. Ciprofloxacin MIC results revealed that 96.1% of the isolates had MICs >256 µg/mL, 83.4% had MICs >512 µg/mL while 34.6% had MIC >1024 µg/mL. Testing of isolates against ciprofloxacin mixed with EtBr at various concentrations resulted in decreased resistant. Sequencing results showed that Ser83Leu was the most common mutation in gyr A that was observed in all quinolone resistant isolates, followed by Asp87Asn. Ser80Ile mutation in par C was observed in 77.7% of the tested isolates. The prevalence of PMQR genes was 92.5% aac (6)-Ib , 51.8% qnr B, 40.7% qep A, and 37% qnr S. Conclusion Quinolone resistance is common in K. pneumoniae isolates in Baghdad. The frequent mutation in gyr A and par C, and the presence of PMQR genes is alarming.

Healthcare-associated items are a common source of acquired infections, and hospital-acquired infections cause significant mortality and morbidity worldwide. Acinetobacter baumannii is the most prevalent infection-causing organism in the hospital environment. Hospital articles and objects are the main sources of infection with the ability to transmit some of the pathogenic microorganisms such as A. baumannii, which is considered a serious problem in therapeutic treatments. In the current study, we isolated A. baumannii from hospital sources and evaluated its antibiotic resistance, virulence factors and resistance gene determinants. The isolates were identified phenotypically as well as genotypically using PCR. In addition, their capability for biofilm formation and ten other virulence factors were measured. Of 112 samples, 21 showed growth of the target organism. Apart from A. baumannii, isolates of Candida albicans, Staphylococcus sp., Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae were also grown. Antibiotic susceptibility test results considered all the A. baumannii to be multidrug-resistant isolates with the highest resistance being 100% to gentamycin, ciprofloxacin; the most effective antibiotics with 100% susceptibility was colistin and tigecycline. All A. baumannii isolates had MIC for ceftriaxone >32 mg/L. All A. baumannii isolates from the hospital environment showed multidrug resistance and had many virulence factors. They have long-term resistance to dry conditions and cause a serious public health issue.

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