Background: Urinary tract infection (UTI) is one of the most common infectious diseases at the community level, worldwide. Objectives: This study aimed to assess the prevalence and antimicrobial susceptibility patterns of the main pathogens responsible for male UTI in the community. Methods: Urine samples were collected from 211 subjects with UTI between January 2017 and February 2020. The samples were inoculated directly on MacConkey and Blood agar and then incubated at 37°C for 24 h. Samples with a colony count of ≥ 105 CFU/mL bacteria were considered positive. Bacterial colonies were determined by standard culture and biochemical characteristics, and their susceptibility to different antibiotics was identified by the Vitek-2 compact equipment. Results: The vast majority of the bacteria were Gram-negative (170 [80.6%]), while 41 (19.4%) of them were Gram-positive. The highest infection was by Escherichia coli (52.6%), followed by Pseudomonas aeruginosa (14.2%). Staphylococcus spp. were the most common Gram-positive bacteria (13.8%). The highest susceptibility of Escherichia coli isolates was found to imipenem (96.4%), and the highest resistance rate was to ampicillin (96.4%). Pseudomonas aeruginosa was resistant to all commonly used antibiotics, and around 86% was susceptible to ertapenem (86.7%). It was also found that Staphylococcus strains were resistant to benzylpenicillin (100%) and sensitive to linezolid (100%), tigecycline (100%), and nitrofurantoin (100%). Conclusions: E. coli isolates were the most frequent pathogens causing UTI in males, followed by P. aeruginosa and Staphylococcus spp. The vast majority of isolates were resistant to commonly prescribed antibiotics such as ampicillin, ceftriaxone, cefepime, benzylpenicillin, oxacillin, and erythromycin. This is an alarming situation, and an urgent plan to control antibacterial resistance is required in the region.

Background: Escherichia coli (E. coli) is one of the most common causative agents of bacterial infections. The emergence of multidrug-resistant E. coli is a major public health threat worldwide. Objectives: This study aimed to determine the antibiotic susceptibility profile of clinical isolates of E. coli from different samples. Methods: A total number of 454 clinical samples, including urine, wound, cervical swab, blood, semen, ascetic, and cerebral spinal fluid samples were collected from patients between January 2017 and February 2020. Then, E. coli was confirmed and susceptibility to different antibiotics was determined using the Vitek-2 compact system. Results: Escherichia coli isolates were more frequent in females (70.7%) than in males (29.3%). In the case of urine samples, E. coli was found to be highly susceptible to ertapenem (97.6%) and imipenem (96.4%) but resistant to ampicillin (87.8%). For wound and cervical swabs, E. coli was 100% resistant to ampicillin and cefepime but 100% sensitive to ertapenem and imipenem. It was found that E. coli isolates from blood samples were 100% resistant to ampicillin, ceftriaxone, and cefoxitin, and around 75% of them were sensitive to ertapenem, ciprofloxacin, and levofloxacin. Finally, E. coli isolated from other clinical samples were highly sensitive to ertapenem, imipenem, levofloxacin, nitrofurantoin, and cefazolin. Conclusions: Escherichia coli isolated from various clinical specimens showed differences in antibiotic sensitivity patterns, with high resistance to commonly used antibiotics. The most effective antibiotics against E. coli isolates were ertapenem, imipenem, and nitrofurantoin. However, the clinical isolates of E. coli displayed high resistance rates to ampicillin, ceftriaxone, and cefepime. Therefore, it is proposed to perform antibiotic sensitivity testing by physicians to select the most effective antibiotics.

Background: Klebsiella pneumoniae is an important opportunistic enteric bacterial strain, which is a major cause of pneumonia and urinary tract infection. Antimicrobial resistance is an increasingly severe threat to the Global Public Health, requiring immediate action across governmental sectors and communities. Objectives: The present study aimed to determine the sensitivity pattern of K. pneumonia isolated from various clinical specimens for common antibiotics in Duhok City, Iraq. Methods: This study was conducted in Duhok City during January 2017-February 2019 on 130 clinical samples of urine, blood, sputum, wound swabs, central venous lines, and oral swabs. K. pneumoniae strains were confirmed and tested in terms of susceptibility to various antimicrobial drugs using the VITEK-2 compact system. Results: In total, 130 positive K. pneumoniae cultures from various clinical samples were examined. The isolates were more predominant in the females (n = 99; 76.2%) compared to males (n = 31; 23.8%). The antibiotic resistance rate of K. pneumoniae varied among different isolate clinical sample sources. Overall, high resistance rates were recorded for ampicillin (96.9%), ceftriaxone (65.8%), and cefepime (60.8%). However, ertapenem (93.8%) and imipenem (82.3%) showed the highest susceptibility rate against the isolates. Conclusions: According to the results, K. pneumoniae isolated from various clinical specimens varied in terms of the antibiotic susceptibility pattern with high resistance to common antibiotics, particularly ampicillin. Ertapenem and imipenem were the most effective antibiotics against the isolates. Our findings could help physicians and clinicians to select appropriate antimicrobial therapies in the region.

Leishmaniasis is caused by protozoan parasites of the genus Leishmania and is a major health problem in various parts of the world. Cutaneous leishmaniasis (CL) occurs, among others, in unpredictable outbreaks after wars and disasters. After the last war in Iraq, the collapse of the health system led to the spread of infectious diseases, including CL. Between September 2016 and November 2017, all patients with confirmed CL having one or more skin lesion(s) were referred to a regional health center in Musol City within the Rabeea District. During this period, 1539 patients visited the clinic. A total of 190 patients were excluded from the study because of poor follow-up. The treatment success rate was 97.7% (1319/1349). Statistically significant associations were found between number of lesions and treatment failure (p = 0.0018; OR = 1.4430; CI = 1.1466–1.8161), number of doses and number of lesions (Pearson’s correlation coefficient = 0.095; p = 0.001), and the lack of municipality services and number of doses used for the treatment (p = 0.008; OR = 1.0629; CI = 1.0158–1.1122). To conclude, the highest number of patients with CL in the city of Musol was recorded after the war in Iraq. The treatment success rate was high, which reflected the strict treatment and follow-up program. An urgent plan is needed to stop the spread of infection.

Background: Urinary Tract Infections (UTIs) are one of the most common bacterial infections worldwide. The study of bacterial uropathogens in a local area and their susceptibility to antimicrobial agents is required to determine empirical therapy. Objectives: This study aimed to assess the profile and antibiotic resistance patterns of bacteria, causing urinary infections isolated from female patients in Duhok province, Iraq. Methods: A total of 530 urine samples were collected from females clinically suspected of UTIs over three years between January 2017 and February 2020. The samples were inoculated directly on MacConkey and Blood agar media and then incubated aerobically for 24 h at 37°C. Samples that gave up colony counts of ≥ 105 CFU/mL were considered as positive growth. Purified colonies were identified through standard bacteriological tests, and their susceptibility to different antibiotics was determined using the Vitek-2 system. Results: Out of 530 urine samples, 450 (84.9%) contained Gram-negative bacteria, while the other 80 (15.1%) harbored Gram-positive bacteria. Escherichia coli was the most common uropathogenic isolate (58.5%), followed by K. pneumoniae (14.3%), Staphylococcus spp. (8.9%), P. mirabilis (6.6%), E. faecalis (3.2%), and S. agalactiae (3.02%). The majority of Gram-negative uropathogens were resistant to ampicillin, aztreonam, ceftriaxone, and cefepime and around 95% were sensitive to ertapenem and imipenem. Most Gram-positive isolates showed high resistance to benzylpenicillin, oxacillin, gentamicin, and erythromycin, and high susceptibility to linezolid, tigecycline, and nitrofurantoin. Conclusions: It was concluded from this study that E. coli is the predominant pathogen causing UTIs in female patients in Duhok province, Iraq. There were increasing antibiotic resistance rates, particularly to ampicillin, aztreonam, ceftriaxone, benzylpenicillin, and erythromycin. Therefore, empirical antibiotic therapy should be based on local sensitivity patterns rather than international guidelines.

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