Background: Methicillin-resistant Staphylococcus aureus (MRSA) is a serious concern of the global health sector and more recently, an escalating problem in the community. Objectives: This study was performed to investigate the incidence of MRSA in hospital staff and community students in Duhok, Kurdistan, Iraq, and make a molecular comparison between the strains based on the detection of mecA gene and Panton-Valentine Leukocidin (PVL) gene. Methods: We obtained 109 and 103 samples from the nares of hospital staff and community students, respectively. Conventional laboratory tests were performed for the detection of Staphylococcus aureus (S. aureus) and antibiotic sensitivity testing to identify MRSA isolates. Besides, PCR was utilized for molecular analysis. Results: All isolates from hospital staff were identified as S. aureus. Out of the 109 isolates, 55 (50.4%) were MRSA carrying the mecA gene, among which 4/55 (3.7%) were MRSA-PVL positive. Additionally, 54/109 (49.5%) isolates were methicillin-sensitive S. aureus (MSSA) but four isolates (3.7%) were MSSA-PVL positive. Furthermore, 23/103 (22.3%) samples from community students were identified as S. aureus, among which 5/23 (21.7%) and 17/23 (73.9%) isolates were MSSA-PVL positive and MSSA-PVL negative, respectively. Moreover, 1/23 (4.3%) was found as MRSA and was PVL gene-positive. Conclusions: The results showed that MRSA is swarming in hospitals and community in Duhok, Iraq. The highest rate of PVL was associated with community-acquired-MSSA (CA-MRSA). With further genotypic study, immediate action is needed to control and reduce the spread of MRSA clones, determine their clonal relations, and conduct epidemiological investigations.

Objective This population-based study aimed to evaluate the seroprevalence of antibodies to SARS-CoV-2 in Duhok City, Kurdistan Region of Iraq. Methods We analyzed the national COVID-19 database that contains data regarding COVID-19 testing, management, and clinical outcomes in Duhok. For this study, different subdistricts within each district of Duhok were considered distinct clusters. Blood samples were collected from and questionnaires were administered to eligible and consenting participants who were members of different families from the subdistricts. Immunoassays were conducted to detect antibodies against SARS-CoV-2, and the associations between certain variables were investigated. Results The average number cases of COVID-19 before November 2020 was 23141 ± 4364, which was significantly higher than the average number of cases between November 2020 and February 2021 (3737 ± 2634; P = 0.001). A total of 743 individuals agreed to participate and were enrolled in the study. Among the participants, 465/743 (62.58%) were found to have antibodies against severe acute respiratory syndrome coronavirus 2. Among the participants with antibodies, 262/465 (56.34%) denied having any history of COVID-19-related symptoms. The most common symptom was fever (81.77%), followed by myalgia (81.28%). We found that antibody levels increased steadily with age (Pearson correlation coefficient = 0.117; P = 0.012). A significant association was found between antibody levels and the presence of symptoms (P = 0.023; odds ratio = 1.0023; 95% confidence interval = 1.0002-1.0061). Conclusions A significant reduction in the number of COVID-19 cases was observed. This might be due to the high prevalence of SARS-CoV-2 antibodies in Duhok. However, infection-prevention measures should be followed as it remains unclear whether acquired immunity is protective against reinfection. It expected that the infection rates during the next wave will not be as high as the first wave due to the high infection rate in the society.

Background Helicobacter pylori is a gram-negative bacterium that infects half of the populations worldwide (1). In addition, it can cause gastric and duodenal ulcer and predispose to individuals gastric adenocarcinoma (2). Further, H. pylori infection is persistent while asymptomatic in most individuals. However, whenever the microorganism is diagnosed, it should be eradicated with the administration of antibiotics and the proton pump inhibitor (3). The determinants of the successful eradication of this microorganism include drug efficacy, bacterial resistance, and the patient's compliance. However, antibiotic resistance is considered as the most common cause of eradication failure and varies in different countries and within different regions of the same country (3), challenging H. pylori eradication and H. pylori-related complication treatment (3). Different variables may play an important role in the treatment failure of H. pylori, including patient characteristics, underlying disease presence, and environmental factors. The recommended course of the treatment includes the combination of amoxicillin plus clarithromycin with a proton pump inhibitor in the majority of international guidelines for the eradication of H. pylori (4, 5). The bismuth-containing quadruple or levofloxacin-based regimen (LBR) is advised for H. pylori eradication if the clarithromycin resistance rate is more than 20%. According to previous research, the clarithromycin resistance rate is 20% in Iraq (6). Nonetheless, no clinical trial study, to the best of our knowledge, has so far investigated the eradication success rates of bismuthcontaining quadruple or LBR in this country. Objectives The aim of our project was to evaluate the effectiveness of levofloxacin versus bismuth-based courses for the eradication of H. pylori.