Background: Acinetobacter baumannii (A. baumanii) has recently emerged as a major pathogen causing nosocomial infections in patients admitted to intensive care units with a surprisingly rapid acquisition of antibiotic resistance. Objective: To study the rate of occurrence of A. baumanii in different clinical samples and to investigate the association between biofilm formation and presence of ompA and bap genes in multi-drug resistance isolates. Methods: A total of 150 clinical samples were collected from (blood, sputum, urine, wound swab) during a period from the first of October 2017 to the end of March 2018 from Al-Imamein Al-Kadhimein City, Central Teaching Hospital of Pediatrics, Welfare Children Protection in Medical City and Al-Yarmouk Teaching Hospital and tested against 14 antibiotics by disc diffusion method. Quantitative microtiter plate assay was done for detection of biofilm formation. Polymerase chain reaction (PCR) was performed to detect ompA and bap genes. Results: There were 75 A. baumanii isolated from different clinical samples as follows: 41 from blood, 13 from wound, 12 from sputum and 9 from urine. The results of antimicrobial susceptibility test showed, high rate of resistance to Aztronem (94.7%) followed by Cefotaxime (89.3%), Cefepim (86.7%), Meropinem (86.7%), Ceftriaxone (86.7%), Ceftazidime (85%), Gentamicin (85%), and Piperacillin (82.7%) respectively. Moderate - to - low rate of resistance to Ciprofloxacin (78%), Impenim (46.7%), Levofloxacin (46%), Amikacin (44%), Tigacycline (42.3%) and Colistin (44%). The detection of biofilm formation showed that (52%) of isolate produce biofilm and the prevalence of ompA gene was 86.7% while the prevalence of Bap-gene was 34.7%. Conclusion: High frequency of A. baumannii infection was observed in different hospitals in Baghdad. More than half of the isolates were biofilm producer and there is highly significant association between the presence of bap gene and the biofilm formation but not with ompA gene. Keywords: Acinetobacter baumannii, ompA, Bap, MD Citation: Talib SS, Abdulrahman TR, Ali SH. Detection of some biofilm genes related with multidrug-resistant in Acinobacter baumannii isolated from clinical isolates. Iraqi JMS. 2018; 16(4): 430-438. doi: 10.22578/IJMS.16.4.11

Background: Legionella pneumophila (L. pneumophila) is gram-negative bacterium, which causes Legionnaires’ disease as well as Pontiac fever. Objective: To determine the frequency of Legionella pneumophila in pneumonic patients, to determine the clinical utility of diagnosing Legionella pneumonia by urinary antigen testing (LPUAT) in terms of sensitivity and specificity, to compares the results obtained from patients by urinary antigen test with q Real Time PCR (RT PCR) using serum samples and to determine the frequency of serogroup 1 and other serogroups of L. pneumophila. Methods: A total of 100 pneumonic patients (community acquired pneumonia) were enrolled in this study during a period between October 2016 to April 2017; 92 samples were collected from patients attended and admitted to Al-Imamein Al-Kadhimein Medical City and 8 samples from those in the (Center of Kidney Diseases and Transplantation) in the Medical City of Baghdad. All patients were under therapy with antibiotics. Serum and urine specimens were obtained from all patients; urine samples were processed for urinary antigen test (rapid test). Serum samples were collected and submitted to DNA extraction for detection of L. pneumophila mip gene by q RT PCR assay. Results: The percentage of L. pneumophila in two hospitals in Bagdad was 30%. Of these 26% was serogroup 1 detected by urinary antigen testing (UAT). In the other hand, 23% of samples were positive by q RT PCR based mip gene, of these 19 % were serogroup 1 and 4% were another serogroup. The sensitivity of UAT is high (P value < 0.001), which means statistically highly significance than q RT PCR. Conclusion: LPUAT is a rapid tool for early diagnosis of Legionella infection, which highlights the need of using this test in hospitals and health institutions and there is a high prevalence of L. pneumophila in Iraq that refer to the necessity of considering this microorganism point of view in future studies for detection and treatment in pneumonic patients. Keywords: L. pneumophila, mip gene, quantitative real time PCR, urinary antigen. Citation: Gauad SA, Abdulrahman TR, Muhamad AK, Jawad AA, Hassan JS. Clinical utility of urinary antigen test and molecular method for detection of Legionella pneumophila. Iraqi JMS. 2018; 16(2): 207-215. doi: 10.22578/IJMS.16.2.13

No abstract

The emergence of multidrug-resistant (MDR) Mycobacterium tuberculosis (Mtb) strains, identified as resistant to at least isoniazid and rifampin, these two drugs form the backbone of the first line drug which is used for tuberculosis (TB) treatment, unresponsive has hampered TB control. As a result of the nearly universal calculation of with half a million new cases of MDR/first line drug TB per year, it is important to keep the database up to date awareness of the processes that contribute to the emergence of MDR Mtb. This resistance is produced for a variety of reasons, including genetic, microbiological factors, non-adherence to treatment by patients and/or failures in therapy administration by some referrer medical centre for TB. This review offers a detailed summary of genetic mechanisms that lead to resistant to first line drug therapy used in management of TB as well as up-to-date information on some new aspects lead to such problem. Keywords: Mycobacterium tuberculosis, first line drug, anti-TB treatment, World Health Organization, isoniazid and rifampin Citation: Hassan JS, Al-Tamimi BJ, Abdulrahman TR, Jamal QW. Resistance mechanisms to first line drug in Mycobacterium tuberculosis: A review. Iraqi JMS. 2022; 20(1): 35-43. doi: 10.22578/IJMS.20.1.5

Background: Mycobacterium tuberculosis (Mtb) is the major causal pathogen of human tuberculosis (TB). Autophagy is a highly conserved cytosolic pathway influencing the immune responses and the elimination of intracellular pathogens including Mtb. Objective: To evaluate the effect of Mtb on autophagy flux with autophagy related genes of LC3I and LC3II, beside the evaluation of serum interferon-gamma (IFN-γ) level in patients with pulmonary TB. Methods: A total of 50 blood samples were collected from patients with pulmonary TB, besides 30 as healthy control. The real-time polymerase chain reaction (PCR) method was determined the measuring of mRNA expression of autophagy-related genes of LC3I and LC3II. Serum IFN-γ protein concentration was measured using sandwich Enzyme Linked ImmunoSorbant assay. Results: The present study showed an increasing in LC3-I level in newly-diagnosed pulmonary TB patients rather than in the control group despite statistically non-significant P˃0.05, while LC3-II showed decreasing in all pulmonary TB groups but statistically non-significant P˃0.05. Autophagy flux ratio of LC3-I and LC3-II genes showed a statistically significant decrease in pulmonary TB groups especially in newly- diagnosed (p value=0.02) rather than control groups. Moreover, the study of the serum level of IFN-γ showed an increase in the level of IFN-γ with p=0.0001 in pulmonary TB patients in comparison with the control group. In addition, the correlation between autophagy-related genes and IFN-γ have been shown a positive significant correlation (p value =0.013) in the multidrug-resistant (MDR) TB group. Conclusion: Autophagy flux ratio showed a statistically significant decrease in pulmonary TB groups particularly in newly-diagnosed TB patients rather than control groups, this indicates the different modulation factors that may affect the process of autophagy. The only positive correlation within biomarkers of the present study has been shown that LC3-II is a dependent factor on IFN-γ in MDR group. Keywords: Pulmonary tuberculosis, autophagy flux, LC3-I, LC3-II, diagnosis, IFN-γ Citation: Wahwah SA, Abdulrahman TR, Mankhi AA. Evaluation of autophagy flux LC3 gene expression and serum IFN-???? in pulmonary tuberculosis patients. Iraqi JMS. 2020; 18(1): 52-60. doi: 10.22578/IJMS.18.1.8