First Record of Dissemination of BLBLI-Resistant Enterobacter cloacae from Public Hospitals in Baghdad, Iraq

Abstract

Background: Enterobacter cloacae are most frequently isolated from human clinical specimens. Objective: This cross-sectional study aimed to investigate the dissemination of E. cloacae clinical isolates resistant to β-lactam-β-lactamase inhibitor (BLBLI) combinations from different clinical specimens of hospitalized patients. Methods: E. cloacae isolates were recovered from different clinical samples of hospitalized patients in three main hospitals in Baghdad city. E. cloacae isolates were identified based on their morphology and biochemical tests, and the identification was confirmed using Vitek-2 system. The antibiotic susceptibility testing of E. cloacae isolates to a variety of antibiotics was achieved using disc diffusion test (DDT) and Vitek-2 system. Results: Results found that among 335 culture-positive samples, 30 isolates (8.9%) belonged to E. cloacae. A high rate of isolation was observed in urine isolates (46.6%), followed by wounds (burns) isolates (26.6%). Out of 30 E. cloacae strains isolated during this study, 18 (60%) showed reduced susceptibility to BLBLI combinations. TEM genes (TEM-1 and TEM-2) were successfully amplified from 7/18 isolates (38.8%) and high rate of BLBLI genes was detected (CTX-M, bla-SHV, SHV-2, and OXA-1). However, no BLBLI genes of bla-AmpC, bla- OXA-2, and bla- OXA-10 were found in E. cloacae isolates when tested using specific primers for bla-AmpC and bla-OXA genes. Conclusion: From this study, we can conclude that the production of inhibitor-resistant β-lactamases by E. cloacae isolates could be increasingly common in nosocomial pathogens other than E. coli or K. pneumoniae in public hospitals in Baghdad, Iraq.

Genotypic Detection of New-Delhi Metallo-β-Lactamase Producing Carbapenem Resistant Escherichia coli in Holy Karbala Province-Iraq

“…In this present study, about 30.15 percent of the cultured samples tested positive for considerable bacterial growth. Similar findings were seen in earlier studies carried out in several Iraqi districts (Sabry et al, 2021), while some other studies reported higher growth rates (Alzaidi and Mohammed, 2022;Al-Asady et al, 2022). This ratio of no growth results from those patients who probably uptake antibiotics, suffering from a viral infection, immunological disorder, or other conditions.…”

Identification and Characterization of a Bacteriophage with Lytic Activity against Multidrug Resistant E. coli

“…In the last decades bacterial infections have become one of the most biggest threats to human health and food security globally [47,48]. Several studies indicated a rapid and uncontrolled spread of antibiotic resistant bacteria among Iraqi patients [49][50][51]. Local studies identified the contamination of Iraqi rivers water with antibiotic-resistant bacteria [52].…”