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Distribution and molecular characterization of integron classes from Escherichia coli and Klebsiella pneumoniae isolates in Sulaymaniyah province of Iraq.

UNLABELLED: The environmental pollution from the misuse of antimicrobial drugs is fueling selection pressure in bacteria, thereby exacerbating the threat to global health. In Iraq, the situation is made worse by the poor implementation of the World Health Organization's Global Antimicrobial Resistance and Use Surveillance System (WHO-GLASS). Consequently, this study aimed to increase surveillance of the spread of antimicrobial resistance in Sulaymaniyah, Iraq. A total of 296 Enterobacteriaceae comprising 147 Klebsiella pneumoniae and 149 Escherichia coli were isolated from humans, poultry, and dairy farms. The isolates were screened using multiplex PCR to assess the prevalence of the clinically important integron integrase (intI) classes and antimicrobial resistance genes (ARGs) of commonly used antibiotics. Remarkably, 81.14% of the isolates carried at least 2 ARGs, 10.47% intI1, and 3.72% intI2. No intI3 was detected. A total of 663 ARGs were identified using multiplex PCR in the two Enterobacteriaceae: beta-lactamase genes were 43%, tetracycline resistance genes 25.20%, sulfonamide resistance gene 16.10%, quinolone resistance gene 10.2%, and aminoglycoside resistance genes 5.7%. K. pneumoniae harbored more integrons and ARGs than E. coli, thus posing a higher antimicrobial resistance threat in this province. This study underscores the importance of implementing more stringent WHO-GLASS and antibiotic stewardship to end the multidrug resistance crisis in Iraq. IMPORTANCE: These data are about the prevalence of integrons and resistance genes, helping to fill a significant gap in global surveillance efforts. Results can be used by global health authorities and the World Health Organization to develop national and international antimicrobial resistance (AMR) control strategies. The study is important because integrons are key genetic platforms that capture and disseminate antibiotic resistance genes among bacteria. In addition, Escherichia coli and Klebsiella spp. are among the top causes of hospital- and community-acquired infections, especially urinary tract infections, bloodstream infections, and pneumonia. Therefore, it will be riskier when these bacteria have a high rate of integrons and resistance genes because it impedes treatments during infection. Another importance of this study is that the study was carried out in Iraq. Iraq, like many low- and middle-income countries, faces challenges with unregulated antibiotic use, leading to high rates of AMR.

Escherichia coli

Experimental studies on the suitability of aquatic snails as intermediate hosts for Paramphistomum cervi in Iraq.

Three of the most common species of aquatic snails in Iraq were examined for their susceptibility to infection with Paramphistomum cervi. Bulinus truncatus was the only susceptible species. No development occurred in Physa acuta or Lymnaea lagotis euphratica. These findings and a previous field observation that infection of B. truncatus with amphistome larvae is not uncommon indicate that B. truncatus is an intermediate host of P. cervi in Iraq. Young snails of B. truncatus were more susceptible to infection than older ones.

Animals

Rheumatoid arthritis in population samples in Iraq.

A prevalence survey for rheumatoid arthritis was carried out during the summer of 1975 in persons aged 16 years and over in areas of Iraq representative of differences in geography and ethnicity. Definite rheumatoid arthritis was observed in 1% of the 6999 individuals studied, but differences in occurrence rates in relation to various associated characteristics were not detected. It is concluded that present rheumatological services in Iraq have not developed in response to the magnitude of the existing burden. Morning stiffness was reported fairly frequently by individuals without rheumatoid arthritis, but the significance of this observation is not easy to determine. Raynaud's phenomenon was also recorded, but comparative evaluation of the findings is not possible.

Adolescent

Inherited bleeding syndromes in Iraq.

This paper presents data on the occurence and pattern of inherited bleeding syndromes (IBS) in Iraq, a hitherto unexplored problem. During the first fourteen months of a prospective on-going study at a major university center, 116 patients from 62 families were diagnosed as having IBS. All patients were referred because of moderate to severe bleeding diatheses. They included 62 haemophiliacs 32 patients with von Willebrand's disease (VWD), 9 with Christmas disease (CD), 6 with afibrinogenemia, 1 with prothrombin deficiency, and 6 were thought to have platelet dysfunction. 32 other bleeders (16 hemophiliacs, 14 VWD, and 2 CD) were also recognized among the pedigrees studied but were not available for full investigations. The clinical and laboratory features of the patients observed in Iraq do not seem to be significantly different from those of patients in Western Europe or North America. Although the absolute incidence and relative distribution of these disorders in the entire population cannot yet be determined, the rate of occurence per segment population is likely to be high, most likely due to the high rate of consanguinity and large number of births per family, phenomena still prevalent in this country.

Adolescent

Aplastic anaemia in Iraq. A prospective study.

The problem of aplastic anaemia (AA) in Iraq has not been previously investigated. This paper describes 60 patients evaluated prospectively at the University of Baghdad Teaching Hospital during the period 1975--1978. Criteria for the diagnosis included pancytopenia and hypocellular or acellular bone marrow. A surprising finding at variance with published reports about the disease from other parts of the world was a 3 : 1 preponderance of males over females. A discernible aetiology of drug or chemical exposure was detected in half of the patients. Chloramphenicol, alone or in combination with other antibiotics, was thought to be responsible for marrow injury in 12 patients. The occurrence of AA seems to be on the rise in Iraq, probably as a result of the increased use of potentially toxic therapeutic agents and chemicals, and of the growing environmental pollution.

Adolescent

Trypanosoma (Herpetosoma) longiflagellum sp.n. from the tomb rat, Taphozous nudiventris, from Iraq.

Trypanosoma (Herpetosoma) longiflagellum sp.n. (Protozoa: Trypanosomatidae) from a bat, Taphozous nudiventris, from Iraq is described. The trypanosome measures 24.0 to 34.2 micron (mean 26.4 micron, SD 2.5) in total length, 13.8 to 18.2 micron (mean 15.2 micron, SD 1.0) in body length, is 1.5 to 2.9 micron (mean 2.0 micron, SD 0.3) in breadth and has a free flagellum of 10.2 to 16.0 micron (mean 11.2 micron, SD 1.6). The nuclear index is 1.4 to 2.1 (mean 1.7 SD 0.1) and the kinetoplastic index is 1.5 to 2.6 (mean 1.9, SD 0.2). This is the second report of a bat trypanosome belonging to the subgenus Herpetosoma and the first report of trypanosomes from bats from Iraq.

Animals

Trypanosoma (Herpetosoma) longiflagellum Sp.N. from the tomb bat, Taphozous nudiventris, from Iraq.

Trypanosoma (Herpetosoma) longiflagellum sp.n. (Protozoa: Trypanosomatidae) from a bat, Taphozous nudiventris, from Iraq is described. The trypanosome measures 24.0 to 34.2 micron (mean 26.4 micron, SK 2.5) in total length, 13.8 to 18.2 micron (mean 15.2 micron, SD 1.0) in body length, is 1.5 to 2.9 micron (mean 2.0 micron,SD 0.3) in breadth and has a free flagellum of 10.2 to 16.0 micron (mrsn 11.2 micron, SD 1.6). The nuclear index is 1.4 to 2.1 (mean 1.7 SD 0.1) and the kinetoplastic index is 1.5 to 2.6 (mean 1.9, SD 0.2). This is the second report of a bat trypanosome belonging to the subgenus Herpetosoma and the first report of trypanosomes from bats from Iraq.

Animals

Molecular characterisation and mutational analysis of antimicrobial resistance genes in Helicobacter pylori isolates in Erbil, Iraq.

BACKGROUND: Antibiotic resistance in Helicobacter pylori poses a significant challenge to the effective eradication of infection worldwide. Understanding molecular mechanisms of resistance is essential for guiding treatment strategies. This study aimed to investigate the molecular basis of antimicrobial resistance in Helicobacter pylori isolates and their associated mutation frequencies. METHODS: In this cross-sectional study, gastric biopsy specimens were collected from 203 patients at Rizgary Hospital in Erbil, Kurdistan Region, Iraq, who underwent endoscopy for dyspepsia-related symptoms. Of the 137 positive patients, 91 Helicobacter pylori isolates were confirmed by colony morphology, Gram staining, and biochemical tests; 63 were successfully subcultured for antimicrobial susceptibility testing (culture success rate: 69.2%). Antimicrobial susceptibility testing was performed by the agar dilution method to determine the minimum inhibitory concentrations. The sequences of specific genes were examined and analysed by next-generation sequencing. Multiple sequence comparisons were performed to identify resistance-related genes and mutations, using 26695 (NC_000915.1) as the reference genome. RESULTS: Only two isolates (3.17%) were susceptible to all antibiotics examined. The frequency of metronidazole resistance was highest (85.71%), followed by levofloxacin (55.55%), clarithromycin (52.38%), amoxicillin (26.98%), tetracycline (6.35%), and rifabutin (4.76%). Mutations in the rdxA and frxA genes correlated with metronidazole resistance, while GyrA protein mutations at positions 87 and 91 were linked to levofloxacin resistance. Clarithromycin resistance was mainly associated with A2142G and A2143G mutations in 23S rRNA. Amoxicillin resistance (26.98%) was associated with mutations in the pbp1A gene, whereas resistance to tetracycline and rifabutin was infrequent. CONCLUSIONS: This study provides the first molecular surveillance data on antimicrobial resistance in Helicobacter pylori in northern Iraq, offering valuable regional evidence to guide local eradication strategies. The relatively high amoxicillin resistance, together with the elevated resistance to metronidazole, levofloxacin, and clarithromycin, underscores the need for susceptibility-guided therapy and continuous local antimicrobial resistance surveillance.

Antibiotic resistance

Burkitt's lymphoma in Iraq. Clinical and pathological study of forty-seven patients.

The clinical and pathological features of 47 patients with Burkitt's lymphoma seen at the University of Baghdad Teaching Hospital over the years 1969-1977 are described. There were 30 males and 17 females with a mean age of 7.5 years. All patients presented with advanced disease; 44 were in Stage III and 3 in Stage IV, (1 with central nervous system involvement; 1 with bone-marrow involvement; 1 presented as acute leukaemia). The abdomen, with or without other sites, was involved in 42 patients. Thirty-four patients died within 18 months, 11 in the immediate post-operative period. Cyclophosphamide in variable dosages was administered to 29 patients with a good response in 15. The 3 patients with Stage IV disease died with poor response to therapy. Thus, in Iraq, a non-endemic area for the disease, Burkitt's lymphoma seems to have somewhat different clinical and pathological features from the endemic (African), or the rare, sporadic disease reported elsewhere.

Adolescent

Serological evidence of the occurrence of bluetongue in Iraq.

Precipitating antibodies against bluetongue were detected in sheep and goat serum samples collected from animals slaughtered in Baghdad abattoir. Out of 294 sheep serum samples and 110 goat serum samples examined, 28 and 18 samples respectively showed precipitating activity. In addition, examination of sheep serum samples collected from localities where clinical cases similar to bluetongue were previously reported revealed the presence of bluetongue precipitating antibodies in 101 sera out of 198 samples examined. This is the first report confirming the occurrence of bluetongue in Iraq.

Animals

The prevalence of brucellosis among sheep and goats in northern Iraq.

Out of a total of 2,368 sheep and 3,156 goats tested against brucellosis by the Brewer's card test in the 5 Mohafadhas of the northern region of Iraq, 0.93% and 4.4% respectively were recorded as positive reactors. The highest incidence (1.36%) among sheep was found in the Kirkuk region while the lowest (0.78%) was in the Mosul (Nineveh) region. Among goats the highest incidence (11.55%) was revealed in the Dukho region while the lowest (1.47%) was in the Sulaimaniya region. The need for more detailed work on the incidence and on the isolation of the local strains, as well as the need for a control programme, is also discussed.

Animals

Isolation and identification of the Sersenk strain of goat pox virus in Iraq.

Goat pox virus was isolated during an outbreak of pox infection among goats in the Sersenk district, Iraq. The isolated virus grew on the chorioallantoic membranes of developing chick embryos and in primary lamb testis cell cultures. It was identified morphologically as a pox virus and serologically as a member of the Capripoxvirus group in the family Poxviridae. The isolated virus was designated the "Sersenk" strain.

Animals

High yield of monogenic short stature in children from Kurdistan, Iraq: A genetic testing algorithm for consanguineous families.

PURPOSE: Genetic testing in consanguineous families advances the general comprehension of pathophysiological pathways. However, short stature (SS) genetics remain unexplored in a defined consanguineous cohort. This study examines a unique pediatric cohort from Sulaimani, Iraq, aiming to inspire a genetic testing algorithm for similar populations. METHODS: Among 280 SS referrals from 2018-2020, 64 children met inclusion criteria (from consanguineous families; height ≤ -2.25 SD), 51 provided informed consent (30 females; 31 syndromic SS) and underwent investigation, primarily via exome sequencing. Prioritized variants were evaluated by the American College of Medical Genetics and Genomics standards. A comparative analysis was conducted by juxtaposing our findings against published gene panels for SS. RESULTS: A genetic cause of SS was elucidated in 31 of 51 (61%) participants. Pathogenic variants were found in genes involved in the GH-IGF-1 axis (GHR and SOX3), thyroid axis (TSHR), growth plate (CTSK, COL1A2, COL10A1, DYM, FN1, LTBP3, MMP13, NPR2, and SHOX), signal transduction (PTPN11), DNA/RNA replication (DNAJC21, GZF1, and LIG4), cytoskeletal structure (CCDC8, FLNA, and PCNT), transmembrane transport (SLC34A3 and SLC7A7), enzyme coding (CYP27B1, GALNS, and GNPTG), and ciliogenesis (CFAP410). Two additional participants had Silver-Russell syndrome and 1 had del22q.11.21. Syndromic SS was predictive in identifying a monogenic condition. Using a gene panel would yield positive results in only 10% to 33% of cases. CONCLUSION: A tailored testing strategy is essential to increase diagnostic yield in children with SS from consanguineous populations.

Humans

One hundred cases of mandibular fractures in children in Iraq.

A survey of 476 cases of mandibular fractures in Iraq revealed that 100 cases (21%) occurred in children under the age of 13 years. Twice as many fractures were seen in the 6- to 13-year-old group than in the 0- to 5-year-old group. The male to female ratio was 2/1. The site distribution in descending order of frequency was canine region, condyle, angle body and symphysis. Of the 33 condylar fractures, only two showed signs of deviation and ankylosis. Most of these fractures were treated by simple methods of fixation.

Adolescent

Isoenzyme characterization of Leishmania species from Iraq.

Leishmaniasis in Iraq takes both the visceral and cutaneous forms. The causative organisms are identified according to the electrophoretic variation of the enzymes MDH, GPI, 6PGD, PGM and IDH. The 37 visceral stocks investigated fall into two groups which differ only with respect to GPI. The six cutaneous stocks were divided into three groups. Group 3 represents Leishmania major, while groups 4 and 5 refer to L. tropica showing intraspecific variation with regard to 6PGD.

Animals

The prevalence of diabetes mellitus in a rural community in Iraq.

A survey was undertaken to estimate the prevalence of diabetes mellitus in a rural community in Iraq. Blood-sugar estimations after glucose-loading were performed on a sample of a village population 15 + years. 4.8% had diabetes and a majority of them had symptoms referable to their diabetic state. Diabetes was totally unknown among this rural population before the survey.

Adolescent