ANTIMICROBIAL RESISTANCE PROFILES OF URINARY TRACT INFECTION BACTERIAL ISOLATES: A MULTICENTER STUDY IN IRAQ

Authors

  • Saddam. H. Sayel College of Dentistry, University of Anbar, Iraq,
  • Anfal Fawzi Farhan Medical Laboratory Techniques Department, College of Health and Medical Technology, Al-maarif University, Anbar, Iraq,
  • Zainab Agab Altaee College of Dentistry, University of Anbar, Iraq
  • Amenah Sabah Noori 4Medical Laboratory Techniques Department, College of Health and Medical Technology, Al-maarif University, Anbar, Iraq
  • Eman Naji Saleh Department of Biology, College of Education for Pure Sciences, University of Anbar / Iraq
  • Safa Yaseen Mohammed Department of Biology, College of Education for Pure Sciences, University of Anbar / Iraq

DOI:

https://doi.org/10.21010/Ajidv20i2S.3%20%20%20

Keywords:

Antimicrobial resistance; carbapenem resistance; Iraq; ESBL; surveillance; urinary tract infection

Abstract

Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, and antimicrobial resistance poses growing therapeutic challenges. Data on antimicrobial resistance in Iraq remain limited. This study characterized antimicrobial resistance profiles of UTI bacterial isolates across multiple healthcare centers in Iraq.

Materials and Methods: A prospective multicenter study was conducted from January to December 2023 across six private hospitals in Baghdad, Basra, and Erbil. Urine samples from patients with clinically suspected UTIs were processed by conventional microbiological methods; identification used the VITEK 2 system, and susceptibility testing followed Clinical and Laboratory Standards Institute (CLSI) disk-diffusion guidelines. ESBL production was confirmed by combination disk testing, and carbapenemase production by the modified carbapenem inactivation method (mCIM). Isolates with intermediate susceptibility were classified as resistant for epidemiological analysis.

Results: Of the total of 1,847 urine samples, 1,524 (82.5%) yielded positive cultures. Escherichia coli predominated (64.2%), followed by Klebsiella pneumoniae (18.7%) and Enterococcus faecalis (8.9%). Resistance was high for ampicillin (89.8%), trimethoprim-sulfamethoxazole (76.3%), and ciprofloxacin (67.2%). ESBL production occurred in 40.9% of Enterobacteriaceae. Phenotypic carbapenem resistance affected 11.8% of Gram-negative isolates for meropenem and 10.7% for imipenem; carbapenemase production was confirmed in 8.6% by mCIM. Resistance varied significantly by hospital setting and age (p<0.05).

Conclusion: This study demonstrates antimicrobial resistance among UTI isolates in Iraq, with high ESBL prevalence and emerging carbapenem resistance, underscoring the need for antimicrobial stewardship and continued surveillance.

References

Background: Urinary tract infections (UTIs) are among the most common bacterial infections worldwide, and antimicrobial resistance poses growing therapeutic challenges. Data on antimicrobial resistance in Iraq remain limited. This study characterized antimicrobial resistance profiles of UTI bacterial isolates across multiple healthcare centers in Iraq.

Materials and Methods: A prospective multicenter study was conducted from January to December 2023 across six private hospitals in Baghdad, Basra, and Erbil. Urine samples from patients with clinically suspected UTIs were processed by conventional microbiological methods; identification used the VITEK 2 system, and susceptibility testing followed Clinical and Laboratory Standards Institute (CLSI) disk-diffusion guidelines. ESBL production was confirmed by combination disk testing, and carbapenemase production by the modified carbapenem inactivation method (mCIM). Isolates with intermediate susceptibility were classified as resistant for epidemiological analysis.

Results: Of the total of 1,847 urine samples, 1,524 (82.5%) yielded positive cultures. Escherichia coli predominated (64.2%), followed by Klebsiella pneumoniae (18.7%) and Enterococcus faecalis (8.9%). Resistance was high for ampicillin (89.8%), trimethoprim-sulfamethoxazole (76.3%), and ciprofloxacin (67.2%). ESBL production occurred in 40.9% of Enterobacteriaceae. Phenotypic carbapenem resistance affected 11.8% of Gram-negative isolates for meropenem and 10.7% for imipenem; carbapenemase production was confirmed in 8.6% by mCIM. Resistance varied significantly by hospital setting and age (p<0.05).

Conclusion: This study demonstrates antimicrobial resistance among UTI isolates in Iraq, with high ESBL prevalence and emerging carbapenem resistance, underscoring the need for antimicrobial stewardship and continued surveillance.

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Published

2026-08-31

How to Cite

Sayel, S. H., Farhan, A. F., Altaee, Z. A., Noori, A. S., Saleh, E. N., & Mohammed, S. Y. (2026). ANTIMICROBIAL RESISTANCE PROFILES OF URINARY TRACT INFECTION BACTERIAL ISOLATES: A MULTICENTER STUDY IN IRAQ. African Journal of Infectious Diseases (AJID), 20(2), 21–32. https://doi.org/10.21010/Ajidv20i2S.3

Issue

Vol. 20 No. 2 (2026): SUPPLEMENTARY

Section

Articles

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