Neonatal intensive care units (NICUs) are specialized health care settings where neonates with critical conditions and preterm births are exposed to a high risk of healthcare-associated infections (HAI). Non-critical medical equipment and frequently touched surfaces in the NICU environment may act as a medium of bacterial transmission. It is important to know the level of bacterial contamination in the NICU environment in order to enhance infection prevention and control. The objectives of the present study were to determine the level of bacterial contamination in the NICU environment in Iraq, to determine the distribution of Gram-positive and Gram-negative bacteria and to determine the most common bacteria present in the NICU environment. A cross-sectional survey was carried out in the NICU of Al-Rifai General Hospital in Al-Rifai City in Iraq from November 2023 to March 2024. A total of 61 swab samples were collected from frequently touched surfaces and frequently used non-critical equipment in the NICU environment. These surfaces and equipment include incubators, suction tips, stethoscopes, door handles, medical equipment, and hands of healthcare workers. These samples were then cultured using standard microbiological practices and incubated at 37°C for up to 48 hours. The bacteria were identified based on their colonial characteristics and Gram staining. Among the total samples, 58 (95.1%) had evidence of bacterial growth, while 3 (4.9%) had no growth. Of the culture-positive samples, Gram-positive organisms were predominant, accounting for 40 (68.9%), while Gram-negative organisms accounted for 18 (31.0%). Among Gram-positive organisms, the most prevalent organism was Staphylococcus aureus, accounting for 13 (32.5%), followed by Bacillus cereus (6, 15.0%), Staphylococcus epidermidis (4, 10.0%), and Enterococcus faecalis (4, 10.0%). Among Gram-negative organisms, Escherichia coli was the predominant organism, accounting for 10 (55.5%), followed by Acinetobacter baumannii (3, 16.6%), and Pseudomonas aeruginosa (2, 11.1%). From the qualitative mapping, it was observed that predominant organisms were isolated from high-touch surfaces and non-critical equipment, including incubators, suction tips, stethoscopes, door handles, and healthcare workers’ hands. The study revealed a high level of environmental contamination in the NICU, with a predominance of Gram-positive organisms and clinically important Gram-positive and Gram-negative organisms. The study also revealed that predominant organisms are associated with high-touch surfaces and non-critical equipment, emphasizing the need for strict hand hygiene and environmental decontamination practices in the NICU setting.

Background: Gallbladder disease is one of the prevalent hepatobiliary disorders, which are often accompanied by metabolic abnormalities, especially dyslipidemia. Nevertheless, in uncomplicated cases, abnormalities in the baseline liver function are not always present. Also, there are temporary changes in liver enzymes after laparoscopic cholecystectomy, although there is limited data of certain region populations. Aims: The purpose of the research was to test the differences in lipid profiles and liver biochemistry between women with the gallbladder disease and healthy control groups, and to determine the changes in liver enzymes in the short term after laparoscopic cholecystectomy surgery in Dhi Qar Governorate. Methods: This was a case control study and prospective observational study. One hundred and thirty-five female patients with a known case of gallbladder disease who are between 30 and 45 years were matched with one hundred and thirty-five healthy seemed controls. All subjects were of regular menstrual cycles and none had a history of chronic psychosis or malignancy. Tests of serum lipid profile and liver functioning were obtained after overnight fasting. They also followed 100 patients who were having elective laparoscopy cholecystectomy and biochemical measurements were conducted before surgery, at 24 and 72 hours of operation. There were statistical analyses of independent and paired t-tests, where p < 0.05 is statistically significant. Results: The patients with gallbladder disease had much higher serum levels of total cholesterol, low-density lipoprotein cholesterol and triglycerides, and much lower levels of high-density lipoprotein cholesterol in comparison with the controls (p < 0.05). There were no significant differences in terms of level of alanine aminotransferase or bilirubin in the two groups. In laparoscopic cholecystectomy AST, ALT, ALP, GGT, and total bilirubin levels were significantly increased at 24hours postoperative (p-value less than 0.05) which began to return to baseline levels after 72 hours. There was no significant postoperative change in the direct bilirubin levels. Conclusions: Gallbladder disease in women of Dhi Qar Governorate is mainly related to dyslipidemia and not baseline liver dysfunction. Laparoscopic cholecystectomy causes temporary and reversible rises in liver enzymes and no signs of long-term hepatocellular damage and biliary dysfunction.

Background: Background Vaginal microbiome is a key factor in mucosal homeostasis and immune regulation in the female reproductive tract. The disturbance of the lactobacillus-dominant flora can contribute to the colonization by opportunistic pathogens such as Pseudomonas aeruginosa. Even though the P. aeruginosa is already known to be a pathogen in many anatomical locations, its contribution to vaginal infection and its systematic immuno-nutritional changes have not been adequately defined. The sustained inflammatory response after infection through therapy might help to cause changed mucosal immunity and general micronutrient deficiency. Aims: This study developed to assess local inflammatory response and systemic micronutrient profiles of women who had been diagnosed of Pseudomonas aeruginosa vaginal infection in the past, five months after standardized treatment with antimicrobials, and control group healthy women. Methods: The case-control study was a 12-month study in Thi-Qar Governorate, Iraq. Two hundred aged 35-50 years women were recruited: 100 women with known history of culture-confirmed P. aeruginosa vaginal infection diagnosed 5 months ago (Group A) and 100 age-matched healthy controls (Group B). All the cases had gone through the same antimicrobial regimens and none of them had chronic illnesses. Vaginal samples were examined by ELISA of pH, count of leukocyte (WBC/HPF), IL-1 B, IL-6, IL-8, TNF- 4 and secretion IgA. The levels of serum zinc, copper, iron, calcium, and 25-hydroxyvitamin D were determined using standard biochemical procedures. Statistical tests were performed involving parametric and non-parametric tests, odds ratios estimation, logistic regression, and principal component analysis (PCA). Results: Women in Group A showed a statistically significant higher vaginal pH, leukocyte infiltration and higher levels of IL-1B, IL-6, IL-8 and TNF-a (all p < 0.001) than controls. There was a significant increase in IL-8 levels, which showed that neutrophil recruitment is persistent. Group A had much lower serum zinc, iron, calcium and vitamin D concentration, and higher levels of copper (p < 0.001). Deficiency of vitamin D was found in 60 percent of the cases compared to 30 percent of controls. Forest plot analysis showed a high likelihood of increased odds of zinc, iron, and vitamin D deficiencies by formerly infected women. Multivariate studies indicated clear clustering distance between groups, which indicated a unique inflammatory-micronutrient signature used with antecedent P. aeruginosa vaginal infection. Conclusions: Pseudomonas aeruginosa vaginal infection history in women results in a sustained inflammatory response in the area and pronounced changes in micronutrients in the system 5 months post-standardized therapy. These results imply that there is integrated inflammatory-nutritional phenotype, which can affect the post-infectious mucosal immune restoration. Additional longitudinal and interventional research is justified to delineate the cause and effect as well as therapeutic implication.

Background: There is micronutrients including vitamin D, zinc, and iron which are important as they are involved in immune regulation, control of inflammatory conditions, and defence of the host against bacterial infections. Pseudomonas aeruginosa is a Gram-negative opportunistic pathogen and is able to take advantage of host micronutrient imbalances by using nutritional immunity mechanisms. The physiological stress and inflammatory reaction that may occur after the birth of a child can cause postpartum women, especially following cesarean section, to have an impact on micronutrient status. Nevertheless, there is not much information on the joint effect of delivery mode and P. aeruginosa infection on the biochemical profiles of the mothers. Aim: The aim of the study was to compare the impacts of the type of delivery and confirmed infection of Pseudomonas aeruginosa infection on serum levels of 25-hydroxyvitamin D, zinc, iron, and calcium in women aged 3045 years in Thi-Qar Governorate, Iraq. Methods: The study involved a comparative cross-sectional study that was controlled and used a total of 400 study participants split into four groups (n=100 each): CS+INF (cesarean section with infection), CS-INF (cesarean section without infection), VD + INF (vaginal delivery with infection), and VD-INF (vaginal delivery without infection). All participants with the infection were confirmed by laboratory tests to have P. aeruginosa infection. Women who have chronic illnesses or are currently on micronutrient supplementation were not allowed. Blood samples (venous blood) were collected and serum 25 (OH)D (ng/mL), zinc (mu g/dL), iron (mu g/dL), and total calcium (mg/dL) measured. Data were presented as the means and SD and measured with the help of the Two-Way ANOVA to evaluate the impact on infection status and delivery mode, as well as their interaction. A p-value less than 0.05 was taken to be statistically significant. Results The concentration of vitamin D, zinc, and iron was significantly lower among the infected groups than the non-infected groups. The lowest levels were always in the CS+INF group (25(OH)D: 13.5 +5.5 ng/mL; zinc: 69 +12 ug/dl; iron: 47 +18 ug/dl). Vaginal delivery in an uninfected (VD-INF) status had the most micronutrient level (25(OH)D: 24.0 ± 8.0 ng/mL; zinc: 92 ± 15 µg/dL; iron: 85 ± 25 µg/dL). Iron level was found to be affected by both infection and mode of delivery whereas those of vitamin D and zinc were related mostly to the state of infection. There was very little difference in total calcium levels between groups and all were within the physiological ranges of reference. Conclusions: Pseudomonas aeruginosa infection is linked to massive losses in the levels of serum vitamin D, zinc and iron amongst women who have given birth. Cesarean birth could also contribute to iron deficiency, probably because of a combination of both the inflammatory and surgical conditions. Calcium homeostasis does not seem to be affected. The given findings underscore the need to monitor micronutrient status of postpartum women who had an infected past especially those who undergo cesarean section in order to promote immune functioning and recovery.

Background: Members of the genus Ichthyophthirius are some of the most notable ectoparasitic ciliates affecting freshwater fishes globally. While infections have been documented in common carp (Cyprinus carpio) and goldfish (Carassius auratus) in Iraq, molecular confirmations and recent updates to host range data are lacking. Considering the recent expansion of aquaculture and the translocation of fish, the potential for greater dissemination of parasites among both native and introduced aquatic ecosystems is concerning. Aim: The primary goal of the current study was to molecularly identify and phylogenetically characterize Ichthyophthirius spp. affecting freshwater fishes in the Al-Diwaniyah River, Iraq, and examine new extensions of host range. Methods: A total of 720 fish specimens belonging to five species were collected and examined between October 2023 and October 2024. Skin and gill tissues were microscopically investigated for the presence of ectoparasitic infections. From these positive samples, DNA was extracted, and the 18S rRNA gene was amplified. Subsequently, the PCR products underwent sequencing, and the resulting data were analyzed using the BLAST and Maximum Likelihood (ML) methods for phylogenetic analysis. Results: Ichthyophthirius spp were found only in skin tissues, affirming strong predilection or specific tissue preference. In molecular amplification, clear 18S rRNA products were found within the range of 1500–3000 bp. In comparison to 18S rRNA sequences of Ichthyophthirius spp, analyses of the sequences showed 98–100% similarity to any of the global reference sequence of Ichthyophthirius in the GenBank. In the phylogenetic reconstruction, Iraqi isolates formed a distinct clade with considerable support of Ichthyophthirius, which is almost identical with Asian strains, albeit minor nucleotide variations which suggest lateral stability. Although the parasite has been documented in Cyprinus carpio and Carassius auratus, this study reports Ichthyophthirius spp. for the first time in Oreochromis aureus, Garra variabilis, and Oreochromis niloticus in Iraq. Conclusion: Molecular data in this study serve to confirm the presence of Ichthyophthirius spp. in the Iraqi freshwater system. This study also expands the number of documented hosts to several cyprinid and cichlid species. Findings of this study are important in the understanding of parasite ecology, transmission cycle, and the possible impacts of aquaculture of Iraq.

Background: Pseudomonas aeruginosa is an opportunistic bacterial pathogen responsible for a significant proportion of hospital infections, especially in intensive care units (ICUs). The bacterium's ability to resist multiple drugs and survive in hospitals makes it more likely to stick around and cause disease. In Diwaniyah Governorate, repeated studies have explored the phenotypic and molecular characteristics of Pseudomonas aeruginosa, particularly its beta-lactamase production and antibiotic resistance. The identification of genetic markers linked to drug resistance is essential for designing antimicrobial guided strategies. Even though previous studies have evaluated Pseudomonas aeruginosa in several hospital settings, little is known about its molecular characterization and resistance profile on this setting. Knowing the prevalence of resistant genes such as GES, blaOXA-48 and SPM may help in establishing measures for infection control. Objectives: The objective of this study was to use molecular techniques to isolate and identify Pseudomonas aeruginosa from clinical samples, find out what kind of antibiotics they are resistant to, and look for genes that make beta-lactamase. Materials: The study involved the different culture media were used, and identification relied on several biochemical reagents, such as Catalase, Oxidase, IMVC, and TSI tests, in addition to the Vitek2 Compact system. To detect β-lactamase activity, Penicillin G solution, starch solution, and iodine solution were applied in the rapid iodine method. For molecular work, genomic DNA was extracted using the Genomic DNA Mini Kit (Geneaid, USA). Preparation of electrophoresis gels required agarose powder (1.5%), TBE buffer (1X), and ethidium bromide as a DNA stain. The amplification of target genes was carried out using Wizpure PCR FDmix, along with specific primers for 16S rRNA, blaSPM, blaGES, and blaOXA-48 genes, in addition to PCR-grade water. Results: Pseudomonas aeruginosa was confirmed in 15 out of 40 clinical samples (37.5%). The highest isolation rate was found in burns (60%), then wounds (26.6%), and finally urine (13.4%). The rapid iodine test and the Vitek 2 system showed that 80% of the isolates made beta-lactamase, which means they were resistant to most antibiotics except for tigecycline. Polymerase chain reaction (PCR) analysis indicated that all isolates possessed the 16S rRNA gene, 75% contained the OXA-48 gene, 40% harboured the bla GES gene, and 20% possessed the SPM gene. This study is one of the first to show what Pseudomonas aeruginosa is made of in the Diwaniyah Governorate. It also shows how resistant it is and what genes are responsible for making beta-lactamase. Conclusion: The results show how important it is to keep an eye on things all the time, follow strict infection control rules, and have antimicrobial stewardship programs in place to stop the spread of drug-resistant Pseudomonas aeruginosa in healthcare settings.

Candida species are the utmost prevalent opportunistic fungal pathogens in the immune-compromised patients and bone marrow transplants patients, as well as in Children suffering from orofacial birth defects called Orofacial Clefts that affect the lip, palate, or both, and are more prone to oral candidiasis. Consequently, this study aimed to identify Candida dubliniensis and its virulence gene, Candida dubliniensis mitochondrial gene using various culture media, PCR, and ELISA. This study was extended between January 2023 to August 2024 at Al-Diwaniya Children’s Hospital /Iraq. A 75 oral swab and blood samples were collected from cleft lip/palate patients (with and /without candidiasis). Candida dubliniensis was identified via culture om CHROM and Sabouraud agar and PCR targeting the Cdub gene. Serum IL-17/IL-23 levels were measured by ELISA. Statistical analysis used SPSS (chi-square). Among the tested specimens (57.33%) were positive for C. dubliniensis, while (42.67%) were negative. All C. dubliniensis isolates from patients with orofacial clefts carried the Candida dubliniensis mitochondrial gene, whereas no mitochondrial gene was detected in patients without candidiasis. The cytokine levels revealed that oral candidiasis significantly increased the concentration of cytokine Interleukin-17 to 115.91 ± 15.42 pg/ml, in comparison to 68.85 ± 10.59 pg/ml and 21.58 ± 2.33 pg/ml in orofacial cleft patients without candidiasis and the control group respectively. Similarly, Interleukin -23 levels were significantly elevated to 77.28 ± 8.94 pg/ml in the candidiasis group, compared to 53.84 ± 8.93 pg/ml and 8.45 ± 2.46 pg/ml in orofacial cleft patients without candidiasis and the control group respectively. In Conclusion: This study demonstrates a relatively high prevalence of Candida dubliniensis in children with orofacial clefts, with a significant association between the presence of the Candida dubliniensis mitochondrial gene and candidiasis. The study also approved the immunological impact of C. dubliniensis infections in orofacial clefts patients with Candida dubliniensis, as evidenced by significantly elevated levels of Interleukin-17 and Interleukin -23 compared to non-candidiasis orofacial cleft patients and control group.