Summary
Atotal of 210 blood specimens were collectedsfrom patientsxadmitted inrIntensive CaretUnito(ICUb) / BaqubahTeaching Hospital. The collection of specimens were starting from 1/9 /2022 to 30 /12 / 2022 . Information about the patients include date of collection and the types of infection were recorded. The bacterial isolates were identified based on the morphologicaland colonycharacteristics and initial biochemical tests ,confirmation of diagnosis by using the VITEK-2 compact system ,and molecular identification by bla- OXA51 gene .
The precensce of A. baumannii isolates was 25from 210 (12%) , these isolates distributed as 4 (16%) for each of septicemia associated with burns infections and Respiratory infection , 5 (20% ) for surgical wounds, 6 (24% ) for diabetes foot ulcers (gas gangrene) , 3 (12% ) for each of brain bleeding and renal failure respectively . The results revealed that all A.baumannii clinical isolates have a very high level of resistance to the most fourteen antimicrobial agents . The resistant to Cefotaxime was 100%, Ticarcillin- clavulante and Ceftriaxone was 96% while Piperacillin- tazobactam,Cefepime ,Tobramycine both showed 92 % and the lowest resistance was to Doxycycline 64 % .
Investigation of biofilms formation revealed that all clinical isolates have the ability to biofilm formation in percentage 15 (60%) of A. baumannii isolates capable to form a strong degree while 10 (40%) were have moderate degree for formation .
Molecular study for the prevalence of RND efflux pumps AdeIJF genes in eighteen isolates were (100%). Investigating the gene expression of three efflux pumps genes (AdeI , AdeF and AdeJ ) in three selected resistant isolates, treated with three treatments in two replication to investigate the effect of ciprofloxacin and resveratol on the expression of AdeIJF efflux genes. Our finding showed the increase in expression of adeI where the folding mean equql to 1.35 after treated by ciprofloxacin ,where the decreased in expression with average of folding after treated with resveratrol 0.59, and combination of ciprofloxacin and resveratrol was 0.79.
Mean folding of AdeF gene showed decrease in expression after treating the isolates with ciprofloxacin , resveratrol and combination were equal to 0.76, 0.50, 0.93 respectively. Thexresults ofvcurrent study showedfthat folding mean value of AdeJ gene after treated with ciprofloxacin , resveratrol and combination of ciprofloxacin and resveratrol were 0.28, 0.43,1.57 respectively . Statistical analysis also revealed significant differences in gens expression between treated and untreated isolates for three genes under study with p – value 0.033 , 0.045 , 0.043 respectively .
The high reduction in expression of Ade I FJ genes after bacterial isolates treated with resveratrol indicate that natural agents (from plant extracts) give promising results and may be benefit to use as Efflux pumps inhibitors and to increase the susceptibility of bacteria to antibiotics.
