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Article Type

Original Study

Abstract

Background: Enterobacter cloacae have challenged global health through nosocomial infections, especially among immunocompromised patients. In the most overburdened healthcare systems, more study and strategy are anticipated. Aim of the study: To determine the prevalence of Enterobacter cloacae in hospital-acquired infections in Baghdad hospitals and to evaluate its antimicrobial resistance patterns across burn, wound, and urine samples, with a focus on multidrug resistance and antibiotic resistance trends. Methods: Three hundred and seventy-seven patient samples were collected and examined at a teaching laboratory in Baghdad between January 2024 and December 2024. These had 513 samples, 238 burn swabs, 139 wound swabs, and 136 urine samples. All the samples were cultured to isolate bacteria, followed by their identification through conventional methods. The susceptibility pattern of the isolates to 25 antimicrobials was determined. using standard procedures. Results: From urine, wound, and burn samples, 134 (26.12%) Enterobacter cloacae isolates were obtained. The results indicated an increasing trend in both patient infections and the isolates of Enterobacter cloacae during 2024. Burn and urine samples were observed to yield the highest numbers consistently. Antimicrobial susceptibility testing showed high rates of resistance, especially against gentamicin (58% in burn isolates), cefotaxime (48% in urine isolates), amoxicillin, and ampicillin. Of concern was meropenem resistance in 44% of the burn isolates, raising carbapenem-resistant Enterobacter species as an issue. Conclusion: The study highlights the very high rates of multi-drug-resistant strains of Enterobacter cloacae in hospitals, the need for infection control, good antibiotic stewardship. Thus, targeted interventions with better surveillance will be required in Baghdad.

Keywords

Baghdad, Enterobacter cloacae, Nosocomial infections, Prevalence, Antibiotic susceptibility

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