Background: Carbapenems are usually the choice of antimicrobial agents in infections produced by Enterobacteriaceae bacteria-producing ESBL (extended spectrum β-lactamases). Carbapenemase production among clinical isolates of Enterobacteriaceae has been widely reported and Resistance to carbapenems group is generally due to production of Carbapenemases. Phenotypic determination and distinction of Carbapenemases in drug-resistant gram-negative is crucial for appropriate infection control. Materials and Methods: Carbapenemase production among Enterobacteriaceae isolates was identified phenotypically using a commercially available EDTA-combined disc diffusion test containing inhibitors to the various carbapenemase classes and Modified Hodge test (MHT). Results: A total of 98 Enterobacteriaceae isolates were included, 42(42.8%) were Multi-drug resistant (MDR), 27(27.5%) were XDR while 8(8.2%) exhibited pan-drug resistance (PDR). Of the 74 isolates of Escherichia coli and 24 Klebsiella pneumoniae that were positive for carbapenemase production, 12 (16.2%) and 9 (37.5%) were Metallo beta-lactamase (MBL) producers respectively, Hence, the overall prevalence of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in this study were 47.3% and 87.5%. Conclusion: Carbapenemase-producing Enterobacteriaceae was indeed recognized in our hospitals. The EDTA-combination disk test was a rapid, cost-effective and suitable method which will be able to identify and distinguish the carbapenem-resistant bacterial isolates within the hospitals especially when molecular detection techniques are not available.

Long non-coding RNAs (lncRNAs) are a heterogeneous group of ncRNAs with characteristic size of more than 200 nucleotides. An increasing number of lncRNAs have been found to be dysregulated in many human diseases particularly cancer. However, their role in carcinogenesis is not precisely understood. DLX6-AS1 is an lncRNAs which has been unveiled to be up-regulated in various number of cancers. In different cell studies, DLX6-AS1 has shown oncogenic role via promoting oncogenic phenotype of cancer cell lines. Increase in tumor cell proliferation, migration, invasion, and EMT while suppressing apoptosis in cancer cells are the effects of DLX6-AS1 in development and progression of cancer. In the majority of cell experiment, mediator miRNAs have been identified which are sponged and negatively regulated by DLX6-AS1, and they in turn regulate expression of a number of transcription factors, eventually affecting signaling pathways involved in carcinogenesis. These pathways form axes through which DLX6-AS1 promotes carcinogenicity of cancer cells. Xenograft animal studies, also have confirmed enhancing effect of DLX6-AS1 on tumor growth and metastasis. Clinical evaluations in cancerous patients have also shown increased expression of DLX6-AS1 in tumor tissues compared to healthy tissues. High DLX6-AS1 expression has shown positive association with advanced clinicopathological features in cancerous patients. Survival analyses have demonstrated correlation between high DLX6-AS1 expression and shorter survival. In cox regression analysis, DLX6-AS1 has been found as an independent prognostic factor for patients with various types of cancer.

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 Emergence of drug resistance in Escherichia coli due to various mechanisms makes the treatment choices very limited. The objective of this research was to investigate extended-spectrum beta-lactamases (ESBLs) and AmpC lactamases in E. coli isolates from urinary tract infections (UTIs) and to assess their antibacterial susceptibility patterns in a health-care context. A total of 70 E. coli isolates from clinically assumed cases of UTI patients during the 9 months period. The isolates with bacteriuria (105 CFU/ml) were identified. ESBL and AmpC were detected phenotypically. Out of the 70 isolates of uropathogenic E. coli, ESBL production was detected in 34 (48.6%) isolates and AmpC producer in 27 (38.6%) of isolates in which 14 (20%) of them showed coexistence phenotype of both ESBLs and AmpC and 23 (32.9%) E. coli isolates were both ESBL and AmpC non-producer. The findings donated information regarding drug resistance. The level of resistance recorded in ESBL- and AmpC-producing uropathogenic E. coli of this study was raising; therefore, it is crucial to have a strict infection control measures and routine monitoring of ESBL- and AmpC-producing bacteria in clinical laboratory.

Introduction Antibiotic resistance is a daunting phenomenon with a growing impact on patient safety, particularly for nosocomial infections. 1 The nosocomial strains of P. aeruginosa are frequently resistant to a broad range of commercially available antibiotics. Their prevalence appears to be increasing worldwide, especially as a cause of ventilator-associated pneumonia and in patients with severe burn injuries. 2 Critically ill patients are prone to colonization and infection by antibioticresistant bacteria because of the frequent exposure of these patients to antibiotics. This dangerous array increased the need for broad-spectrum antibiotics, reduced antimicrobial efficacy, and increased antibiotic resistant strains. 3 These infections are complicated to treat due to the occurrence of multidrugresistant (MDR) organisms, which include resistance to beta-lactams, aminoglycosides, fluoroquinolones, and carbapenems. 4 Carbapenems were subsequently introduced as the last resorts of antibiotics due to their high potency and the exceptional broad spectrum of antimicrobial activity, but the carbapenemases, are capable of causing resistance to a wide variety of β-lactam antibiotics, including carbapenems. 5 P. aeruginosa can become resistant to the carbapenems through a number of mechanisms mainly due to the production of OXA-type carbapenemases (class D) Background and objective: Pseudomonas aeruginosa is an opportunistic pathogen and inherently resistant to many antibiotics and can mutate to even more resistant strains during therapy. Resistance to the antibiotics in this group of bacteria increased due to the activity of β-lactamase genes and one of the most important groups of genes, blaOXA gene producing enzymes. The current study aimed to determine the prevalence of Ambler class D β-lactamases, including OXA-10 gene among P. aeruginosa isolated from patients in Erbil, Kurdistan. Methods: Different clinical specimens were taken from patients with clinical symptoms of infection during one year. Identification was carried out on all isolates by Vitek2 system. Antibiotic susceptibility for antimicrobial agents was performed according to the clinical and laboratory standards institute (CLSI) guidelines. Production of Ambler class D β-lactamases was confirmed by polymerase chain reaction technique. Results: A total of 100 isolates of P. aeruginosa, 57 isolates (57%) had shown resistance to six or more than six antibiotics, and 15 isolates showed resistance to one antibiotic. Also, none of the resistant isolates were showed complete resistance to all antibiotics. Out of 89 P. aeruginosa, 38.2% of isolates possessed the blaOXA-10 gene. Conclusion: The results revealed the occurrence of extended-spectrum β-lactamases producing Pseudomonas aeruginous, and proper infection control practices are crucial to avert the spreading of ESBL-producing isolates in hospitals.