Emergence of Raoultella ornithinolytica Producing Beta Lactamase Enzyme in Different Clinical Specimens in Erbil City

Abstract

Background: Raoultella ornithinolytica should never be regarded as merely a saprophytic bacterium that occasionally contaminates bronchial lavage or other deep respiratory samples or surgical sites is an underreported, emerging hospital-acquired infection and is particularly related with invasive operations.R. ornithinolytica isolates have significant antimicrobial resistance rates, and physicians should be aware of this so that, before accurate microbiological data are received, an immediate broad-spectrum antibiotic treatment can be instituted..
 Objectives: The goal of our study was to retrospectively examine R. ornithinolytica, which was isolated from a variety of clinical samples in Erbil, and to examine its epidemiology, antibiotic sensitivity patterns, and ability to produce the enzyme extend spectrum beta lactamase.
 Methods: A total of 2350 samples were collected from three different sources(Urine ,High vaginal swab and wound), collected from female and male from patient attending Rizgary hospital and Central lab in Erbil city during the July 2017 to Februry 2018 . Only 10 cases had been identified as R. ornithinolytica and all isolates isolated and identified by using microscopical, morphological , biochemical tests and Vitek 2 compact system . Also antibiotics susceptibility testing was performed by using Vitec 2 compact system according to the standard protocol against 13 antibiotics which are (Ampicillin /Sulbactam , Piperacillin/ Tazobactam, Cefazolin, Ceftazidim , Ceftriaxon , Cefepime, Levofloxacin , Trimethoprim/ Sulfamethoxazol, Gentamycin, Tobramycin, Ertapenem, Imipenem, Ciprofloxacin).
 Results: Only ten R. ornithinolytica isolates isolated from 2350 distribution according to their source of isolation High vaginal swab 6(0.23%) appeared to be the most dominant specimen than other specimens followed by urine sample 3(0.13%) then wound 1(0.04%).The highest percentage of R. ornithinolytica. isolated from female .Most isolates from high vaginal swab sample 6(0.26%) followed by urine 3 (0.13%) then wound 1(0.04), when performing of antibiotic susceptibility the highest resistances rate were to Cefazolin and Trimethoprim / Sulfamethoxazol 10 (100%) followed by Ampicillin / Sulbactam , Piperacillin / Tazobactam, Ceftriaxon , Gentamycin , Tobramycin and Ciprofloxacin 7(70%) for each, 6(60%)isolates ESBL producer, all isolated R. ornithinolytica were resistance to more than 8 antibiotics and two isolates completely resistance to all thirteen antibiotics.
 Conclusion: The overall prevalence of R. ornithinolytica isolates was low in Erbil city and we can be observed and isolated from varies clinical samples and causes serious infections and susceptibility to some antibiotics are low and also most isolates multiresistance and ESBL producers and These findings offer a reliable measure of the prevalence of Raoultella ornithinolytica in our region and provide a baseline for future studies that will enable the monitoring of trends over time. If current resistance trends continue, high societal and economic costs can be anticipated; better management of infections caused by resistanceR.ornithinolytica is becoming essential.