Distribution of blaTEM, blaSHV, blaCTX-M, blaOXA, and blaDHA in Proteus mirabilis Isolated from Diabetic Foot Infections in Erbil, Iraq.

Diabetic foot infection is considered to be one of the most important medical, economic, and social problems and a major cause of morbidity and mortality. Proteus mirabilis is a common etiologic agent of diabetic foot infections. This study aimed to determine the prevalence of beta-lactamase genes in P. mirabilis recovered from patients with diabetic foot wounds in Erbil, Iraq. Eighteen P. mirabilis isolated from 84 patients with diabetic foot ulcers were first phenotypically examined for the existence of extended-spectrum beta-lactamases by combined disc method and double-disc synergy method that all isolates showed positive results by both methods. The results were confirmed genetically by PCR to detect beta-lactamase-encoding genes (blaTEM, blaSHV, blaCTX-M, blaOXA, and blaDHA). The results revealed that all isolates contained extended-spectrum beta-lactamase and that 80% of the P. mirabilis isolates contained blaDHA, 60% had blaTEM, 53.3% had blaOXA, and 26.7% had blaCTX-M, whereas no isolates harbored blaSHV. The coexistence of two or more beta-lactamase genes in one isolate was observed. The existence of four genes (blaTEM + blaCTX-M + blaOXA + blaDHA) in the same isolate was documented in two isolates. In conclusion, this is the first study that reports a high prevalence of blaDHA and the coexistence of four resistance genes in the same organism in P. mirabilis isolated from diabetic foot patients in Iraq.

Water source quality testing in Gezira State, Sudan, using the compartment bag test.

Although poor water quality is recognized as a public health threat, it has been little investigated in Sudan. In this paper, water sources in Gezira State, Greater Wad Medani locality, have been categorized as safe, intermediate safe and high-risk unsafe sources using the compartment bag test (CBT) to detect E. coli, which is an indicator of fecal contamination of water. The CBT is simple, portable and self-contained, and it can be done in the field environment. A total of 122 samples were collected from different water sources and included rivers, water treatment plant, boreholes/tube wells, hand pumps, public water taps, public water coolers, public elevated water tanks and household elevated water tanks. It was found that 69% (84/122) of investigated water sources were safe to drink. The sources most likely to be contaminated were those close to industrial points and factories or open sources exposed to pollution. The result showed that the highest level of contamination of water sources (high risk and unsafe) was observed in rural area (9.1%) followed by urban (5.7%) and peri-urban (1.6%). Frequent and routine qualitative analysis of water sources using CBT is recommended to improve human health and hence the country's development.