Journal of Infection in Developing Countries最新文献

{"title":"Risk factors linked to surgical site infections: a prospective survey on an Albanian population following abdominal surgery.","authors":"Ardit Kaçani, Krenar Lilaj, Vjollca Shpata, Fjoralba Mulgeci, Sara Ferizaj, Irisi Xure, Emigleo Sulku, Vjollca Durro","doi":"10.3855/jidc.22105","DOIUrl":"https://doi.org/10.3855/jidc.22105","url":null,"abstract":"<p><strong>Introduction: </strong>Despite global improvements in perioperative care, surgical site infections (SSIs) continue to pose a significant burden, and data from Albania remain limited. This study aimed to determine the incidence of SSIs following abdominal surgery in an Albanian tertiary hospital and identify associated risk factors, microbiological profiles, and antimicrobial resistance patterns.</p><p><strong>Methodology: </strong>A prospective observational study was conducted at the University Hospital Centre \"Mother Theresa\" in Tirana. A univariate and multivariate logistic regression adjusted for confounders was performed to identify factors associated with the development of SSIs.</p><p><strong>Results: </strong>1179 patients were enrolled in the study, with a mean age of 57.80 ± 16.16 years (range, 19-92 years), and 51.23% were male. 64 patients (5.43%) developed surgical site infections following abdominal surgery. The most frequently isolated microorganisms from infected surgical wounds were Escherichia coli and Enterococcus faecalis, identified in 39.0% and 22.0% of cases, respectively. The rate of SSIs was higher in patients undergoing lower gastrointestinal surgery compared to those having upper gastrointestinal procedures. As risk factors for developing SSIs in univariate regression analysis, age ≥ 50 years (OR: 2.69, 95% CI: 1.25-5.78), comorbidities (OR: 2.71, 95% CI: 1.53-4.83), and type 2 diabetes mellitus (OR: 2.98, 95% CI: 1.59-5.56) were identified.</p><p><strong>Conclusions: </strong>Although the rate of SSIs after abdominal surgery has decreased, it remains a significant concern in Albania. Age, comorbidities, and lower gastrointestinal surgery are important risk factors. The findings emphasise the need for improved infection control and antimicrobial stewardship to reduce postoperative complications.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"359-365"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biofilm-associated genes and their role in antibiotic resistance among clinical Staphylococcus aureus isolates.","authors":"Asmaa S Mohsin, Munim R Ali, Ali H Alsakini","doi":"10.3855/jidc.22026","DOIUrl":"https://doi.org/10.3855/jidc.22026","url":null,"abstract":"<p><strong>Introduction: </strong>Staphylococcus aureus is a significant pathogen known for its ability to form biofilms, which enhances survival under adverse conditions. This study investigated the molecular mechanisms underlying biofilm formation in clinical S. aureus isolates, focusing on key biofilm-associated genes and their correlation with antibiotic resistance (ABR).</p><p><strong>Methodology: </strong>A total of 40 clinical S. aureus isolates were collected from Medical City Teaching Hospital, Baghdad. Biofilm production was assessed using the microtiter plate assay. Biofilm-related genes (icaB, icaC, crtM, crtN) were examined by polymerase chain reaction (PCR). Antimicrobial susceptibility was evaluated using the Kirby-Bauer disk diffusion method, and genes was correlated with resistance profiles.</p><p><strong>Results: </strong>A significant variation in biofilm production was observed, with 80% of isolates classified as non-biofilm formers, 12.5% as weak, 5% as moderate, and 2.5% as strong biofilm producers. Genetic testing revealed that all investigated isolates had a high percentage of icaB and icaC, with 95 % possessing crtM. A significant prevalence of mecA (97.5 %) was observed; however, an increased prevalence of mecA did not correlate significantly with enhanced biofilm formation.</p><p><strong>Conclusions: </strong>This is the first report from Baghdad demonstrating the prevalence of these biofilm-associated genes and their link to ABR, offering potential targets for future therapeutic interventions. These results highlight the importance of biofilm-associated genes in the persistence and reinfection potential of S. aureus within clinical settings. Additionally, the common occurrence of icaB with icaC suggests that both genes could serve as new targets for developing treatments aimed at preventing biofilm formation and enhancing therapy effectiveness.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"416-424"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and laboratory characteristics of critically ill COVID-19 patients with chronic lung disease.","authors":"Tunzala Yavuz, Omurhan Sarac, Ozcan Alpdogan, Hicret Yeniay, Didem Celik","doi":"10.3855/jidc.21431","DOIUrl":"https://doi.org/10.3855/jidc.21431","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic lung diseases (CLD) are associated with increased susceptibility to respiratory infections and may influence COVID-19 outcomes. This research aims to assess the clinical, laboratory findings, and prognostic outcomes in critically ill COVID-19 patients with and without CLD, and to explore differences between various CLD types.</p><p><strong>Methodology: </strong>A retrospective analysis was conducted on 406 critically ill COVID-19 patients, comparing those with CLD and those without. Clinical characteristics, laboratory markers, and mortality rates were assessed. Subgroup analyses evaluated differences between COPD, asthma, and other CLD types.</p><p><strong>Results: </strong>Patients with CLD were older and had significantly lower lymphocyte and platelet levels than those without CLD (p values were 0.034, 0.021, and 0.013, respectively). The mean age, urea level, and platelet count in the COPD group showed significant differences compared to the other groups. Among critically ill COVID-19 patients, mortality rates were observed to be higher in the CLD group compared to those without CLD, and in the COPD group compared to other CLD types; however, these differences did not reach statistical significance. Systemic steroid use was associated with reduced 3-month (OR: 0.403, 95% CI: 0.226-0.719, p = 0.002) and 1-year mortality (OR: 0.513, 95% CI: 0.288-0.914, p = 0.023). Inhaled corticosteroid use did not increase mortality and was predominantly utilized for symptom management. Laboratory markers such as lymphopenia and thrombocytopenia were significantly associated with worse outcomes.</p><p><strong>Conclusions: </strong>CLD and its subtypes were not independently linked to mortality in critically ill COVID-19 patients; however, their association with older age and worse laboratory profiles highlights their clinical significance.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"318-326"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of COVID-19 on the treatment outcomes of secretory otitis media.","authors":"Jishuai Zhang, Weihao Zhao, Ting Zhang, Qiying Wu, Jing Di, Xiaobo Mao","doi":"10.3855/jidc.21341","DOIUrl":"https://doi.org/10.3855/jidc.21341","url":null,"abstract":"<p><strong>Introduction: </strong>The World Health Organization (WHO) officially lifted the global emergency designation for coronavirus disease 2019 (COVID-19) in May 2023. Nonetheless, the long-term repercussions of the pandemic-referred to as 'long COVID'-have persisted. It is also highly likely for the disease to be complicated by secretory otitis media (SOM). This study aimed to determine if there is anything particularly distinctive about SOM associated with long-COVID, and could it affect the therapeutic outcomes of the latter.</p><p><strong>Methodology: </strong>A total of 102 patients diagnosed with COVID-19-associated SOM between December 2022 and May 2023 were retrospectively analyzed. Pre- and post-treatment pure-tone audiometry thresholds were assessed to evaluate therapeutic efficacy. Follow-up assessments were performed at 1, 3, 6, and 12 months' post treatment, and the findings were compared with those of a control group of 98 patients who had SOM but not COVID-19 infection during the same time frame.</p><p><strong>Results: </strong>All patients showed normal hearing thresholds post treatment. A comparative analysis using a two-sample t-test revealed no statistically significant difference in the average speech-hearing thresholds between the two groups post-treatment (t = 0.099, p = 0.92). No recurrence was observed in either group during the year-long follow-up period.</p><p><strong>Conclusions: </strong>Although COVID-19 is commonly associated with SOM, patients can expect satisfactory recovery of their hearing function with proactive treatment strategies.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"327-331"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term follow-up of hospitalized COVID-19 patients with interstitial lung involvement.","authors":"Özer Özdemir, Gülru Polat, Mine Gayaf, Filiz Güldaval, Damla Serçe Unat, Tarık Şimşek","doi":"10.3855/jidc.21215","DOIUrl":"https://doi.org/10.3855/jidc.21215","url":null,"abstract":"<p><strong>Introduction: </strong>Data regarding the residual lung findings persisting beyond 12 months from acute infection in patients with COVID-19 with pulmonary involvement are scarce. This study investigates the long-term radiological and functional findings of previously hospitalized COVID-19 patients who had residual pulmonary involvement at 3-6-month follow-up.</p><p><strong>Methodology: </strong>This retrospective cohort study was an extended analysis of a previously published study, including patients with COVID-19 pneumonia hospitalized between June 2020 and March 2021. Residual lung involvement due to COVID-19 pneumonia was classified according to the presence of ground glass opacities, honeycombing, traction bronchiectasis, reticulations, and parenchymal bands.</p><p><strong>Results: </strong>51 out of the 157 patients with abnormal chest findings in high-resolution computed tomography (HRCT) scans at 3-6-month follow-up were included. Mean age of the study population was 60.5 ± 10.5 years; 35 subjects were male (68.6%). HRCT controls were obtained 25.7 ± 6.36 months after the diagnosis. There was regression of predefined radiological involvement in 39 patients (76.5%), whereas 11 patients (21.6%) exhibited stable findings, and one patient had progressive lung involvement with a usual interstitial pneumonia pattern. Persistent residual parenchymal bands were found mostly in ICU-admitted patients (p = 0.04), and reticulations were seen in patients with a CT severity score > 18 (p = 0.04).</p><p><strong>Conclusions: </strong>In most patients with pulmonary sequelae, lesions showed improvement after 18 months, with complete resolution in about one third of patients after a 6-month follow-up. There was a correlation between initial severity and persistence of lung abnormalities.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"342-349"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serotyping, drug resistance, virulence, and antibiotic resistance genes of Salmonella isolated from contaminated food.","authors":"El Hanafi Motassim, Safae Skenndri, Mohamed Mouahid, Brahim Bouchrif, Said Dahani, Nourreddine Bouchriti, Sami Derkaoui, Hakim Karib, Imane Abdellaoui Maane, Saadia Nassik","doi":"10.3855/jidc.21392","DOIUrl":"https://doi.org/10.3855/jidc.21392","url":null,"abstract":"<p><strong>Introduction: </strong>Antibiotic resistance (AMR) is a serious problem for veterinary and human health. Its progression is leading to therapeutic failures and risks taking humanity back to the era before the discovery of antimicrobials. The impact of AMR on the economy is considerable. This study was carried out to assess the extent of AMR in Salmonella isolated from food products.</p><p><strong>Methodology: </strong>The European Committee on Antimicrobial Susceptibility Testing (EUCAST) standard method and the recommendations of the Antibiotic Susceptibility Committee of the French Society of Microbiology (CA-SFM) version 2023 V.1.0. 19 were used to test antibiotic susceptibility. A total of 41 antimicrobials were tested on the isolates. Virulence genes fimA and stn, and the antibiotic resistance gene CMY-2 were tested by real-time polymerase chain reaction (PCR) on bacterial DNA extracted using the MacheryNagel RNA viral nucleospin extraction kit. The integrated search engine on the National Center for Biotechnology Information (NCBI) website was used to search for the primer sequence of interest for the predefined genes.</p><p><strong>Results: </strong>All the isolates were resistant to at least one antibiotic, while 90% of isolates were multiresistant (resistant to at least 3 antimicrobial agents). All strains tested positive for the presence of the stn and fimA virulence genes, with the exception of one isolate. Similarly, with the exception of one strain, all strains tested positive for CMY-2.</p><p><strong>Conclusions: </strong>These results point to the progression of AMR, which is increasingly gaining ground, and to the danger of Salmonella virulence as a major agent of food-borne illness in Morocco.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"374-380"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of β-lactam monotherapy and conventional anti-staphylococcal combination therapy for polymicrobial MSSA infections.","authors":"Gulnihal Akbulut, Kathy Tin, Julia Sapozhnikov, Abdullah Chahin","doi":"10.3855/jidc.21579","DOIUrl":"https://doi.org/10.3855/jidc.21579","url":null,"abstract":"<p><strong>Introduction: </strong>Staphylococcus aureus (SA) remains a major pathogen in both community-acquired and healthcare-associated infections, necessitating effective treatment strategies. Management of infections involving methicillin-susceptible S. aureus (MSSA) has traditionally included the use of targeted anti-staphylococcal antibiotics in combination with broad-spectrum agents. Recent evidence suggests that beta-lactam antibiotics may provide equivalent or superior outcomes in MSSA infections, challenging conventional treatment paradigms.</p><p><strong>Methodology: </strong>This retrospective cohort study evaluated adult patients with polymicrobial infections involving MSSA across multiple healthcare facilities from January 2019 to December 2023. Patients receiving beta-lactam monotherapy were compared with those receiving beta-lactam therapy plus a traditional anti-staphylococcal agent. Primary outcomes included treatment failure, defined as recurrence or escalation of infection within 90 days. Secondary outcomes were 90-day hospital readmission rates and all-cause mortality.</p><p><strong>Results: </strong>Of 1,000 patient records reviewed, 108 met the inclusion criteria. Beta-lactam monotherapy was associated with a significantly lower treatment failure rate compared with combination therapy (1.6% vs. 17.0%, p = 0.035). Hospital readmission rates (24.6% vs. 51.1%, p = 0.093) and all-cause mortality (11.5% vs. 19.1%, p = 0.784) were lower in the beta-lactam group, though the differences were not statistically significant.</p><p><strong>Conclusions: </strong>Beta-lactam monotherapy demonstrated comparable or superior efficacy to traditional anti-staphylococcal combination regimens for polymicrobial infections with MSSA. These findings support the potential for simplifying treatment regimens, reducing unnecessary antibiotic exposure, and enhancing antibiotic stewardship. Further prospective studies are needed to confirm these results and inform clinical practice guidelines.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"393-397"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the cleaning effectiveness of pulsed vacuum cleaning and disinfection machine versus spraying cleaning and disinfection machine for rigid endoscope instruments.","authors":"Jian Li, Yue Hu, Licong Bo, Xue Wang, Wenjing Hu","doi":"10.3855/jidc.21547","DOIUrl":"https://doi.org/10.3855/jidc.21547","url":null,"abstract":"<p><strong>Background: </strong>This study aims to compare the cleaning effectiveness of the pulsed vacuum cleaning and disinfection machine (PVD) and the spraying cleaning and disinfection machine (SCD) in cleaning rigid endoscope instruments.</p><p><strong>Methodology: </strong>A total of 900 postoperative rigid endoscope instruments from the sterilization supply room of our hospital, collected between July and December 2024, were included in the study. Instruments were randomly divided into two groups using a computer-generated random number sequence, ensuring a 1:1 allocation ratio: the research group (450 items) and the control group (450 items). The research group used the PVD machine, while the control group used the SCD machine. The sterilization effectiveness, cleaning quality, ATP bioluminescence assay, and protein residue measurement were compared between the two groups.</p><p><strong>Results: </strong>The sterilization time in the research group was longer than that in the control group. The instrument damage rate and endotoxin positive rate were significantly lower in the research group (p < 0.05). The research group showed significantly higher results in the paper test method compared to the control group (p < 0.05). No significant difference was found between the two groups in visual inspection and blood residue comparison (p > 0.05). The ATP bioluminescence detection and protein residue pass rates were higher in the research group than in the control group, with a statistically significant difference (p < 0.05).</p><p><strong>Conclusions: </strong>The pulsed vacuum cleaning and disinfection machine performs better than the spraying cleaning and disinfection machine in cleaning rigid endoscope instruments, offering potential benefits for patient safety and instrument longevity.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"457-463"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exogenous colonization of carbapenem-resistant Klebsiella pneumoniae and vancomycin-resistant Enterococcus in preterm infants: a PFGE-based molecular epidemiology study.","authors":"Ahmet Aktaş, Elif Seren Tanriverdi, Tuba Demirkalp, Barış Otlu, Yaşar Nakipoğlu","doi":"10.3855/jidc.22083","DOIUrl":"https://doi.org/10.3855/jidc.22083","url":null,"abstract":"<p><strong>Introduction: </strong>Carbapenem-resistant Klebsiella pneumoniae (CRKP) and vancomycin-resistant Enterococcus (VRE) pose significant threats in neonatal intensive care units (NICUs) due to their high transmission potential and limited treatment options. Identifying the source of colonization and detection of predominant antibiotic-resistant genes are crucial for effective infection control measures.</p><p><strong>Methodology: </strong>In this study, we analyzed 20 carbapenem-susceptible Klebsiella pneumoniae (CSKP) and 20 Vancomycin-susceptible Enterococcus (VSE) of meconium versus 20 CRKP and 20 VRE of rectal swabs isolates, respectively, from 20 preterm infants hospitalized in the NICU. Pulsed-field gel electrophoresis (PFGE) and arbitrarily primed PCR (AP-PCR) were used for molecular epidemiological analysis. The presence of carbapenemase (blaOXA-48, blaNDM, blaKPC) and Vancomycin-resistance (vanA, vanB, vanC) genes was investigated by multiplex PCR.</p><p><strong>Results: </strong>No predominant outbreak strain was detected, and isolates exhibited high genetic diversity, indicating an exogenous source of colonization of both CRKP and VRE. PFGE analysis revealed 24 distinct genotypes among CRKP and 25 among VRE isolates, with a clustering rate of 57.5%. The most commonly detected resistance gene in CRKP isolates was blaOXA-48 (50%), followed by blaNDM (35%) and blaKPC (10%). Among VRE isolates, only the vanA gene was present (85%).</p><p><strong>Conclusions: </strong>The absence of a clonal outbreak and the detection of resistance genes primarily on plasmids indicate healthcare-associated transmission rather than endogenous selection. This highlights the critical role of hand hygiene and strict infection control measures in preventing multidrug-resistant pathogen colonization in vulnerable preterm infants.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"407-415"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of silent plasmid-mediated fosfomycin-resistance genes among clinical isolates of fosfomycin-susceptible Escherichia coli.","authors":"Rojan I Albazaz, Haliz S Hasan, Najim A Yassin","doi":"10.3855/jidc.21476","DOIUrl":"https://doi.org/10.3855/jidc.21476","url":null,"abstract":"<p><strong>Introduction: </strong>Infections caused by Escherichia coli place a considerable burden on both patients and healthcare facilities. This study aims to investigate the prevalence and molecular detection of silent plasmid-mediated fosfomycin-resistance (PMFR) genes among fosfomycin-sensitive, extended-spectrum β-lactamase (ESβL)- producing E. coli isolates.</p><p><strong>Methodology: </strong>Clinical samples of E. coli were collected from various sources and hospitals in Duhok' Iraq' from December 2020 to April 2021. Standard microbiological techniques and the Vitek II system were used to identify E. coli, which was further confirmed through species-specific genes. The Kirby-Bauer method was employed for antimicrobial sensitivity testing, followed by the detection of targeted PMFR and genes using conventional polymerase chain reaction (PCR).</p><p><strong>Results: </strong>High resistance levels were observed against ampicillin, ceftriaxone, tetracycline, and ciprofloxacin, whereas a lower resistance rate was detected for carbapenems. Notably, all the isolates were susceptible to fosfomycin. Four isolates tested positive for fosA3, four were positive for fosA, and 16 were positive for the blaCTX-M9 gene. Within the isolates, three co-harbored fosA3, fosA, and blaCTX-M9 genes, while one isolate co-expressed fosA3 and blaCTX-M9 genes. The distribution of these genes, both individually and co-harbored, was observed across all clinical samples analyzed, except those derived from blood and sputum.</p><p><strong>Conclusions: </strong>The dissemination of silent PMFR genes could pose a future risk for public health under the selective pressure of antibiotics, especially extended-spectrum beta-lactams, for a long time, or transfer to other bacteria, potentially leading to the activation of these genes.</p>","PeriodicalId":49160,"journal":{"name":"Journal of Infection in Developing Countries","volume":"20 3","pages":"366-373"},"PeriodicalIF":1.2,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}