First Record of Dissemination of BLBLI-Resistant Enterobacter cloacae from Public Hospitals in Baghdad, Iraq

Jawad R. Alzaidi1, *, Ahmed S. Mohammed2
1 Medical Lab Technology, Shatrah Technical College, Southern Technical University, Thi Qar, Iraq
2 Medical Lab Technology, College of Health and Medical Technology, Middle Technical University, Baghdad, Iraq

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 158
Abstract HTML Views: 46
PDF Downloads: 0
ePub Downloads: 0
Total Views/Downloads: 204
Unique Statistics:

Full-Text HTML Views: 106
Abstract HTML Views: 34
PDF Downloads: 0
ePub Downloads: 0
Total Views/Downloads: 140

Creative Commons License
© 2022 Alzaidi and Mohammed.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Medical Lab Technology, Shatrah Technical College, Southern Technical University, Thi Qar, Iraq; Tel: 07801193307; E-mail:



Enterobacter cloacae are most frequently isolated from human clinical specimens.


This cross-sectional study aimed to investigate the dissemination of E. cloacae clinical isolates resistant to β-lactam-β-lactamase inhibitor (BLBLI) combinations from different clinical specimens of hospitalized patients.


E. cloacae isolates were recovered from different clinical samples of hospitalized patients in three main hospitals in Baghdad city. E. cloacae isolates were identified based on their morphology and biochemical tests, and the identification was confirmed using Vitek-2 system. The antibiotic susceptibility testing of E. cloacae isolates to a variety of antibiotics was achieved using disc diffusion test (DDT) and Vitek-2 system.


Results found that among 335 culture-positive samples, 30 isolates (8.9%) belonged to E. cloacae. A high rate of isolation was observed in urine isolates (46.6%), followed by wounds (burns) isolates (26.6%). Out of 30 E. cloacae strains isolated during this study, 18 (60%) showed reduced susceptibility to BLBLI combinations. TEM genes (TEM-1 and TEM-2) were successfully amplified from 7/18 isolates (38.8%) and high rate of BLBLI genes was detected (CTX-M, bla-SHV, SHV-2, and OXA-1). However, no BLBLI genes of bla-AmpC, bla-OXA-2, and bla-OXA-10 were found in E. cloacae isolates when tested using specific primers for bla-AmpC and bla-OXA genes.


From this study, we can conclude that the production of inhibitor-resistant β-lactamases by E. cloacae isolates could be increasingly common in nosocomial pathogens other than E. coli or K. pneumoniae in public hospitals in Baghdad, Iraq.

Keywords: β-lactamase inhibitors, BLBLI, Enterobacter cloacae, IRT, Hospitals, Dissemination.