Molecular Detection of blaNDM, qnrA, and mcr-1 Clinical Escherichia Coli Isolates From Baqubah Teaching Hospital, Diyala, Iraq

Abstract

Antimicrobial-resistant genes such as blaNDM, qnrA, and mcr-1 have emerged as a major global threat, with their prevalence increasing in many countries. International travel, hospital outbreaks, and the food chain have all contributed to their global dissemination. The aim of the study is to assess the prevalence of antimicrobial-resistant genes blaNDM, qnrA, and mcr-1, among E. coli, to compare these levels with the global estimates, and to identify risk factors associated with the carriage of these genes. Over seven months, clinical samples were collected from. Inpatients at Baqubh teaching hospital. E. coli isolates were identified by routine culture. Molecular diagnosis was performed by extracting genomic DNA and using validated primers for blaNDM, qnrA, and mcr-1 in a single Multiplex PCR reaction. Data management and prevalence estimation were performed with binomial exact Clopper–Pearson confidence intervals. The prevalence of blaNDM (6.9%) and qnrA (3.4%) appeared low relative to other countries’ reports. Clopper–Pearson upper bounds were 22.7% and 18.1%, respectively, reflecting considerable statistical uncertainty due to the limited sample size. Regarding the mcr-1 gene, the point prevalence was 0%.