The most frequent bacteria in hemodialysis patients in Basra-Iraq

Abstract

Kidney failure is one of the acute chronic diseases and it is the end of kidney disease, resulting in the body’s inability to get rid of toxins, waste, and excess fluids. Here, either undergo a kidney transplant, or permanent dialysis, consequence the patient becomes vulnerable to bacterial and viral infections.75 samples were collected from patients undergoing hemodialysis (HD) in Al-Sadr Teaching Hospital in Basrah. with age ranged between 16 - 70 years old. The samples from water entering the dialysis machine and water leaving the patient, in addition to sample from HD patient’s blood. Conventional microbiological and molecular approaches were applied. Bacteria were identification: 66 were Gram positive (72.5%) and 25 were Gram negative bacteria (27.4%). The 16S rDNA gene of 91 isolates was successfully amplified, sequenced, and proofreaded,  the results showed that the bacterial species were belong to : Bacillus 46 (50.5%) included 9 species; B. cereus was the highly frequented (29) isolates , B.paramycoides 5, B. safensis 3,B. lichenformis 3, B. subtilis 2, whereas all the other Bacillus species frequency was 1 isolate for each as it will be demonstrated later, Staphylococcus 9, included S. epidermidis 4, while all the other Staphylococcus species frequency was 1 isolate for each, Pseudomonas 11,included P. stutzeri 9 , P. putida 1, and P. aeruginosa 1,Enterobacter 5, included E.cloacae 3, E.xiangfangensis 1,E.asburiae 1, Enterococcus 4included E.casselifarus 2, E.faecium 2. The present study was recorded the isolation and identify of three Aerococcus included A. viridans 2, A. urinaeequi 1 which it for our knowledge the first report of such bacteria in HD in Basrah-Iraq. In addition, Lysinibacillus macrolides 3, Halomonas stevensii 3, Acinetobacter radiorsistens 2, whereas Stenotrophomonas rhizophila, Exiguobacterium aestuarii, Shigella sonnei, Klebsiella oxytoca and Margonella morganii each of them 1. Out of 91 isolates fourteen new isolates

were recorded as new strains in the National Center for Biotechnology Information (NCBI) and the Gene bank DNA sequences. The phylogenetic tree showed affinity between most of the studied isolates. Most of the 91 isolates were resistance to most of the antibiotics such as Ceftazidime and Cefepime more than Cefotaxime, Ceftriaxone, and Vancomycin. Among the ninety-one isolates that were tested for biofilm production on Congo red agar, (14) isolates gave positive result.  However, the results of RAPD-PCR for 26 antibiogram closely related isolates, B. cereus were shown to be genetically close. As for the 4 isolates of P. stutzeri two of four were showed to be closely related, as well as two isolates of S. epidermidis showed genetically identical.  The study has recommended that hemodialysis facilities' water supplies should be continuously monitored and that appropriate preventative measures be implemented to reduce the risk of these immunocompromised patients being exposed to polluted water sources.