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Author : Mustafa N. Hussein, Prof Dr. Zainab N. Al-Saadi, Dr. Jalal Abdulrazzaq Tofah Al-Azzawi

Abstract : Background : Covid-19 cause acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) which leads to pulmonary failure. Secondary infections were diagnosed when patients showed clinical symptoms or signs of bacteremia, and had a positive culture of a new pathogen. In COVID-19 patients coinfected with bacteria in the ICU-death group, carbapenem resistant Klepsiella pneumonia, was isolated. This nosocomial, antibiotic-resistant pathogen is known to pose challenges in antibiotic therapy, and to increase the death-risk. Materials and Methods: A total of three hundred eighty clinical samples were collected from covid19 patients, in Iraq from October 2021 to February 2021, in the bacteriology Unit. Patients samples were included upper respiratory tract, 190 (50%) from Nasopharyngeal (NP) and 190 (50%) from and Oropharyngeal (OP) specimen. The recovered isolates were subjected to different morphological and biochemical tests for identification to the species level and disk diffusion test, in addition to identification of resistance genes included magA, K2A, entB, iutA, fyuA, kfu, bla Kpc2 and carbapenemase genes. Result: Disc diffusion technique, was used to test the susceptibility of 50 isolates of K. pneumoniae using 10 different antibiotics, K. pneumoniae isolates were resistant to Ceftriaxone, Cefixime, Cloramphenicole, Augmentine, Aztreonam and Trimethoprime-sulphamethoxazole in percentage of 25 (50%), 19(38%), 29(58%), 20 (40%), 39 (78%) and 30(60%) respectively, while K. pneumoniae isolates has been showed sensitivity to Ciprofloxacillin, Amikacin, Gentamicin and Imipenem in a percent of 35 (70%), 36 (72%), 41 (82%) and 45 (90%). entB, and fyuA of Klebsiella pneumoniae isolates showed that all isolates gave positive result for entB gene while only two lane gave positive result for fyuA gene. intA gene of Klebsiella pneumoniae isolates gave positive result for intA gene. Two gene (bla kpc2 and kfu) of Klebsiella pneumonia isolates using PCR showed that 9 isolates gave positive result for both genes. MagA, K2A and Carbapenenmase showed that the multiplex PCR product of all genes were negative. Conclusion: Our results showed that K. pneumonia virulence genes was more correlated to covid-19 patients, especially entB gene.