جۆری توێژینه‌وه‌: Original Article


1 1Kalar general hospital

2 2College of education for pure science-Tikrit university


There are many opportunistic bacterial species that are uncommon and infrequently exist in
clinical specimen, most of them are difficult to routine identification, even some of them are
poorly documented in clinical specimen. also had no less role in the coordinates of the disease
than common bacterial species. Six hundred and fifty samples were collected from patients
attending to some hospitals in Sulaimanya City and Kalar General Hospital during the period
from October 2015 to November 2016.
Samples were firstly cultured on different media in order to isolate and identify bacterial
isolates according to cultural characteristics, morphological features and biochemical reactions in
addition to Vitek 2 system for identifying uncommon and infrequent isolates. The identification
and susceptibility test were performed in Kalar General Hospital. Isolated 286(44%) bacterial
strains from different clinical samples, 125 of them were identified by Vitek 2 automated
system, while 23(8%) of isolates were considered as uncommon bacterial species.
The antimicrobial susceptibility of uncommon isolates, showed significant variation against
twenty four antibiotics. Four isolates; Acinatobacter baumanii, Acinatobacter calcoaceticus,
Enterobacter ludwigii and Gemella sanguinis were resistant to all antibiotics. Whereas
Aerococcus urinae, (Citrobacter freundii and Alloiococcus otitis), (Morganella morganii,
Sphingomonas paucimobilis, Pantoea agglomerans, Streptococcus sobrinus and Kocuria rosea
n.2), ( Ochrobactrum anthropi n.1 and Kocura kristinae), (Ochrobactrum anthropi n.2 and
Kocuria rosea n.1 ), (Pseudomonas stutzeri, Pseudomonas fluorescens and Citrobacter koseri ),
(Aeromonas salmonicida and Micrococcus luteus n.1) and Micrococcus luteus (n.2) resistant to
the antibiotics as these percentages 95.8%, 91.6%, 87.5%, 83.3%, 79.1%, 70.8%, 66.6% and
62.5%, respectively.

Abas Y.A., Khudaier and Salih Y.A. 2014. Detection of Multidrug Resistant Pseudomonas spp. in Clinical Cases and Hospital Environments at Thi-Qar Province. Journal of College of Education for Pure Sciences Vol. 4

Abdulla H. 2014.  Neonatal enteral feeding tube as loci for Enterobacteriaceae colonisation and risk to neonatal health. A thesis of Doctor of Philosophy  /Nottingham Trent University.

Al-Hissnawy D.S., AL-Thahab A.A. and Al-Jubori S.A. 2010.  Evaluation of Citrobacter freundii isolated in Najaf governorate as an enterotoxin producer. College of Dentistry/Kufa University.

Auda J. Gh. and Al-Grawi I. Gh. 2009. Isolation, Identification, and Antimicrobial Susceptibility of Uropathogenic Morganella Morganii Al- Kindy Col Med J; Vol .5 (1) P:32-35.

Ausubel F.M., Brent R., Kingston R.E., Moore D.D., Smith J.A., Seidman J.D. and Struhl K. 1987. Curren Protocol in Molecular Biology. Jhon Wiley and Sons. Inc, NewYork.

Austin B., Austin D. A. 1987. Bacterial fish pathogens: Disease in farmed and wld fish. EUis Honvood Limited, Chichester, p. 11 1-195.

Bhatia R., Tomar J.  2016.  Sphingomonas paucimobilis - an emerging pathogen.  Int J Contemp Pediatr. 3(3):1123-1125.

Bodey G. P., Elting L., Kassamali H. and Lim B. 1986. Escherichia coli bacteremia in cancer patients. Am. J. Med. 81(Suppl. 1A):85–95.

Bodey G. P., Elting L., Rodriguez S. and Hernandez M. 1989. Klebsiella bacteremia: a 10-year review in a cancer institution. Cancer 64:170–178.

Bodey G. P., and Jadeja J. 1985. Pseudomonas bacteremia: retrospective analysis of 410 episodes. Arch. Intern. Med. 145:1621–1629.

Chen H., Chi H. Chiu N. and Huang F. 2015. Kocuria kristinae: A true pathogen in pediatric patients. Journal of Microbiology, Immunology and Infection 48, 80e84. Polish.

Christensen J. J., and Gutschik E. 1991. Urosepticemia and fatal endocarditis caused by Aerococcus-like organisms. Scand. J. Infect. Dis. 23:717–721.

Christensen J.J., Jensen I.P., Faerk J., Kristensen B., Skov R., Korner B. 1995. Bacteremia/septicemia due to Aerococcus-like organisms: report of seventeen cases. Danish ALO Study Group. Clin Infect Dis 1995; 21: 943–947.

Faden H., and Dryja D. 1989. Recovery of a unique bacterial organism in human middle ear fluid and its possible role in chronic otitis media. J. Clin. Microbiol. 27:2488-2491.

Folland D., Armstrong D, and Seides S. 1974. Pneumococcal bacteremia in patients with neoplastic disease. Cancer 33:845–849.

Forbes B.A., Sahm D.F.  and Weissfeld A.S. (2007). Bailey & Scott`s Diagnostic Microbiology. 12th ed. Mosby, Inc., an Affiliate of Elsevier Inc.  

Frank D.N., Spiegelman G.B., Davis W., Wagner E., Lyons E. and Pace N.R. 2003. Culture-independent molecular analysis of microbial constituents of the healthy human outer ear. J Clin Microbiol 41:295–303.

Friedman S., Reif S., Assia A., Levy I. 2015. Clinical and laboratory characteristics of non-E coli urinary tract infections. http://adc.bmj.com/ Published by group.bmj.com.

Gajaylife B. D. 1984.  Serotyping of Acinetobacter calcoaceticus. J Clin Pathol 37:1388-1391.

Gates  M.L., Sanders  C.C., Goering R.V., Sanders  W.E. 1986. Evidence of multiple forms of type I chromosomal beta-lactamase in Pseudornonas aeruginosa. Antimicrobial Agents and Chemotherapy, 30: 453- 457.3

Gomez-Hernando C., Toro C., Gutierrez M.,  Enriquez A., and M. Baquero. 1999. Isolation of Alloiococcus otitidis from the external ear in children. Eur. J. Clin. Microbiol. Infect. Dis. 18:69–70.

Gayral J. P.,  Robinson R., and Sandstedt  D. 1997. A new integrated system for microbiological testing: the Vitek II system, abstr. P254. Clin. Microbiol. Infect. 3(Suppl. 2):53.

Guttman D. S., Morgan, R. L. and Wang, P. W. 2008. The evolution of the Pseudomonads, In: M. Fatmi, A. Collmer, N. S. Iacobellis, J. W. Mansfield, J. Murillo, N. W. Schaad, and M. Ullrich (eds) Pseudomonas syringae Pathovars and Related Pathogens, 307–20, Springer, Netherlands.

Helio S.,Sadera b., Ronald N and Jonesa c. 2005. Review; Antimicrobial susceptibility of uncommonly isolated non-enteric Gram negative bacilli. International Journal of Antimicrobial Agents 25, 95–109.

Hendolin  P. H., Markkanen A., Ylikoski J., and Wahlfors J. J. 1997. Use ofmultiplex PCR for simultaneous detection of four bacterial species in middleear effusions. J. Clin. Microbiol. 35:2854–2858.

Hoffmann  H., Stindl  S., Stumpf. A., Mehlen  A., Monget  D., Heesemann  J., et al. 2005.  Deion of Enterobacter ludwigii sp. Nov., a novel Enterobacter species of clinical relevance. Systematic and Applied Microbiology, 28, 206–212.

Jossart, M. F., and  Courcol R.J. 1999. Evaluation of an automated system for identification of Enterobacteriaceae and nonfermenting bacilli. Eur. J. Clin. Microbiol. Infect. Dis. 18:902–907.

Kalcioglu M. T., Oncel S., Durmaz R., Otlu B., Miman M.C., and Ozturan O. 2002. Bacterial etiology of otitis media with effusion; focusing on the high positivity of Alloiococcus otitidis. New Microbiol. 25:31–35.

Kaplan J. B., Anita P. J.  and Nichols B. P. 1984. Nucleotide Sequence of the Acinetobacter calcoaceticus trpGDC Gene Cluster. WALTER M. FITCH, reviewing editor.

Kilic A., Senses Z., Kurekci A.E., Aydogan H., Sener K., Kismet E., et al. 2007. Nosocomial outbreak of Sphingomonas paucimobilis bacteremia in a hemato/oncology unit. Jpn J Infect Dis 60:394–6.

Kiser K.M., Payne W.C.  and Taff T.A. 2011. Clinical Laboratory Microbiology A Practical Approach. Pearson education, Inc., New Jersey.

Lakshmikantha M., Devki V. and Yogesh C. 2015.  Is Kocuria kristinae an upcoming pathogen?. Int.J.Curr.Microbiol.App.Sci  4(4): 885-889.

Lapagel S.P.,. 1968. Hill R. Reeve J. Pseudomonas stutzeri i n pathological material. J. MlD. Microbi0l.-vol. 1

Leskinen K., Hendolin P., Virolainen-Julkunen A., Ylikoski J. and Jero J. 2002. The clinical role of Alloiococcus otitidis in otitis media with effusion. Int J Pediatr Otorhinolyngol  66:41–8.

Levinson W. 2010. Review of Medical Microbiology and Immunology. 11th ed. McGraw-Hill companies. New York.

Ma  M., Bhalla  L. S., Shete V., Grover C.N. 2015. Gemella sanguinis: A rare cause of native valve endocarditis in a child. Medical  Journal med forces India a. 628; No. of Pages 3.

Pal R.B., Kale V.V. 1981. Acinatobacter calcoaceticus an oportunistic pathogenic.  Vol. 27  Issue : 4 : 218-21.

Peces R., Gago E., Tejada F., Laures A.S. and Alvarez-Grande J. 1997. Relapsing bacteraemia due to Micrococcus luteus in a haemodialysis patient with Perm-Cath catheter. Nephrol Dial Transplant 12:2428-2429.

Raoof W.M.,  Ali K.O. and Mohammed S.A. 2013. Study The Resistance of some Bacteria at the Most Commonoly Isolated from Tikrit Teaching Hospital Infections to Antibiotics and their Relation with Plasmids.Tikrit university/Iraq.

Rit  k., Nag F., Raj H.J. and  Maity P.K. 2013. Prevalence and Susceptibility Profiles of Nonfermentative Gram-negative Bacilli Infection in a Tertiary Care Hospital of Eastern India. Indian Journal of Clinical Practice, Vol. 24, No. 5.

Robert C. N. and Overman S.B. 1994. Pseudomonas stutzeri Infection A Review of Hospital Isolates and a Review of the Literature. DIAGN MICROBIOL INFECT DIS 51;19:51-56.

Shahid M. 2010. Citrobacter spp. Simultaneously Harboring blaCTX-M, blaTEM, blaSHV, blaampC, and Insertion Sequences IS26 and orf513: an Evolutionary Phenomenon of Recent Concern for Antibiotic Resistance. Journal of clinical microbiology, p. 1833–1838 Vol. 48, No 5.

Shrooq R.K.,  Kifah A.J. and Mayssaa, E.A. 2014. The antimicrobial activity of bacteriocin from pseudomonas fluorescens against pathogenic bacteria . Basrah Journal of Science (B) Vol. 32(2) , 206-213 

Sierra-Hoffman M, Watkins K, Jinadatha C, Fader R, Carpenter JL. Clinical significance of Aerococcus urinae: a retrospective review. Diagn Microbiol Infect Dis 2005; 53: 289–292.

Sih, T., B. Schwartz, G. Bosley, and R. Facklam. 1992. Chronic otitis media effusion caused by Alloiococcus otitis: clinical and laboratory features, abstr. 671, p. 222. In Program and abstracts of the 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy. American Society for Microbiology, Washington, D.C.

Stanier R. Y., Palleroni N.J. and  Doudoroff M. 1966. The aerobic Pseudomonas: a taxonomic study. J. Gen. Microbiol. 43:159.

Szczerba I. 2003. Susceptibility to antibiotics of bacteria from genera Micrococcus, Kocuria, Nesternkonia, Kytococcus and Dermacoccus. Med Dosw Mikrobiol. 55:75-80.

Tewari R., Dudeja M., Das A.K. and Nandy S. 2013. Kucuriae kristinae in catheter asociated urinary tract infection: a case report.  Journal of Clinical and Diagnostic Research.  Vol-7(8): 1692-1693.

Theodore J. C., Drabick C. J., Fisher G.W. and Robb M. L.1992. Catheter-Associated Sepsis Caused by Ochrobactrum anthropi: Report of a Caseand Review of Related Nonfermentative Bacteria. http://cid.oxfordjournals.org/ at University of Manitoba

Vandepitte J., Verhaegen J., Engbaek K., Rohner P., Piot P. and Heuck C.C. 2003. Basic laboratory procedures in clinical bacteriology. WHO. Geneva.

Weinstein M.P., Towns M.L., Quartey S.M., et al. 1997. The clinical significance of positive blood culture in the 1990s: a prospective comprehensive evaluation of the microbiology, epidemiology and outcome of bacteremia and fungemia in adults. Clin. Infect. Dis. 24:584-602.

Young M., Artsatbanov V.,  Beller H.R. et al. 2010. Genome Sequence of the Fleming Strain of Micrococcus luteus, a Simple Free-Living Actinobacterium. Journal of bacteriology,  p. 841–860