• Over 80 samples, 13 (16.3%) presented a CRPA • Eleven CRPA did not presented an MBL but mutations in the orpD gene • One ST773 isolate carried the bla NDM-1 gene, one ST654 the bla VIM-2 gene Objectives: The emergence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a critical challenge in the management of diabetic foot infections (DFIs), particularly in regions with limited healthcare resources. This study aimed to assess the prevalence and genetic diversity of CRPA isolates obtained from diabetic foot ulcers in outpatients in Iraq. Methods: Eighty wound swabs were collected, and CRPA were isolated on selective plates. Antibiograms by disc diffusion and short-read WGS were performed on all CRPA. Resistance genes were looked for using the CGE tools and phylogenetic analysis were carried on using cgMLST and SNP-based methodologies. Results: Over the 80 samples, 13 CRPA (16.3%) were identified, which were also mostly resistant to amikacin, ceftazidime, cefepime and aztreonam. Colistin was the only antibiotic for which all isolates remained susceptible. Two isolates (2.5%) carried an acquired carbapenemase gene ( bla NDM-1 and bla VIM-2 ), while the 11 remaining isolates presented mutations in the oprD gene. Several different STs were identified, including the international high-risk clones ST308 and ST773. Conclusion: This study adds important knowledge on the CRPA clones and carbapenem-resistance mechanisms circulating in Iraq, and offers baseline data to be compared with further surveillance studies.
Al-Barrakee et al. (2026) studied this question.