16S RRNA-BASED IDENTIFICATION AND ANTIBIOTIC RESISTANCE PROFILING OF Staphylococcus aureus ISOLATED FROM WOMEN WITH URINARY TRACT INFECTIONS FROM KURDISTAN REGION OF IRAQ
Abstract
Among women, urinary tract infections (UTIs) continue to be a significant health issue; Staphylococcus aureus is increasingly identified as a prominent but usually disregarded causal agent. This work examined the presence of S. aureus in female UTI patients and evaluated their antibiotic resistance patterns. The total sample consisted of 167 individuals, with ages ranging from 17 to 56 years (standard deviation = 8.38). Samples were collected from women living in Koysinjaq, Erbil, and Sulaymaniyah cities in the Kurdistan Region of Iraq. Among 29 isolates identified using phenotypic methods, 24 were confirmed by 16S rRNA sequencing, closely linked to S. aureus strain S33 R. High degrees of resistance to ciprofloxacin (87.5%), erythromycin (83.3%), and cefoxitin (54.2%) were found in antibiotic sensitivity testing. By contrast, every isolate turned out to be sensitive to vancomycin. Moreover, in assessing vancomycin sensitivity, minimum inhibitory concentration (MIC) testing proved more accurate than the disc diffusion technique. The study highlights the high prevalence of MRSA and multidrug-resistant Staphylococcus aureus in urinary tract infections, confirming 16S rRNA gene sequencing as an effective diagnostic tool and emphasizing the clinical significance of resistance patterns in guiding appropriate infection management.
Full text article
References
Abduljabar, S. S. & Naqid, I. A. (2022). Staphylococcus aureus among athletes in Zakho City, Kurdistan Region, Iraq: Nasal carriage rate, risk factors, and antibiotic sensitivity profile. Science Journal of University of Zakho, 10, 112-118.https://doi.org/10.25271/sjuoz.2022.10.3.929.
Abduljabar, S. S. & Naqid, I. A. (2023). Factors Associated With The Nasal Carriage Rate of Methicillin-Resistant Staphylococcus aureus (MRSA) and the Molecular Detection of the mecA Gene Among Athletes. Egyptian Academic Journal of Biological Sciences. C, Physiology and Molecular Biology, 15, 749-760.https://doi.org/10.21608/eajbsc.2023.328290.
Abdulkareem, W. L., Hussein, N. R., Mohammed, A. A., Arif, S. H. & Naqid, I. A. (2020). Risk factors association for MRSA nasal colonization in preoperative patients in Azadi Teaching Hospital-Duhok, Kurdistan Region, Iraq. Science Journal of University of Zakho, 8, 88-91.https://doi.org/10.25271/sjuoz.2020.8.3.712.
Chokshi, A., Sifri, Z., Cennimo, D. & Horng, H. (2019). Global contributors to antibiotic resistance. Journal of global infectious diseases, 11, 36-42. https://doi.org/10.4103/jgid.jgid_110_18.
Church, D. L., Cerutti, L., Gürtler, A., Griener, T., Zelazny, A. & Emler, S. (2020). Performance and application of 16S rRNA gene cycle sequencing for routine identification of bacteria in the clinical microbiology laboratory. Clinical microbiology reviews, 33, 10.1128/cmr. 00053-19.https://doi.org/10.1128/cmr.00053-19.
CLSI (2020). Performance Standards for Antimicrobial Susceptibility Testing, Clinical and Laboratory Standards Institute.
Farhood, H. S. & Hamim, S. S. (2024). Molecular profile of Staphylococcus aureus related with UTIs pregnant women in Al-Nasiriyah City, Iraq. Microbes and Infectious Diseases.https://doi.org/10.21608/mid.2024.297550.1999.
Gbinigie, O. A., Onakpoya, I. J., Richards, G. C., Spencer, E. A., Koshiaris, C., Bobrovitz, N. & Heneghan, C. J. (2019). Biomarkers for diagnosing serious bacterial infections in older outpatients: a systematic review. BMC geriatrics, 19, 1-9.https://doi.org/10.1186/s12877-019-1205-0.
Ghazi, A. R., Münch, P. C., Chen, D., Jensen, J. & Huttenhower, C. (2022). Strain identification and quantitative analysis in microbial communities. Journal of Molecular Biology, 434, 167582.https://doi.org/10.1016/j.jmb.2022.167582.
Guo, Y., Song, G., Sun, M., Wang, J. & Wang, Y. (2020). Prevalence and therapies of antibiotic-resistance in Staphylococcus aureus. Frontiers in cellular and infection microbiology, 10, 107.https://doi.org/10.3389/fcimb.2020.00107.
Hami, I. A. & Ibrahim, K. S. (2023). Incidence of methicillin-resistant Staphylococcus aureus (MRSA) recovered from patients with urinary tract infections in zakho city/kurdistan-Iraq. Science Journal of University of Zakho, 11, 91-97.https://doi.org/10.25271/sjuoz.2023.11.1.1041.
Hossain, T. J. (2024). Methods for screening and evaluation of antimicrobial activity: A review of protocols, advantages, and limitations. European Journal of Microbiology and Immunology, 14, 97-115.https://doi.org/10.1556/1886.2024.00035.
Hussein, N. R., Naqid, I. A., Ibrahim, N., Ahmad, S. I., Daniel, S. S., Yahya, A. H., Muhammed, A. S., Muhammed, G. J., Ramadan, N. T. & Mihe, S. I. (2025). Trends in Antimicrobial Resistance of Staphylococcus aureus Uropathogens: A Retrospective Study From Duhok Province, Kurdistan Region, Iraq. Cureus, 17.https://doi.org/10.7759/cureus.77553.
Kowalska-Krochmal, B. & Dudek-Wicher, R. (2021). The minimum inhibitory concentration of antibiotics: methods, interpretation, clinical relevance. Pathogens, 10, 165.https://doi.org/10.3390/pathogens10020165.
Krivošíková, K., Šupčíková, N., Gaál Kovalčíková, A., Janko, J., Pastorek, M., Celec, P., Podracká, Ľ. & Tóthová, Ľ. (2023). Neutrophil extracellular traps in urinary tract infection. Frontiers in Pediatrics, 11, 1154139.https://doi.org/10.3389/fped.2023.1154139.
Kuo, I.-C., Lee, J.-J., Hwang, D.-Y., Lim, L.-M., Lin, H. Y.-H., Hwang, S.-J., Chen, H.-C. & Hung, C.-C. (2020). Pyuria, urinary tract infection and renal outcome in patients with chronic kidney disease stage 3–5. Scientific reports, 10, 19460.https://doi.org/10.1038/s41598-020-76520-5.
Liu, C.-P., Chen, Z.-D., Ye, Z.-Y., He, D.-Y., Dang, Y., Li, Z.-W., Wang, L., Ren, M., Fan, Z.-J. & Liu, H.-X. (2021). Therapeutic applications of functional nanomaterials for prostatitis. Frontiers in Pharmacology, 12, 685465.https://doi.org/10.3389/fphar.2021.685465.
Mcfarland, J. (1907). The nephelometer: an instrument for estimating the number of bacteria in suspensions used for calculating the opsonic index and for vaccines. Journal of the American Medical Association, 49, 1176-1178.https://doi.org/10.1001/jama.1907.25320140022001f.
Mintz, I., Chowers, M. & Obolski, U. (2023). Prediction of ciprofloxacin resistance in hospitalized patients using machine learning. Communications Medicine, 3, 43.https://doi.org/10.1038/s43856-023-00275-z.
Nandhini, P., Kumar, P., Mickymaray, S., Alothaim, A. S., Somasundaram, J. & Rajan, M. (2022). Recent developments in methicillin-resistant Staphylococcus aureus (MRSA) treatment: a review. Antibiotics, 11, 606.https://doi.org/10.3390/antibiotics11050606.
Raza, A., Ngieng, S. C., Sime, F. B., Cabot, P. J., Roberts, J. A., Popat, A., Kumeria, T. & Falconer, J. R. (2021). Oral meropenem for superbugs: challenges and opportunities. Drug discovery today, 26, 551-560.https://doi.org/10.1016/j.drudis.2020.11.004.
Selim, S., Faried, O. A., Almuhayawi, M. S., Saleh, F. M., Sharaf, M., El Nahhas, N. & Warrad, M. (2022). Incidence of vancomycin-resistant Staphylococcus aureus strains among patients with urinary tract infections. Antibiotics, 11, 408.https://doi.org/10.3390/antibiotics11030408.
Tacconelli, E., Sifakis, F., Harbarth, S., Schrijver, R., Van Mourik, M., Voss, A., Sharland, M., Rajendran, N. B., Rodríguez-Baño, J. & Bielicki, J. (2018). Surveillance for control of antimicrobial resistance. The Lancet Infectious Diseases, 18, e99-e106https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(17)30485-1/abstract.
Tuon, F. F., Suss, P. H., Telles, J. P., Dantas, L. R., Borges, N. H. & Ribeiro, V. S. T. (2023). Antimicrobial treatment of Staphylococcus aureus biofilms. Antibiotics, 12, 87.https://doi.org/10.3390/antibiotics12010087.
Vashisht, V., Vashisht, A., Mondal, A. K., Farmaha, J., Alptekin, A., Singh, H., Ahluwalia, P., Srinivas, A. & Kolhe, R. (2023). Genomics for emerging pathogen identification and monitoring: Prospects and obstacles. BioMedInformatics, 3, 1145-1177.https://doi.org/10.3390/biomedinformatics3040069.
Yu, G., Lou, Y., He, L., Wang, Z. & Ren, Y. (2025). β-lactam antibiotics vs vancomycin in treating methicillin-sensitive staphylococcus aureus bloodstream infections: a meta-analysis of clinical outcomes. European Journal of Clinical Microbiology & Infectious Diseases, 1-13.https://doi.org/10.1007/s10096-025-05164-y. .
Zhang, T., Li, H., Ma, S., Cao, J., Liao, H., Huang, Q. & Chen, W. (2023). The newest Oxford Nanopore R10. 4.1 full-length 16S rRNA sequencing enables the accurate resolution of species-level microbial community profiling. Applied and Environmental Microbiology, 89, e00605-23.https://doi.org/10.1128/aem.00605-23.
Zhou, J., He, C., Yang, H., Shu, W. & Liu, Q. (2024). Integrative omics analysis reveals insights into small colony variants of Staphylococcus aureus induced by sulfamethoxazole-trimethoprim. BMC microbiology, 24, 212.https://doi.org/10.1186/s12866-024-03364-8.
Authors
Copyright (c) 2026 Ali A. Aziz, and Aqeel I. Gheni

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License [CC BY-NC-SA 4.0] that allows others to share the work with an acknowledgment of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work, with an acknowledgment of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online.