Tehran University of Medical Sciences Iranian Journal of Microbiology 2008-3289 17 2 2025 04 05 268 277 EN Moslim Khalaf Department of Pathological Analysis, College of Applied Medical Sciences, Al-Shatrah University, Thi-Qar, Iraq; Department of Biology, College of Science, University of Al-Qadisiya, Al-Qadisiya, Iraq Firas Abd Al-Mayahi Department of Biology, College of Science, University of Al-Qadisiya, Al-Qadisiya, Iraq 2025 01 02 2025 03 03 Background and Objectives: The emergence of carbapenem resistance in Escherichia coli (E. coli) poses an urgent threat. The study aims to assess carbapenem resistance and the presence of carbapenemase genes in E. coli clinical isolates from Thi-Qar Hospital, Iraq. Materials and Methods: A total of 2203 specimens were collected from patients at two hospitals between January and October 2024. E. coli was identified via biochemical tests and confirmed with the Vitek2® system. Antibiotic sensitivity was evaluated using disc diffusion, and carbapenemase production was investigated through combined disc tests (CDT) and modified Hodge tests (MHT). PCR was used to detect carbapenemase genes. Results: Out of 2203 specimens, 1212 (55.02%) exhibited bacterial growth, with E. coli accounting for 15.35% (186/1212) of isolates. Among these, 40 (21.51%) were resistant to at least one carbapenem. CDT identified 10, and MHT identified 1 as a carbapenemase producer. The most detected gene was blaNDM (60.00%), followed by blaOXA (40.00%) and blaOXA-48 (15.00%). blaOXA-51 and blaVIM were found in 5.00% of isolates each. No blaKPC, blaNMC, blaIMI, blaGES, blaSPM, blaGIM, or blaSIM was detected. Conclusion: The high prevalence of carbapenem resistance and the corresponding encoding genes in E. coli in Thi-Qar province pose a concerning challenge for managing serious infections caused by this pathogen. https://ijm.tums.ac.ir/index.php/ijm/article/view/5226 https://ijm.tums.ac.ir/index.php/ijm/article/download/5226/1766