{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:44:11Z","timestamp":1791812651732,"version":"4.3.4"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p><jats:italic>Pseudomonas aeruginosa<\/jats:italic> is an opportunistic Gram-negative pathogen and a critical-priority organism according to the World Health Organization. Its increasing resistance to multiple antimicrobial classes, including carbapenems, poses a major challenge in treating infections among immunocompromised individuals, particularly burn and cancer patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study investigated phenotypic resistance profiles, carbapenemase classifications using an advanced expert system, and the molecular prevalence of <jats:italic>bla<jats:sub>VIM<\/jats:sub><\/jats:italic> and <jats:italic>bla<jats:sub>NDM<\/jats:sub><\/jats:italic> genes in 50 clinical isolates from cancer, burn, and other immunocompromised patients in Erbil, Iraq.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Multidrug resistance and carbapenem resistance were detected in 66.0 and 58.0% of isolates, respectively, with the highest burden among burn patients (93.8%). Carbapenem resistance was significantly associated with prior carbapenem exposure (<jats:italic>p<\/jats:italic>\u202f=\u202f0.0044) and increased mortality (p = 0.0392). Carbapenemase-producing isolates classified by the advanced expert system exhibited universal multidrug resistance and more than 95% resistance to imipenem and meropenem. Molecular analysis identified <jats:italic>bla<jats:sub>VIM<\/jats:sub><\/jats:italic> in 47.5%, <jats:italic>bla<jats:sub>NDM<\/jats:sub><\/jats:italic> in 10.0%, and both genes in 30.0% of tested isolates, with <jats:italic>bla<jats:sub>NDM<\/jats:sub><\/jats:italic> significantly associated with carbapenem resistance (<jats:italic>p<\/jats:italic>\u202f=\u202f0.027). Resistance patterns varied by patient group and antibiotic class, with burn isolates demonstrating the highest rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion\/conclusion<\/jats:title><jats:p>These findings highlight the need for enhanced molecular surveillance, infection control, and antimicrobial stewardship in high-risk settings.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmicb.2025.1672531","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T05:33:39Z","timestamp":1757914419000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Molecular detection of blaVIM and blaNDM in multidrug-resistant Pseudomonas aeruginosa from cancer and burn patients in Erbil, Iraq"],"prefix":"10.3389","volume":"16","author":[{"given":"Bahra Kakamin","family":"Hamad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muayad Ahmed","family":"Mahmud","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"804","DOI":"10.1186\/s12879-025-11182-0","article-title":"Multidrug-resistant Pseudomonas aeruginosa in immunocompromised cancer patients: epidemiology, antimicrobial resistance, and virulence factors","volume":"25","author":"Abdulhak","year":"2025","journal-title":"BMC Infect. 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