Detection of Other Microbial Infections Among COVID-19 Patients in Thi-Qar Province/Southern Iraq


  • Ammar Ahmed Abed College of Medicine /Department of Microbiology / University of Thi-Qar
  • Amal Khudair Khalaf College of Medicine /Department of Microbiology / University of Thi-Qar


Entamoeba histolytica, Cytomegalovirus, Bacteria and COVID-19


Background. SARS-CoV-2 virus, a type of Coronaviridae virus that affects people, is the
cause of COVID-19.This viral disease like any other diseases, the infection linked to this
one might be brought on by a parasite, virus, bacteria, or other kind of microbe.
Methods. Examining the level of antibodies in the serum of patients of anti- E. histolytica
IgA, IgG and IgM antibodies and anti-CMV IgG and IgM antibodies are measured by
immunoassay of patient's sera by ELISA system and whole blood was withdrawn to check
for bacteremia.
Results. As a result, 60 blood samples from COVID-19 patients were taken, along with 30
samples from healthy individuals, for testing to find antibodies against E. histolytica and
Cytomegalovirus. The patients were clinically and radiographically proven to have the
COVID-19. To screen for bacteremia, the entire blood was tested.
Conclusions. The results show a significant difference in the titration of E. histolyticaIgA antibody, IgG and IgM. COVID-19 patients with CMV-IgG antibody showed (100%) rate
of infection reporting a significant differences during the current study, while CMV-IgM
antibody showed (3.3%) rate of infection. Regarding bacteremia, all results of bacteria
detection in blood culture of Covid-19 patients were negative and there is no relationship
between the infection of COVID-19 and bacteremia.


- Yanagawa, Y., Nagata, N., Yagita, K., Watanabe, K., Okubo, H., Kikuchi, Y., Gatanaga, H., Oka, S., &

Watanabe, K. (2021). Clinical Features and Gut Microbiome of Asymptomatic Entamoeba histolytica

Infection. Clinical Infectious Diseases, 73(9), 3163–3171.

- Yang, L., Liu, S., Liu, J., Zhang, Z., Wan, X., Huang, B., Chen, Y., & Zhang, Y. (2020). COVID-19:

immunopathogenesis and Immunotherapeutics. Signal Transduction and Targeted Therapy 5(1).

- Hemphill, A., Müller, N., & Müller, J. (2019). Comparative pathobiology of the intestinal

protozoan parasites giardia lamblia, Entamoeba histolytica, and Cryptosporidium parvum.


- Ankri, S. (2021). Entamoeba histolytica—gut microbiota interaction: More than meets the eye.

Microorganisms,9(3) ,1–12.

- Mohammed Saba, A., Muhammad, A., Baba, J., Mustapha, A., & Hussaini, H. B. (2020).

Prevalence Of Entamoeba Histolytica Infection Among Primary School Children In Five Selected

Communities Of Wushishi Local Government Area, Niger State, Nigeria. Fudma Journal Of Sciences, 4(3),


- Chinese Center for Disease Control and Prevention.(2020). Technical

documents for COVID-19 prevention and control. CCDC Weekly, 2 (19), 332-337.

- Kiyoyama, T., Tokuda, Y., Shiiki, S., Hachiman, T., Shimasaki, T., & Endo, K. (2009). Isopropyl

alcohol compared with isopropyl alcohol plus povidone-iodineas skin preparation for prevention of

blood culture contamination. Journal of Clinical Microbiology, 47(1), 54–58.

- Ghosh, S., Padalia, J., & Moonah, S. (2019). Tissue Destruction Caused by Entamoeba histolytica

Parasite: Cell Death, Inflammation, Invasion, and the Gut Microbiome.Current Clinical Microbiology

Reports ,6( 1), 51–57.

- Zorbozan, O. (2022). The Impact of COVID-19 Pandemic on Access to Healthcare: The

Experience of the Diagnostic Parasitology Laboratory of Ege University. Turkish Journal of Parasitology,

(2), 124–128.

- Azmi, N., & Othman, N. (2021). Entamoeba histolytica: Proteomics bioinformatics reveal

predictive functions and protein–protein interactions of differentially abundant membrane and cytosolic

proteins. Membranes, 11(6).

- Elsaftawy, E., Wassef, R., & Amin, N. (2021). Can endemic parasitic diseases and/or vectors play

a role in the COVID-19 pandemic?, parasitologists united journal, 14(1), 7–14.

- Abuljadayel, D., Atef, A., Al-Matary, M., Edris, S., Al-Quwaie, D. A. H., Alsubhi, N. H., Al-Hindi, R.

R., Sabir, J. S. M., Hall, N., & Bahieldin, A. (2020). Detection of a negative biomarker for amebiasis

(Entamoeba histolytica) in the human gut mycobiome. Applied Ecology and Environmental Research,

(2), 2363–2394.

- Mahmood, N., & AL-Ghazal, A. (2020). Prevalence of Cytomegalovirus and its Roles in Cytokines

Stimulation in Immunocompromised Patients in Mosul City. Rafidain journal of science, 29, 17-27. Iraq,

(3), 17–27.

- Flaih, M. H., Khazaal, R. M., Kadhim, M. K., Hussein, K. R., & Alhamadani, F. A. B. (2021). The

epidemiology of amoebiasis in Thi-Qar Province, Iraq (2015-2020): Differentiation of Entamoeba

histolytica and Entamoeba dispar using nested and real-time polymerase chain reaction. Epidemiology

and Health, 43.

- Hamza, D.M., Malaa, S.F., & Alaaraji, K.K. (2021). Real-Time-PCR Assay Based on

Phosphoglycerate Kinase Gene for Detection of Entamoeba histolytica Trophozoites in Stool Samples in

Holy Karbala, Iraq. Medico-Legal Update, 21, 1656-1664.

- Mahmood, S. A. F., & Bakr, H. M. (2020). Molecular Identification and Prevalence of Entamoeba

histolytica, Entamoeba dispar and Entamoeba moshkovskii in Erbil City, Northern Iraq. Polish journal of

microbiology, 69(3), 263–272.

- Al-Salehy, Z.K., & Mohammad, Z.A. (2020). Relationship between fecal calprotectin and other

immunological parameters in diarrheal children infected with Entamoeba histolytica and pathogenic

bacteria in thi-qar province,Iraq. Plant Archives,20 , 1089-1095.

- Afar, J. ’, Adam, S., Yahaya, M. G., Nas, F. S., Mu’azu, L., & Ali, M. (2021). Determination of

prevalence rate of Entamoeba histolytica among children diagnosed with acute diarrhea in kano,

Nigeria. Journal of the Medical Sciences, 9,16-18.

- Smith, A.P., & Pawelec, G. (2020). Possible causes of disparities in the risk and outcomes of

COVID-19: Cytomegalovirus and aged immune phenotype. Journal of Clinical and Translational

Research, 6, 92 - 93.

- Ibrahim, M. N. (2021). Seroprevalence of cytomegalovirus antibodies among COVID-19 patients.

Biomedical and Pharmacology Journal, 14(3), 1561–1565.

- Alanio, C., Verma, A., Mathew, D., Gouma, S., Liang, G., Dunn, T., Oldridge, D. A., Weaver, J.,

Kuri-Cervantes, L., Pampena, M. B., Betts, M. R., Collman, R. G., Bushman, F. D., Meyer, N. J., Hensley, S.

E., Rader, D., Wherry, E. J., Baxter, A. E., D’Andrea, K., … Vanderbeck, A. N. (2022). Cytomegalovirus

Latent Infection is Associated with an Increased Risk of COVID-19-Related Hospitalization. The Journal

of Infectious Diseases,10,1-11.

- Gatto, I., Biagioni, E., Coloretti, I., Farinelli, C., Avoni, C., Caciagli, V., Busani, S., Sarti, M.,

Pecorari, M., Gennari, W., Guaraldi, G., Franceschini, E., Meschiari, M., Mussini, C., Tonelli, R., Clini, E.,

Cossarizza, A., Girardis, M., Girardis, M., … Serpini, G. F. (2022). Cytomegalovirus blood reactivation in

COVID-19 critically ill patients: risk factors and impact on mortality. Intensive Care Medicine,48,706-

- Lantos, P. M., Hoffman, K., Permar, S. R., Jackson, P., Hughes, B. L., & Swamy, G. K. (2017).

Geographic disparities in cytomegalovirus infection during pregnancy. Journal of the Pediatric Infectious

Diseases Society, 6(3), 55– 61.

- Hemmersbach-Miller, M., Alexander, B. D., Pieper, C. F., & Schmader, K. E. (2020). Age matters:

older age as a risk factor for CMV reactivation in the CMV serostatus–positive kidney transplant

recipient. European Journal of Clinical Microbiology & Infectious Diseases,39(3), 455–463.

- A.ALTaie, A., A.Ibraheem, M., & A. Muhammad, M. (2019). Detection of Cytomegalovirus by

ELISA Technique in Rheumatoid Arthritis Patients in Mosul / Iraq. The 6th International Conference of

Biotechnology, Environment and Engineering Sciences. 141–147.

- Esquer Garrigos, Z., Wingler, M.J., Svoronos, P., Vijayvargiya, P., Goodman-Meza, D., O’Horo, J.C.,

Navalkele, B.D., Cretella, D.A., Frame, I.J., Parham, J.J., & Lucar, J. (2021). Increased rates of blood

culture contamination during the coronavirus disease 2019 pandemic. Infection Control and Hospital

Epidemiology, 1 - 3.

- Gülseren, Y. D., Esenkaya Taşbent, F., & Ozdemir, M. (2019). Investigation of CMV and Rubella

Seroprevalence and Age Related Distribution in Pregnant Women. Journal of Turkish Microbiology

Society, 49(3):154-161.

- Siennicka, J., Dunal-Szczepaniak, M., Trzcińska, A., Godzik, P., & Rosińska, M. (2016). High

Seroprevalence of CMV Among Women of Childbearing Age Implicates High Burden of Congenital

Cytomegalovirus Infection in Poland. Polish journal of microbiology, 65, 425 - 432.

- Ait Zirri, K., Elfersani, F., Amrani, A., & Soraa, N. (2021). Microbial Coinfections in Patients with

SARS-CoV2. International Journal of Medical Science and Health Research, 05(02), 260–266.

- Mahmoudi, H.(2020)Bacterial co-infections and antibiotic resistance in patients with COVID19,15.

- Mahmoudi, H. (2020). Bacterial co-infections and antibiotic resistance in patients with COVID19. GMS Hygiene and Infection Control, 15.

- Mormeneo Bayo, S., Palacián Ruíz, M. P., Moreno Hijazo, M., & Villuendas Usón, M. C.

(2022).Bacteremia during COVID-19 pandemic in a tertiary hospital in Spain. Infectious Diseases and

Clinical Microbiology,40(4), 183–186.

- Ibrahim, H.M., Mohamed, A.M., & Mabrook, H. (2021). Hematological and biochemical effects of

Toxoplasma gondii, Entamoeba histolytica, and Schistosoma infection among Hepatitis C virus patients

from Menoufia Province, Egypt. Biomedical and Biotechnology Research Journal (BBRJ),5(3), 295–301.

- Thelen, J.M., Buenen, A.G., van Apeldoorn, M.J., Wertheim, H.F., Hermans, M.H., & Wever, P.C.

(2021). Community-acquired bacteraemia in COVID-19 in comparison to influenza A and influenza B: a

retrospective cohort study. BMC Infectious Diseases, 21(1).

- Koksal, I., Aksoy, F., Kaya, S., Taş, M., & Yılmaz, G. (2019). 2310. No Recurrence in Recovered

People with CCHF: A Cross-Sectional Study From Turkey, Preliminary Report. Open Forum Infectious

Diseases, 6, S792 - S792.

- Suarez-de-la-Rica, A., Serrano, P.M., de-la-Oliva, R., Sánchez-Díaz, P., Molinero, P., FalcesRomero, I., Ferrando, C., Rello, J., & Maseda, E. (2021). Secondary infections in mechanically ventilated

patients with COVID-19: An overlooked matter? Spanish Journal of Chemotherapy, 34, 330 - 336.



Arch. Vol. 22, No. 2, pp. 3441-3447.

- Abed A.A. and Khalaf A.Kh. (2023) . Serological Detection for Toxoplasmosis among Patients

with Covid-19 in Thi-Qar Province. Archives of Razi Institute, Vol. 78, No. 2 (2023) 715-720.

- Hameed F.A. and Khalaf A.Kh. (2022). Serological detection for Entamoeba histolytica among

cancer patients suffering from diarrhea in Thi-Qar province/ Southern Iraq. Journal of Science

(UTJsci),Volume (9), No.2.

- Sabeeh F.A and Khalaf A.Kh. (2022).Biochemical study for Amoebic dysentery in patients with

Entamoeba histolytica in Thi-Qar province/southern Iraq. BASRAH JOURNAL OF VETERINARY

RESEARCH, 21(S1):14-26