en <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#f79646">Aims:</span></span></span></b> <span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:black">This study compared the performance of culture, automated identification systems (VITEK&reg; 2), and species-specific polymerase chain reaction in detecting bacterial pathogens in respiratory samples obtained from symptomatic Iraqi patients</span></span></span><span style="font-size:10.0pt"><span cambria="" style="font-family:">.</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#f79646">Materials & Methods:</span></span></span></b><span style="font-size:10.0pt"><span cambria="" style="font-family:"> This cross-sectional study included 180 patients aged 2&ndash;50 years with symptoms of </span></span><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:black">respiratory tract infections</span></span></span><span style="font-size:10.0pt"><span cambria="" style="font-family:">. Sputum and nasopharyngeal swab samples were cultured on blood and MacConkey agar. Colony morphology and VITEK&reg; 2 were used to identify the isolates. PCR targeting ply (<i>Streptococcus pneumoniae</i>), nuc (<i>Staphylococcus aureus</i>), CW753 (<i>Klebsiella pneumoniae</i>), and EsxA (<i>Mycobacterium tuberculosis</i>) was performed. Chi-square tests Fisher&rsquo;s exact tests were used to compare detection rates.</span></span><span style="font-size:10.0pt"><span style="font-family:"Cambria",serif"></span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#f79646">Findings:</span></span></span></b><span style="font-size:10.0pt"><span cambria="" style="font-family:"> Among 180 patients, 150 (83.3%) had confirmed bacterial respiratory infections. VITEK&reg; 2 most frequently identified <i>Klebsiella pneumoniae</i> (26.7%), <i>Streptococcus pneumoniae</i> (20.0%), and <i>Staphylococcus aureus</i> (18.7%), whereas PCR detected more <i>Streptococcus pneumoniae</i> (41.3% vs. 20.0%; p<0.001) and uniquely identified <i>Mycobacterium tuberculosis</i> in 20 cases (13.3%). Single-pathogen infections predominated (57.2%), and infection was significantly associated with smoking and chronic disease (p<0.0001).</span></span></span></span></span></span><br> <span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:#f79646">Conclusion:</span></span></span></b> <span style="font-size:10.0pt"><span cambria="" style="font-family:"><span style="color:black">Combining polymerase chain reaction with culture and VITEK&reg; 2 improves the detection and management of bacterial respiratory infections in Iraq.</span></span></span><span style="font-size:10.0pt"><span style="font-family:"Cambria",serif"></span></span></span></span></span></span><br> &nbsp; Respiratory Tract Infections,Streptococcus Pneumoniae,Polymerase Chain Reaction,Iraq, 249 255 http://ijwph.daneshafarand.org/browse.php?a_code=A-10-1-148&slc_lang=en&sid=3 A.H. Jasim 1003194753284600387967 1003194753284600387967 No Department of Pathological Analysis, College of Applied Medical Sciences, University of Kerbala, Karbala, Iraq A.A. Hammadi 1003194753284600387968 1003194753284600387968 Yes Department of Pathological Analysis, College of Applied Medical Sciences, University of Kerbala, Karbala, Iraq S. Barton 1003194753284600387969 1003194753284600387969 No Department of Analytical Chemistry, Faculty of Pharmaceutics, Kingston University, London, England