The lungs are a common site for infection by prevalent pathogens which be faced in worldwide, include bacteria, atypical, viruses, fungi and other infectious agents. Ten million persons became infected with TB and 1.6 million died of this disease. This study was designed to explore the rate of AFB, the most common bacteria and fungi in the sputum specimen obtained from patients with respiratory tract infection. Positive sputum culture was 1155 (5.6%).The prevalence of Gram negative 752 (80.1%) was higher than Gram positive 187 (19.91%). The most common Gram-negative bacteria were: Pseudomonas aeruginosa (19.91%), Moraxella catarrhalis (17.14%), then Klebsiella pneumoniae and Escherichia coli (15.86%), (13.31%) respectively. Streptococcus pneumoniae (15.0%) is at the top of Gram-positive bacteria. A significant greater proportion of TB in West Baghdad than in the East Baghdad. Bacterial isolates exhibited a high frequency of resistance to most of common antibiotics such as: Ticaricillin (TI), Amoxacillin (AMX), Rocephin (CTR), Gentamycin (GEN). Gram negative bacteria population was the most common organisms for RTI then TB and fungi, higher prevalence of microbial infection in men than women and increased of antibiotic resistance especially β-lactam antibiotics.

• Adhikari, A., Sahu, S., Bandyopadhyay, A., Blanc, P. D., & Moitra, S. (2015). Fungal contamination of the respiratory tract and associated respiratory impairment among sawmill workers in India. ERJ open research, 1(2).
• Aghili, S. R., Shokohi, T., Hedayati, M. T., Abastabar, M., Aliyali, M., & Hasanpour, H. (2016). Invasive forms of Candida and Aspergillus in sputum samples of pulmonary tuberculosis patients attending the tuberculosis reference laboratory in Ghaemshahr, Northern Iran: an analysis of samples collected during the past 10 years. International journal of mycobacteriology, 5(5), 179.
• Altiner, A., Wilm, S., Däubener, W., Bormann, C., Pentzek, M., Abholz, H. H., & Scherer, M. (2009). Sputum colour for diagnosis of a bacterial infection in patients with acute cough. Scandinavian journal of primary health care, 27(2), 70-73.
• Aly M., & Balkhy H.H(2012). The prevalence of antimicrobial resistance in clinical isolates from Gulf Corporation Council countries. Antimicrobial Resistance and Infection Control 1:26.http://www.aricjournal.com/content/1/1/26
• Ambreen, A., Jamil, M., ur Rahman, M. A., & Mustafa, T. (2019). Viable Mycobacterium tuberculosis in sputum after pulmonary tuberculosis cure. BMC infectious diseases, 19(1), 923.
• Anvari, M. S., Naderan, M., Boroumand, M. A., Shoar, S., Bakhshi, R., & Naderan, M. (2014). Microbiologic spectrum and antibiotic susceptibility pattern among patients with urinary and respiratory tract infection. International journal of microbiology, 2014.
• Bekkari, H., Benchemsi, N., Touijer, H., Berrada, S., Maniar, S., Ettayebi, M., & El Ouali Lalami, A. (2016). Microbial analysis of air in a public hospital in the city of Fez, Morocco. Int. J. Pharm. Clin. Res, 8, 533-537.
• Biswas, S., Das, A., Sinha, A., Das, S. K., & Bairagya, T. D. (2013). The role of induced sputum in the diagnosis of pulmonary tuberculosis. Lung India: Official Organ of Indian Chest Society, 30(3), 199.
• Braue, J., Hagele, T., Yacoub, A. T., Mannivanan, S., Sokol, L., Glass, F., & Greene, J. N. (2015). A case of rupioid syphilis masquerading as aggressive cutaneous lymphoma. Mediterranean journal of hematology and infectious diseases, 7(1).
• Budayanti, N. S., Suryawan, K., Iswari, I. S., & Sukrama, D. M. (2019). The Quality of Sputum Specimens as a Predictor of Isolated Bacteria From Patients With Lower Respiratory Tract Infections at a Tertiary Referral Hospital, Denpasar, Bali-Indonesia. Frontiers in Medicine, 6, 64.
• Campbell, S., & Forbes, B. A. (2011). The clinical microbiology laboratory in the diagnosis of lower respiratory tract infections. Journal of Clinical Microbiology, 49(9 Supplement), S30-S33.
• Clinical and Laboratory Standards Institute. (2017). Performance standards for antimicrobial susceptibility testing. CLSI supplement M100.
• Cukic, V. (2013). The most common detected bacteria in sputum of patients with the acute exacerbation of COPD. Materia socio-medica, 25(4), 226.
• Cukic, V., & Hadzic, A. (2016). The most common detected bacteria in sputum of patients with community acquired pneumonia (CAP) treated in hospital. Medical Archives, 70(5), 354.doi: 10.5455/medarh.2016.70.354-358
• Dara, M., Acosta, C. D., Melchers, N. V. V., Al-Darraji, H. A., Chorgoliani, D., Reyes, H., ... & Migliori, G. B. (2015). Tuberculosis control in prisons: current situation and research gaps. International Journal of Infectious Diseases, 32, 111-117.
• Datta, S., Shah, L., Gilman, R. H., & Evans, C. A. (2017). Comparison of sputum collection methods for tuberculosis diagnosis: a systematic review and pairwise and network meta-analysis. The Lancet Global Health, 5(8), e760-e771.
• Deka, D. J., Choudhury, B., Talukdar, P., Lo, T. Q., Das, B., Nair, S. A., ... & Kumar, A. M. V. (2016). What a difference a day makes: same-day vs. 2-day sputum smear microscopy for diagnosing tuberculosis. Public health action, 6(4), 232-236.
• Dodd, P. J., Looker, C., Plumb, I. D., Bond, V., Schaap, A., Shanaube, K., ... & Beyers, N. (2016). Age-and sex-specific social contact patterns and incidence of Mycobacterium tuberculosis infection. American journal of epidemiology, 183(2), 156-166.
• ElKorashy, R. I. M., & El-Sherif, R. H. (2014). Gram negative organisms as a cause of acute exacerbation of COPD. Egyptian Journal of Chest Diseases and Tuberculosis, 63(2), 345-349.
• Exner, M., Bhattacharya, S., Christiansen, B., Gebel, J., Goroncy-Bermes, P., Hartemann, P., ... & Merkens, W. (2017). Antibiotic resistance: What is so special about multidrug-resistant Gram-negative bacteria?. GMS hygiene and infection control, 12.
• Farooq, L., Memon, Z., Ismail, M. O., & Sadiq, S. (2019). Frequency and antibiogram of multi-drug resistant pseudomonas aeruginosa in a Tertiary Care Hospital of Pakistan. Pakistan journal of medical sciences, 35(6), 1622.
• Fletcher, S. (2015). Understanding the contribution of environmental factors in the spread of antimicrobial resistance. Environmental health and preventive medicine, 20(4), 243-252.
• Froment, P., Marchandin, H., Perre, P. V., & Lamy, B. (2014). Automated versus manual sample inoculations in routine clinical microbiology: a performance evaluation of the fully automated InoqulA instrument. Journal of clinical microbiology, 52(3), 796-802.
• Gebremeskel, H., Abebe, H., Jaleto, K., & Biratu, W. (2016). Genotypic Difference in Growth and Yield Related Traits of Onion (Allium Cepa L.) Varieties at Southern Tigray. Current Research in Agricultural Sciences, 3(2), 16-21.
• Geneva, S., World Health Organization, & World Health Organization. (2015). Global tuberculosis report 2015.
• Hammadi, A.A., AlrawiSK., & Hayyawi,A.H.(2017). Bacterial isolates and antimicrobial susceptibility in AL-Yarmouk teachinghospital in Baghdad. Glouble Journal of Bio-science and Biotechnology. 6(4): 595-600.
• Hasan, Z.A., Al-Sulami, A.A, Al-TaeeAMR, & Al-Rubeai, D.B.(2015).Gram positive and Gram-negative bacteria from sputum of clinically tuberculosis suspected patients. International Journal of Current Research. 7(4): 14289-91.
• Kali, A., Charles, M. P., Noyal, M. J., Sivaraman, U., Kumar, S., & Easow, J. M. (2013). Prevalence of Candida co-infection in patients with pulmonary tuberculosis. The Australasian medical journal, 6(8), 387.
• Kalyani, C. S., & Koripella, R. L. (2016). Madhu Ch. Fungal Isolates in Sputum Samples of Multidrug-resistant Tuberculosis Suspects. Int J Sci Stud, 4(2), 164-166.
• Karthik, L., Kumar, G., Keswani, T., Bhattacharyya, A., Chandar, S. S., & Rao, K. B. (2014). Protease inhibitors from marine actinobacteria as a potential source for antimalarial compound. PloS one, 9(3), e90972.
• Karthik, L., Kumar, G., Keswani, T., Bhattacharyya, A., Chandar, S. S., & Rao, K. B. (2014). Protease inhibitors from marine actinobacteria as a potential source for antimalarial compound. PloS one, 9(3), e90972.
• Khaliq, A., Khan, I. H., Akhtar, M. W., & Chaudhry, M. N. (2015). Environmental risk factors and social determinants of pulmonary tuberculosis in Pakistan. Epidemiology (sunnyvale), 5(3), 201.
• Lönnroth, K., Corbett, E., Golub, J., Godfrey-Faussett, P., Uplekar, M., Weil, D., & Raviglione, M. (2013). Systematic screening for active tuberculosis: rationale, definitions and key considerations [State of the art series. Active case finding/screening. Number 1 in the series]. The International journal of tuberculosis and lung disease, 17(3), 289-298.
• Máiz, L., Vendrell, M., Olveira, C., Girón, R., Nieto, R., & Martínez-García, M. Á. (2015). Prevalence and factors associated with isolation of Aspergillus and Candida from sputum in patients with non-cystic fibrosis bronchiectasis. Respiration, 89(5), 396-403.DOI: 10.1159/000381289.
• Manikandan, C. andAmsath, A.(2013). Antibiotic susceptibility of bacterial strains isolated from patients with respiratory tract infections. International journal of Pure and Applied Zoology. 1(1), Available online at: http://www.ijpaz.com. Int.
• Mansoor, S., Qadir, S., Javed, S., Shah Jehan, F., & Kundi, M. (2017). Antimicrobial susceptibility of organisms isolated from sputum culture of Karachi, Pakistan. Pakistan journal of pharmaceutical sciences, 30(6).
• Mason, P. H., Roy, A., Spillane, J., & Singh, P. (2016). Social, historical and cultural dimensions of tuberculosis. Journal of biosocial science, 48(2), 206-232.
• Mason, P. H., Snow, K., Asugeni, R., Massey, P. D., & Viney, K. (2017). Tuberculosis and gender in the Asia-Pacific region.doi: 10.1111/1753-6405.12619
• Minnesota Department of Health. Instructions for Collecting Sputum for TB. Tuberculosis (TB) Prevention and Control Program. 2018, P.O. Box 9441 Minneapolis, MN 55440-9441 612-676-5414. www.health.state.mn.us/tb
• Mwaura, E. N., Matiru, V., & Bii, C. (2013). Mycological Findings of Sputum Samples from Pulmonary Tuberculosis Patients Attending TB Clinic in Nairobi, Kenya. Virol Mycol 2: 119. doi: 10.4172/2161-0517.1000 119 Page 2 of 6 threatening diseases [12].DOI: 10.4172/2161-0517.1000119
• Nagalingam, N. A., Adesiyun, A. A., Swanston, W. H., & Bartholomew, M. (2005). A cross-sectional study of isolates from sputum samples from bacterial pneumonia patients in Trinidad. Brazilian Journal of Infectious Diseases, 9(3), 231-240.
• Narasimhan P., Wood J., MacIntyre CR., and Mathai D. Risk Factors for Tuberculosis. Pulmonary Medicine. 2013; pages 1 -11. http://dx.doi.org/10.1155/2013/828939
• Nhamoyebonde, S., & Leslie, A. (2014). Biological differences between the sexes and susceptibility to tuberculosis. The Journal of infectious diseases, 209(suppl_3), S100-S106.
• Osman, N. M., Gomaa, A. A., & Sayed, N. M. (2013). Microarray detection of fungal infection in pulmonary tuberculosis. Egyptian Journal of Chest Diseases and Tuberculosis, 62(1), 151-157.
• Papanikolaou, I.C., & Tsenempi, X.A. (2020). Tropical Lung Diseases. Hunter's Tropical Medicine and Emerging Infectious Diseases; 1-7. doi: 10.1016/B978-0-323-55512-8.00001-6
• Prajapati, B., Talsania, N., & Sonaliya, K. N. (2011). A study on prevalence of acute respiratory tract infections (ARI) in under five children in urban and rural communities of Ahmedabad district, Gujarat. National Journal of Community Medicine, 2(2), 255-259.
• Promite, S., Saha, S. K., Ahsan, S., & Akhter, M. Z. (2017). Characterization and Antibiotic Sensitivity Profile of Bacteria Isolated from Patients with Respiratory Tract Infections in Bangladesh. Dhaka University Journal of Pharmaceutical Sciences, 16(2), 235-244.
• Rai, D. K., Kirti, R., Kumar, S., Karmakar, S., & Thakur, S. (2019). Radiological difference between new sputum-positive and sputum-negative pulmonary tuberculosis. Journal of family medicine and primary care, 8(9), 2810.
• Review on Antimicrobial Resistance. (2016). Tackling drug-resistant infections globally: final report and recommendations. Review on antimicrobial resistance. https://amreview.org/sites/default/files/160518_Final%20paper_with%20cover.pdf
• RiedelS., Hobden, J.A., Miller,S., Morse, S.A., Mietzner, T.A., Detrick, B., et al. MitchellTG., Sakanari JA., HotezP. And MejiaR. In: Jawetz JB., Melnick JL., Adelbergg’sEAPrinciples of Diagnostic Medical Microbiology.Section VII: Diagnostic medical microbiology and clinical,Chapter 47: Principles of Diagnostic Medical Microbiology. 28thed. McGraw-Hill Education (LANGE), New York. pp 741-771.
• Safwat, T. M., Fattah, E. B. A., & Soliman, A. G. (2019). Gender differences in pulmonary tuberculosis in Abbassia Chest Hospital. Egyptian Journal of Bronchology, 13(3), 408.
• Samad, A., Ahmed, T., Rahim, A., Khalil, A., & Ali, I. (2017). Antimicrobial susceptibility patterns of clinical isolates of Pseudomonas aeruginosa isolated from patients of respiratory tract infections in a Tertiary Care Hospital, Peshawar. Pakistan journal of medical sciences, 33(3), 670.
• Satapara, D.J, Gohi,l P. Patel, J.N, Patel, N.R, Sheta, M.M, Radhika, Thacker, R.., Koravadia, A.(2017).. Fungal infections in chronic stable bronchiectasis patients. International Journal of Medical and Health Research3(2);1-03. www.medicalsciencejournal.com
• Singh, S. K., Kashyap, G. C., & Puri, P. (2018). Potential effect of household environment on prevalence of tuberculosis in India: evidence from the recent round of a cross-sectional survey. BMC pulmonary medicine, 18(1), 66.
• Srivastava, K., Kant, S., Verma, A. (2015). Role of Environmental factors in Transmission of Tuberculosis. Transmission of Tuberculosis. 2(4). http://journalofhealth.co.nz/?page_id=982
• Stinson, K.W., Eisenach, K., Kayes, S., Matsumoto, M., Siddiqi, S., Nakashima, S., Hashizume, H., Timm, J., Morrissey, A., Mendoza, M., Mathai, P.92014).global laboratory initiative-gli-advancing TB diagnosis, Mycobacteriology Laboratory Manual, First Edition, April A publication of the Global Laboratory Initiative a Working Group of the Stop TB Partnership., pp:1-147
• Subramanyam, B., Sivaramakrishnan, G., Dusthackeer, A., & Kumar, V. (2013). Phage lysin to control the overgrowth of normal flora in processed sputum samples for the rapid and sensitive detection of Mycobacterium tuberculosis by luciferase reporter phage assay. BMC Infectious Diseases, 13(1), 44.
• van Woerden, H. C., Gregory, C., Brown, R., Marchesi, J. R., Hoogendoorn, B., & Matthews, I. P. (2013). Differences in fungi present in induced sputum samples from asthma patients and non-atopic controls: a community based case control study. BMC infectious diseases, 13(1), 69.
• Zhang, Q., Illing, R., Hui, C. K., Downey, K., Carr, D., Stearn, M., ... & Chung, K. F. (2012). Bacteria in sputum of stable severe asthma and increased airway wall thickness. Respiratory research, 13(1), 35.http://respiratory-research.com/content/13/1/35

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.