Prevalence and Antimicrobial Resistance of Pseudomonas aeruginosa for Patients with Ear Infection in Wasit Province

Abstract

Bacterial ear infections represent a significant public health challenge, particularly in developing regions where antimicrobial resistance is escalating at an alarming rate. This cross-sectional study investigated the prevalence, bacteriological profile, and antimicrobial resistance patterns of pseudomonas aeruginosa isolated from patients with ear infections attending Al-Zahraa Teaching Hospital and private otolaryngology clinics in Wasit Province, Iraq between November 2024 and June 2025. A total of 300 ear swabs were collected and processed under standardized microbiological protocols. P. aeruginosa was detected in 16.67% (50/300) samples, representing 36.08% of total bacterial isolates. Among the 50 confirmed isolates, 74% were associated with otitis externa and 26% with otitis media. All isolates were confirmed by PCR targeting the 16S rRNA gene (956 bp amplicon), yielding 100% concordance with conventional biochemical identification. The highest infection rate was recorded in patients aged 40-60 years (24.39%), with no statistically significant gender differences (P > 0.05). Antimicrobial susceptibility testing followed Clinical and Laboratory Standards Institute (CLSI) 2025 guidelines, revealing optimal activity for ceftazidime (90%), amikacin (88%), meropenem (86%), and imipenem (84%). Multidrug resistance (MDR) was detected in 40% of isolates and extensive drug resistance (XDR) in 8%. Piperacillin demonstrated near-universal resistance (98%), rendering it clinically ineffective. These findings underscore the urgent necessity for continuous antimicrobial surveillance and evidence-based empirical treatment protocols in Wasit Province.