A New Preview of Antibiotic-resistant Spectrum in Community-acquired Pneumonia: A Cross-Sectional Study from Iraq

Community-acquired pneumonia (CAP) remains one of the leading sources of morbidity/mortality in the world. However, the increasing problem of antimicrobial resistance (AMR) aggravates the issue. This research intends to explore the prevalent levels of resistance to antibacterial drugs in bacteria isolated from patients in Iraq experiencing CAP.

A cross-sectional study was conducted on 122 clinically and radiologically confirmed CAP patients at Al-Yarmouk Teaching Hospital, Baghdad, from May 2023 to June 2024. Sputum samples were evaluated microscopically and analyzed for culture and sensitivity using the VITEK^® 2 system.

Of 122 patients, 44 (36.1%) had positive bacterial cultures. S. pneumoniae and S. sanguinis bacteria, along with S. aureus and P. aeruginosa, stood out as the common ones, causing 18.2% each. S. aureus comprised 11.4%, followed by P. aeruginosa. S. pneumoniae and S. sanguinis showed 100% resistance to azithromycin, clindamycin, and ciprofloxacin. S. aureus was 60% & 20% resistant to vancomycin & linezolid. Extremely alarming was the near-total resistance of Acinetobacter baumannii.

This study provides the first detailed resistance profile for CAP pathogens in Iraq using modern automated diagnostics. The findings reveal alarmingly high levels of antibiotic resistance, including pan-resistant strains.

The problem of antibiotic resistance in CAP in Iraq is very serious and rising because of the development of pan-resistant bacteria. Currently, the requirement exists for comprehensive antibiotic stewardship programs in the whole of Iraq, along with strict implementation of measures against the free sale of antibiotics.