Four-year analysis of antimicrobial resistance patterns in Iraq

Area of Science:

• Clinical microbiology
• Infectious diseases
• Public health

Background:

• First nationwide assessment of antimicrobial resistance (AMR) patterns in Iraq.
• Focus on World Health Organization (WHO) target pathogens.

Purpose of the Study:

• Analyze antimicrobial resistance patterns in Iraq over a four-year period (2020-2023).
• Utilize data from the national surveillance system to understand resistance trends.

Main Methods:

• Analysis of 238,973 clinical specimens from 106 surveillance sites across Iraq.
• Data collected from 2020-2023 using WHONET software and analyzed with SPSS version 26.

Main Results:

• Significant increase in carbapenem resistance in Acinetobacter baumannii (80% in 2023).
• High resistance rates to third-generation cephalosporins in Acinetobacter baumannii and Escherichia coli.
• Methicillin-resistant Staphylococcus aureus (MRSA) at 74.0%.
• Increased multidrug resistance and extensively drug-resistant profiles for Acinetobacter spp. and Klebsiella pneumoniae.
• Rising resistance to last-line antibiotics like colistin and tigecycline.

Conclusions:

• Key pathogens in Iraq exceed critical resistance thresholds, compromising empirical therapies.
• Treatment options are narrowing due to widespread antimicrobial resistance.
• Urgent strengthening of antimicrobial stewardship and prescription practices is crucial to preserve treatment efficacy.