Prevalence and Antibiogram of Multidrug-Resistant Aeromonas spp. Isolated from Clinical and Environmental Sources in Duhok City/ Iraq

The genus Aeromonas comprises opportunistic pathogens of increasing clinical and environmental concern, mainly in aquatic and healthcare-related environments. This study was aimed at ascertaining the occurrence and antimicrobial resistance of Aeromonas bacteria from different environmental and clinical samples obtained from Duhok City, Kurdistan Region, Iraq. A total of 387 samples (180 environmental and 207 clinical) were analyzed using phenotypic, biochemical, automated Vitek 2 compact system, and molecular methods, utilising the PCR amplification of the GCAT gene, to confirm the presence of Aeromonas bacteria. Environmental samples had a higher rate of isolation (38/180; 21.1%) than clinical samples (3/207; 1.45%). In general, out of 51 phenotypically presumptive isolates, 41 (80.39%) were confirmed by PCR. The cumulative rate of multidrug resistance MDR was 97.56%. The environmental isolates recorded an MDR rate of 97.37%, and 100% within the clinical isolates.

The highest resistance was exhibited by tested antimicrobials against imipenem (95.12% total; 94.74% environmental; 100% clinical), followed by amikacin (90.24% total; 92.11% environmental; 66.67% clinical) and tetracycline (85.37% total; 86.84% environmental; 66.67% clinical). Moderate resistance rates were detected for trimethoprim/sulfamethoxazole, meropenem and aztreonam.

On the other hand, the lowest resistance rates were against ciprofloxacin (39.02%; environmental: 34.21%, clinical: 100%) and chloramphenicol (26.83%; environmental: 26.32%, clinical: 33.33%). This study reveals the environmental and clinical prevalence and multidrug resistance of Aeromonas bacteria, especially in hospital-associated microhabitats, and their significance to public health. The results suggest environmental surveillance on a regular basis, increased infection control, and more restrictive antibiotic policies in the region