Bacterial Contamination and Antibiotic Resistance Patterns in Al Anbar Province Water Sources

Abstract

Bacterial pollution and antibiotic resistance pose substantial public health issues in Anbar Governorate, Iraq. Contamination of environmental water sources and the rise of multidrug-resistant bacterial phenotypes pose significant threats to public health and the effectiveness of healthcare systems. This study sought to assess bacterial contamination levels, delineate antibiotic resistance patterns, and analyze the genetic properties of the primary bacterial pathogens in the region. Approaches: Clinical and environmental specimens, including water samples, were collected from the Euphrates River, institutional water storage facilities, and healthcare institutions. Specimens received thorough microbiological analysis, encompassing bacterial culture, biochemical characterization, and molecular identification for accurate strain designation. Antimicrobial susceptibility was assessed using the Kirby-Bauer disk diffusion method, with resistance profiles analyzed in accordance with Clinical and Laboratory Standards Institute (CLSI) criteria. Polymerase chain reaction (PCR) amplification was utilized to identify resistance determinants, specifically the blaCTX-M, blaNDM, and mexA/mexB genes. Statistical studies were performed to clarify resistance patterns and evaluate relationships among various sample sources, thoroughly defining regional bacterial resistance trends. Outcomes: Analysis indicated heightened bacterial contamination in the Euphrates River, with total coliform and fecal coliform levels surpassing acceptable limits. Water quality degradation was significant, as shown by large bacterial loads from institutional water sources. The most common isolates were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, with high levels of resistance against antimicrobials, including ceftriaxone (85-90%), ciprofloxacin (55-80%), and meropenem (60-95%). Molecular characterization showed that important resistance determinants were common, with blaCTX-M being the major factor identified among K. pneumoniae isolates and mexA/mexB genes indicating multidrug resistance in P. aeruginosa. Results of statistical analyses highlighted significant correlations between levels of contamination with a range of sources and patterns of antimicrobial resistance, solidifying the increasing threats from bacterial contamination and antimicrobial resistance in the region. The results revealed that water sources in Anbar Governorate are critical bacterial contamination locations, and the prevalence of antimicrobial resistance within clinical and environmental isolates reached high levels. While our findings reveal new determinants of resistance, they highlight the need for improved infection control policies, robust antimicrobial stewardship, and coordinated water treatment strategies. Reducing resistant bacterial spread requires intervention based on bringing together public health authorities, health care providers, and environmental agencies to guarantee better water quality and health benefits population.