Bacterial Isolates from Wound and Burn Infections in Three Iraqi Provinces (Baghdad, Sulaymaniyah and Misan): A Review of Epidemiology, Pathogenesis and Antimicrobial Resistance
DOI:
https://doi.org/10.23851/mjs.v37i2.1853Keywords:
Pseudomonas aeruginosa, Staphylococcus aureus, Nosocomial infection, Biofilm, Virulence factorsAbstract
Background: Burn and wound infections represent a significant public health burden in Iraq, contributing to high rates of morbidity and mortality. Decades of armed conflict, economic instability and deteriorating healthcare infrastructure have severely compromised the capacity of Iraqi hospitals to prevent and manage these infections effectively. Objective: This comprehensive review consolidates scientific literature to evaluate the epidemiology, antimicrobial resistance patterns, pathogenic mechanisms and clinical outcomes associated with bacterial wound and burn infections across Iraqi hospitals and healthcare systems. Methods: A systematic search identified studies on bacterial isolates from wound and burn infections across Iraqi hospitals, with data drawn primarily from Sulaymaniyah, Baghdad and Misan provinces as geographically and demographically representative samples rather than a comprehensive national survey. Results: Pseudomonas aeruginosa, Staphylococcus aureus and Acinetobacter baumannii collectively account for the majority of wound and burn infections. Multidrug-resistant (MDR) pathogens are highly prevalent, including MRSA rates approaching 87%, ESBL-producing Enterobacteriaceae and carbapenem-resistant Gram-negative organisms. Nosocomial transmission is the predominant route of spread, driven by overcrowding, poor infection control and contaminated environments. Burn patient mortality ranges from 13–28%, with sepsis responsible for 44–65% of burn-related deaths. Virulence factors, biofilm formation and bacterial adaptation to wound environments contribute to treatment failure and infection persistence. Conclusions: Urgent improvements are required in antibiotic stewardship, infection prevention, epidemiologic surveillance and evidence-based treatment protocols across Iraqi healthcare facilities. Inter-hospital collaboration and investment in regional microbiological diagnostic capacity are essential to addressing this growing public health crisis.
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