Descriptive Assessment Of General Patterns Of Multidrug Resistance Observed In Various Dermatological Conditions Across Patient Groups

Abdul Rehman; Babu Shah Mohammed; Areeba Sajjad; Sidrah Hafeez; Sajjad Ahmad; Muhammad Jawad; Badeea Farrukh

doi:10.61919/zs0hn496

Authors

Abdul Rehman Medical Officer, District Health Office Killa Saifullah; MBBS, Mekran Medical College, Turbat, Pakistan Author
Babu Shah Mohammed Bolan Medical College, Quetta, Pakistan Author
Areeba Sajjad Department of Pharmacy, The University of Faisalabad, Faisalabad, Pakistan; Faculty of Pharmaceutical Sciences, Lahore University of Biological and Applied Sciences, Lahore, Pakistan. Author
Sidrah Hafeez Faculty of Pharmaceutical Sciences, Hamdard University, Islamabad, Pakistan Author
Sajjad Ahmad Senior Lab Technologist, Institute of Basic Medical Sciences (IBMS), Khyber Medical University, Peshawar, Pakistan. Author
Muhammad Jawad Kohat University of Science and Technology, Kohat, Pakistan Author
Badeea Farrukh Medical Officer, IRM Hospital, Islamabad, Pakistan. Author

DOI:

https://doi.org/10.61919/zs0hn496

Keywords:

Antimicrobial resistance, dermatological infections, multidrug resistance, skin infections, Staphylococcus aureus, Pseudomonas aeruginosa, South Punjab

Abstract

Background: Multidrug resistance (MDR) in dermatological infections is an increasing clinical and public health concern, particularly in settings where empirical antimicrobial prescribing, self-medication, and limited routine culture testing may contribute to resistant disease. Objective: To determine the prevalence and distribution of MDR among microbiologically confirmed dermatological infections across patient groups in South Punjab. Methods: A descriptive cross-sectional study was conducted over four months in outpatient dermatology clinics and tertiary healthcare facilities across South Punjab. A total of 384 patients with confirmed microbial skin infections were enrolled. Demographic and clinical data were collected using a structured proforma, and skin swabs, scrapings, or biopsy specimens were processed using standard microbiological methods. Antimicrobial susceptibility was assessed using the Kirby-Bauer disk diffusion method, and MDR was defined as resistance to at least one agent in three or more antimicrobial classes. Data were analyzed using SPSS version 26. Results: The mean age was 38.6 ± 15.2 years, with equal male and female representation. Rural residents accounted for 62.0% of participants. Overall, MDR was identified in 196 of 384 patients (51.0%). Mixed infections showed the highest MDR proportion (58.8%), followed by bacterial (55.8%), parasitic (47.4%), and fungal infections (44.3%). Adults aged 18–40 years contributed the largest number of MDR cases (82/146; 56.2%). Staphylococcus aureus showed the highest pathogen-specific MDR rate (68/104; 65.4%), followed by Pseudomonas aeruginosa (42/68; 61.8%). Conclusion: MDR was frequent among dermatological infections in South Punjab, particularly in mixed and bacterial infections and among common bacterial pathogens. Culture-guided therapy, rational antimicrobial use, and regional resistance surveillance are essential to improve dermatological infection management.

References

1. Ugoala EJ. Antimicrobial drug resistance: a systematic review and assessment of resistant pathogen infection prevention and control. 2023.

2. El-Saadony MT, Saad AM, Mohammed DM, Korma SA, Alshahrani MY, Ahmed AE, et al. Medicinal plants: bioactive compounds, biological activities, combating multidrug-resistant microorganisms, and human health benefits: a comprehensive review. 2025;16:1491777.

3. Cosio T, Pica F, Fontana C, Pistoia ES, Favaro M, Valsecchi I, et al. Stephanoascus ciferrii complex: the current state of infections and drug resistance in humans. 2024;10(4):294.

4. Hardefeldt L, Thomas K, Page S, Norris J, Browning G, El-Hage C, et al. Antimicrobial prescribing guidelines for horses in Australia. 2025.

5. Open Resources for Nursing, Ernstmeyer K, Christman E. Antimicrobials. In: Nursing Pharmacology. 2nd ed. Chippewa Valley Technical College; 2023.

6. Agarwal D. Clinicopathological study of skin tumors. 2023.

7. Huia Haira T. The chemical biology of antimicrobial bioactivity derived from kānuka (Kunzea robusta). Wellington: Te Herenga Waka—Victoria University of Wellington; 2024.

8. Duhaniuc A, Păduraru D, Nastase EV, Trofin F, Iancu LS, Sima CM, et al. Multidrug-resistant bacteria in immunocompromised patients. 2024;17(9):1151.

9. Iancu AV, Maftei NM, Dumitru C, Baroiu L, Gurau G, Elisei AM, et al. Prevalence of multidrug resistance pathogens in dermatology: a retrospective study in Romania, 2018–2022. 2024;21(3).

10. Lawal H, Saeed S, Gaddafi M, Mansor N, Yang Q, Hossain D, et al. Nanoparticle-based therapeutics for the treatment of skin infections in animals: a comprehensive literature review. Ger. 2025;5(1):4-19.

11. Marzaman ANF, Roska TP, Sartini S, Utami RN, Sulistiawati S, Enggi CK, et al. Recent advances in pharmaceutical approaches of antimicrobial agents for selective delivery in various administration routes. 2023;12(5):822.

12. Jiang S, Wei Y, Ke H, Song C, Liao W, Meng L, et al. Shengming Jiang, Yangyan Wei, Hu Ke, Chao Song, Wenbiao Liao, Lingchao Meng, Chang Sun, Jiawei Zhou, Chuan Wang, Xiaozhe Su, Caitao Dong, Yunhe Xiong and Sixing Yang. 2023.

13. Khan A, Ali N, Fatima S, Jamshaid A, Saeed A, Zahid MA. Prevalence and antibiotic resistance patterns of Staphylococcus aureus in dermatological infections: a 5-year retrospective study. Int J Biol Res. 2025;3(2):386-393.

14. Hameed S. Human fungal diseases: diagnostics, pathogenesis, drug resistance and therapeutics. Boca Raton: CRC Press; 2024.

15. Chambial P, Thakur N, Bhukya PL, Subbaiyan A, Kumar U. Frontiers in superbug management: innovating approaches to combat antimicrobial resistance. Arch Microbiol. 2025;207(3):60.

16. Labes A. Marine resources offer new compounds and strategies for the treatment of skin and soft tissue infections. Mar Drugs. 2023;21(7):387.

17. Chakrabarti A, Balaji V, Bansal N, Gopalakrishnan R, Gupta P, Jain A, et al. NAMS task force report on antimicrobial resistance. 2025:1-40.

18. Loeffler A, Cain CL, Ferrer L, Nishifuji K, Varjonen K, Papich MG, et al. Antimicrobial use guidelines for canine pyoderma by the International Society for Companion Animal Infectious Diseases. Vet Dermatol. 2025;36(3):234-282.

19. Kelkar R. Microbiology in oncology. In: Tata Memorial Centre Textbook of Oncology. Singapore: Springer; 2024. p. 89-97.

20. Safdar M, ur Rehman S, Hussain M, Nawaz MN, Mueen MA, e Subhani F, et al. Antimicrobial resistance: a global challenge in disease prevention and control. 2023;2.

21. Anderson E, Nair B, Nizet V, Kumar G. Man vs microbes: the race of the century. J Med Microbiol. 2023;72(1):001646.

22. Alqahtani M, Alshehri R, Albarnawi F, Almalki H, Alhalwani A, Alobaidallah M, et al. The correlation between blood antioxidant levels and Klebsiella pneumoniae urinary tract infection. 2023.

23. Bamgbose T, Abdullahi IO, Inabo HI, Bello M, Anvikar AR, editors. Probiotics for the control of malaria and other infectious diseases. 44th Annual Conference of the Nigerian Society for Microbiology; 2023.

24. Lee H, Park SY, Yoon YK. Infection & chemotherapy. 2024;56(1):S1-S98.