Bacterial isolates and antimicrobial resistance patterns in ear infections: a multicenter study from medical laboratories in Sana’a, Yemen

Ear infections are a major public health concern globally, with a disproportionate burden in low and middle-income countries. This study aimed to characterize the bacterial profile, antimicrobial susceptibility, and age- and gender-related patterns of ear infections in patients attending multiple laboratories and hospitals in Sana’a, Yemen. A retrospective cross-sectional study was conducted from January 2022 to December 2023 in Sana’a, Yemen. Data were collected from four medical laboratories and two referral hospitals. Ear discharge samples from 313 patients were cultured, and bacterial isolates were identified using standard microbiological techniques. Antimicrobial susceptibility testing was performed using the KirbyBauer disk diffusion method, and results were interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Statistical analysis was carried out using SPSS v22. Of the 313 patients, 271 (86.6%) had positive bacterial cultures. The majority of infections occurred in males (50.2%) and in the 21–30year age group. Staphylococcus aureus (54.6%) and Pseudomonas aeruginosa (15.9%) were the most frequently isolated organisms. High levels of resistance were observed to amoxicillin (96.8%), cefoxitin (70.3%), and amoxiclavulanic acid (58.6%). In contrast, clindamycin (83.5%), ofloxacin (75.6%), and levofloxacin (70.5%) demonstrated higher sensitivity. Overall, 48.8% of the 2,644 antibiotic susceptibility tests performed showed resistance. This study found a significant prevalence of bacterial ear infections in Sana’a, Yemen, along with widespread resistance to routinely used medicines, particularly beta lactams. The prevalence of S. aureus and P. aeruginosa , as well as the reported resistance trends, point out the critical need for local antimicrobial stewardship programs. Regular surveillance and updated empirical treatment guidelines are critical for slowing the spread of AMR and improving clinical outcomes in the region.