Barw Barw Medical Journal 2960-1959 2024 11 16 Evolution of Antimicrobial Resistance in Community vs. Hospital-Acquired Infections 10.58742/bmj.v2i4.138 eng Ayman M. Mustafa Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. aymanmajid75@gmail.com Rawezh Q. Salih Biology Department, College of Science, University of Sulaimani, Karkuk Road Street, Sulaymaniyah, Iraq. Rawezh.mohammed@univsul.edu.iq Hidayat A. Yaseen Laboratory Department, Shar Hospital, Malik Mahmood, Sulaymaniyah, Iraq. hidayat45@gmail.com Wafa A. Hamadameen Biology Department, College of Science, University of Sulaimani, Sulaymaniyah, Iraq. Wafa.a.mangury@gmail.com Suhaib H. Kakamad Department of Immunology and Hematology, College of Medicine, Kurdistan University of Medical Science, Sanandaj, Iran. suhaib.kakamad@gmail.com Fakher Abdullah Kscien Organization for Scientific Research (Middle East office), Hamid Street, Azadi Mall, Sulaymaniyah, Iraq. fakherabdullah1976@gmail.com Karokh K. Mohammed Smart Health Tower (Raparin Branch), Karux Street, Ranya, Iraq. karokh12@gmail.com Dyari Q. Hamad Smart Health Tower (Raparin Branch), Karux Street, Ranya, Iraq. dyari.hamad@gmail.com Brwa H. Ismaeel Smart Health Tower (Raparin Branch), Karux Street, Ranya, Iraq. brwa.ismaeel@gmail.com Hawnaz S. Abdullah Biology Department, College of Science, University of Sulaimani, Sulaymaniyah, Iraq. hawnazsalh364@gmail.com Shnya H. Ahmed Medical Laboratory Science Department, Komar University of Science and Technology, Sulaymaniyah, Iraq. shnya.ahmed@gmail.com Berun A. Abdalla Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. berun.anwer95@gmail.com Fahmi H. Kakamad College of Medicine, University of Sulaimani, Madam Mitterrand Street, Sulaymaniyah, Iraq. fahmi.hussein@univsul.edu.iq Miran O. Salih Medical Laboratory Science Department College of Health Science, University of Human Development, Sulaymaniyah, Iraq. miran.salih@gmail.com Sarhang S. Abdalla Scientific Affairs Department, Smart Health Tower, Madam Mitterrand Street, Sulaymaniyah, Iraq. sarhang.abdullah@gmail.com 2024 10 10 Introduction Hospitals are high-risk environments for infections. Despite the global recognition of these pathogens, few studies compare microorganisms from community-acquired and hospital-acquired infections (HAIs). This study compares these microorganisms and explores their relationship with patients' comorbidities and socio-demographic factors. Methods This retrospective cross-sectional study was conducted at Smart Health Tower, Iraq, from January to December 2023, focusing on patients with community-acquired infections and HAIs. Data were extracted from microbiology laboratory records, including blood cultures, urine samples, and other body fluids, with patients classified based on CDC and IDSA guidelines. Bacterial identification combined conventional methods and the BD Phoenix™ M50 system, while antibiotic susceptibility was tested using the Kirby-Bauer method and the same automated system. Statistical analysis of resistance patterns utilized SPSS version 25, with significance set at p ≤ 0.05. Results In this study of 2,157 participants, 1,303 (60.4%) were male, with microbial growth observed in 1,177 cases (54.6%). Notably, 41.1% of females and 52.1% of males showed no growth (p < 0.001). The mean age was 43.62 ± 23.3 years. Wound samples had the highest growth rate (91.2%), while body fluids had the lowest (33.0%) (p < 0.001).  The overall multidrug resistance rates were 62.5% for community-acquired infections and 79.3% for HAIs. Patients with pre-existing comorbidities demonstrated significantly higher rates of hospital-acquired infections (p < 0.05). Conclusion Multidrug-resistant isolates are more prevalent in HAIs than in community-acquired infections, highlighting the need for enhanced surveillance to optimize antibiotic use and control HAIs through early detection of resistance.