Isolation and Molecular Characterization of Bacterial Pathogens Associated with Circumcision-Related Infections in Pediatric Patients

Background: Circumcision is one of the most surgical processes in pediatric patients, with a transition rate from 0.1% to 5%, based on technology, settings and post -operative care. Understanding bacterial etiology of circumcision -related infections is important for proper antimicrobial therapy and infection prevention strategies. Objective: Pediatric patients include bacteria associated with circumcised infections to separate, identify and molecular and determine their antimicrobial sensitivity patterns. Methods: A possible study was conducted at three pediatric hospitals in 18 months (January 2023 - June 2024). Samples of wound stick and tissue were presented with circumcision -related infections from 127 pediatric patients (age limit: 2 days - 16 years). Bacterial isolation was performed using standard microbiological techniques, followed by molecular identification using 16S rRNA gene sequencing and MALDI-TOF mass spectrometry. Antimicrobial susceptibility testing was performed according to CLSI guidelines. Results: Bacterial pathogens were isolated from 118 (92.9%) cases. Staphylococcus aureus was the most prevalent organism (34.7%), followed by Escherichia coli (18.6%), Enterococcus faecalis (12.7%), and Pseudomonas aeruginosa (9.3%). Methicillin-resistant S. aureus (MRSA) accounted for 23.4% of S. aureus isolates. Extended-spectrum β-lactamase (ESBL) production was detected in 31.8% of Enterobacteriaceae isolates. Molecular characterization revealed genetic diversity within species, with several virulence factors identified including biofilm formation genes and toxin production capabilities. Conclusions: Circumcision-related infections in pediatric patients are predominantly caused by Gram-positive cocci, particularly S. aureus, though Gram-negative bacteria constitute a significant proportion. The high prevalence of antimicrobial resistance emphasizes the need for routine culture and susceptibility testing to guide appropriate therapy.