A comprehensive review of resistome profiles in ocular pathogens: Insights into Pseudomonas aeruginosa and emerging resistance trends

Eye infections are a significant area of microbial adaptation and therapeutic challenge, as antibiotic resistance threatens vision. In the last ten years, our knowledge of the ocular resistome has expanded through genomics and molecular epidemiology. An analysis of global evidence from 2015 to 2025 on the resistance architecture of major ocular pathogens will be presented, with a focus on Pseudomonas aeruginosa (P. aeruginosa). The organism shows remarkable genomic flexibility by incorporating intrinsic resistance elements, biofilm-mediated tolerance, and by acquiring ARGs such as bla_VIM, bla_GES, QnrVC and RmtB by horizontal transfer. According to researchers, Staphylococcus aureus (S. aureus), Streptococcus pneumoniae (S. pneumoniae), and Acinetobacter baumannii (A. baumannii) have evolved mechanisms of drug resistance. Geographic analysis shows regional disparities, particularly in South Asia and North America, which are associated with antibiotic use and clinical exposure. To prevent the emergence of ocular antimicrobial resistance, there's an urgent need for rapid molecular diagnostics, genomic-based surveillance, and responsible antimicrobial stewardship.