The incidence and antimicrobial resistance of Gram-negative non-fermentative bacteria isolated over 1 year at King Abdulaziz University Hospital, Jeddah, Saudi Arabia were investigated. A total of 499 of these microorganisms were collected and account for 16% of all Gram-negative bacteria isolated. The most common species were Pseudomonas aeruginosa 291 (56%), Acinetobacter baumannii 170 (34%), and Stenotrophomonas maltophilia 35 (7%). 168 (34%) of these microorganisms were isolated from Intensive Care Unit (ICU), 147 (30%) from General Medicine, and 24 (25%) from Surgery wards. ICU was the main site of isolation of P. aeruginosa and S. maltophilia, while A. baumannii was more frequently isolated from medicine and surgery units. The vast majority of the isolates were resistant to many antibiotics tested. The antimicrobial resistance patterns of P. aeruginosa showed lowest resistance to imipenem (13%), amikacin (17%), and ciprofloxacin (18%). Imipenem was also the most active antimicrobial agent against A. baumannii (15%) resistance. S. maltophilia exhibited multi-drug resistance, and was susceptible only to sulfonamide (6%).

Midstream and catheter stream specimens of urine from inpatients and outpatients at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, were collected over a period of 12 months to determine prospectively the incidence of urinary tract infection, the predominant causative organisms, and their antimicrobial susceptibility. A total of 575 of 9845 specimens (5.8%) showed significant bacteriuria. The overall prevalence of urinary tract infection was 12.1%, 7.4% in inpatients and 4.7% in outpatients. Infection was found more frequently in females than males (2:1). Four percent of the patients were catheterized at the time of the survey; 21% of catheterized patients and 6% of noncatheterized patients were infected. A knowledge of local organisms and their antimicrobial susceptibility pattern is invaluable for the empirical treatment of urinary tract infection. Guidelines for the use of the urethral catheter, when introduced and followed, can reduce hospital-acquired urinary tract infection.AT Eltahawy, RMF Khalaf, Urinary Tract Infection at a University Hospital in Saudi Arabia: Incidence, Microbiology, and Antimicrobial Susceptibility. 1988; 8(4): 261-266 MeSH KEYWORDS: Urinary tract infections, microbiology; Escherichia coli infections; Klebsiella infection URINARY TRACT INFECTION is a relatively common condition in both hospitalized and nonhospitalized patients, particularly females.1 Infections of the urinary tract are one important cause of bacteremia due to gram-negative microorganisms in Saudi Arabia 2 and other countries. [3][4][5] Early detection and eradication of bacteriuria and prevention of recurrence reduce the incidence of subsequent life-threatening consequences of persistent or repetitive urinary tract infection. The aim of this study was to determine the incidence of urinary tract infection in both hospitalized and nonhospitalized patients, the predominant causative organisms, and their antimicrobial susceptibilities. Materials and MethodsMidstream and catheter stream specimens of urine from inpatients and outpatients were collected over a period of 12 months from October 1985 through September 1986. Patients were given instructions in Arabic on how to wash and collect a midstream specimen of urine in a sterile universal container. Urine samples obtained from indwelling catheters were collected by aspiration from the tube after the tube was cleaned with alcohol pads and

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Medical advances during the past decade have improved preventive, diagnostic and therapeutic capabilities for a variety of diseases. However, certain therapies that involve the use of invasive surgical procedures and immunosuppression predispose the host to an expanding group of opportunistic pathogens. Most fungal infections are caused by commonly recognized opportunistic fungi such as Candida species, Aspergillus species, Histoplasma capsulatum, Blastomyces dermatitidis, Coccidioides immitis, and Cryptococcus neoformans. Of late, fungi such as Candida glabrata, Trichosporon beigelii, Malassezia species, Hansenula species, Rhodotorula species and Geotrichum candidum, are emerging as significant causes of infection in immunocompromised patients. In this report, we describe a case of Rhodotorula rubra sepsis in an immunocompromised patient, and discuss the clinical aspect and management of the condition, with a review of the relevant literature. Case ReportA 65-year-old female was admitted at King Fahd General Hospital in Jeddah, Saudi Arabia, in February 1999, with intestinal obstruction, septicemia and fecal fistula. She was treated with cephradine 500 mg iv/6 hr, metronidazole 500 mg iv/8 hr, and cefoxitin 1 mg iv/8 hr for seven days. An emergency laparotomy was done one week later. Her bowel was fragile, with multiple adhesions and multiple perforations during dissection. Hemicolectomy and jejunoileal anastomosis were performed, and about 100 cm of small bowel and jejunum were removed. The patient was put on metronidazole 500 mg iv/8hr, amikacin 500 mg iv/12hr, and cefuroxime 750 mg iv/8hr.Postoperatively, the patient developed a recurrence of fecal fistula through the operation site, and was put on total parenteral nutrition. The histopathology report confirmed metastatic mucoid epidermoid carcinoma. One week later, she had pyrexia of 39°C, and one set of blood was withdrawn from the peripheral line and sent for culture, using Bactec 9240 (Beckton Dickinson Company, USA). The blood culture was positive two days later, and the gram-stained smear showed blastoconidia with a budding (no lyphae) faint capsule (Figure 1). Culture of the blood on Sabouraud agar grew pink, mucoid colonies (Figure 2) that were identified with the use of Candifast (International Microbio., France) and Vitek (Bio Merieux, France) as Rhodotorula rubra. The antifungal susceptibility test using Candifast showed the organism to be sensitive to fluconazole and miconazole, but resistant to amphotericin B, flucytosine, econazole and ketoconazole. The patient was treated with miconazole 200 mg iv/8hr for 10 days. Her total and differential white blood cells before the fungemia were within normal limits.