Background Antimicrobial resistance is one of the important and serious public health problems worldwide. Syria has a severe lack of data regarding this problem, especially after war. We aimed from this study to provide a unique snapshot on antimicrobial resistance in Syria.Methods This is a multi-centric cross-sectional in-vitro study. The results of routine antimicrobial susceptibility tests were collected and analyzes from five major hospitals during the period from 1st March 2018 through 31th October 2018.Results Final analysis included 2861 isolates. We noticed extremely high rates of antimicrobial resistance among all the species studied. Gram negatives have high resistance rates for cephalosporins. 77% of E.coli, 73% of Klebsiella and 82% of pseudomonas are resistant for ceftriaxone. We also noticed minimal effect of macrolides on gram negatives. 25% of Salmonella typhi strains were resistant to ciprofloxacin. High resistance rates to nitrofurantoin is seen among uropathogenic bacteria. Most gram positive bacteria still have a low resistance rate to vancomycin and linezolid. 54% of staphylococcus aureus and 38% of streptococcus pyogens are resistant to amoxicillin-clavulanate. Resistance rates to Colistin are minimal. The comparison with resistance rates before war reveals the great impact of war on antimicrobial resistance problem.Conclusion Antimicrobial resistance rates in Syria are worrying. We recommend that the Syrian health authorities apply a policy to restrict the irrational use of antibiotics, and to increase awareness toward antimicrobials use.
Background: Globally, lower respiratory tract infections (LRTIs) are one of the lead causes of death. Bacterial and susceptibility profiles are not constant over time and geographically, and different patient factors can be correlated with those infections. Objective: This study aimed to scan the bacterial spectrum causing LRTIs, their susceptibility profile and patient related risk factors. Material and methods: Two hundred sixty-eight specimens from LRTIs suspected patients attending University Hospital were collected. Specimens included bronchial washings, transtracheal aspiration samples and sputum. After appropriate culture and identification tests, susceptibility test was done using minimum inhibitory concentration method. Data were collected from patients for further analysis. Results: of total specimens, 150 showed positive culture results (Acinetobacter baumannii, Pseudomonas aeruginosa, Citrobacter koseri, Escherichia coli, Klebsiella pneumonia, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Streptococcus pneumonia and Candida spp.). The antibiogram showed high resistance among all bacterial isolates against most antibiotics. Good susceptibility rates were shown to colistin in Gram-negative group and piperacillin\tazobactam in Gram-positive group. Trimethoprim\sulfamethoxazole showed good susceptibility results in both groups. Many factors showed correlation with LRTIs such as age (P=0.004), smoking (P=0.049), residency (P=0.043), hypertension (P=0.012), lung chronic disease (P=0.007) and cancer (P=0.048). Conclusion: The leading cause of LRTIs in our study were A. baumannii and P. aeruginosa which both are very troublesome pathogens and multidrug resistant frequency was alarming. Random empirical antibiotic using can highly lead to increased resistance. Further care must be taken after patients with risk factors, and adjustments should be done to those modifiable factors.
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