Antibiotic Resistance Among Gram-Negative Non-Fermentative Bacteria at a Teaching Hospital in Saudi Arabia

Abstract

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%).

Non fermentative gram negative bacilli as nosocomial pathogens: Identification and antibiotic sensitivity in clinical samples of indoor patients

“…In our study too, Pseudomonas aeruginosa was the most common non fermenter, accounting for 48.9% of the isolates. This was in consensus with some studies 9, that have reported the incidence 42.41% and 56.0% respectively. Other studies 4,15 from various parts of India have reported higher prevalence (more than 70%) and few 13 have reported lower prevalence i.e.…”

“…In India, very few studies on Acinetobacter species have been reported and in view of their increasing importance in nosocomial infections, further studies are warranted in this part of world. In our study prevalence of Acinetobacter baumannii was 33%, which was comparable to many studies 9,11,12,15 in which the prevalence was reported to be in the range of 28% to 36%. .…”

“…8 In our study a total of 25.7% (94/519) NFs were isolated. It is higher than the studies done in Saudi Arabia 9 and Orissa 10 in which an incidence of 16% and 15.75% were reported, respectively. It was lower than that reported by the study done by KK Lahiri et al 11 who had reported 31.2% from a tertiary care hospital.…”

“…Other studies have also reported higher incidences from ICUs. 9,12 Tracking nosocomial infections by site has become difficult in the last few years because of shorter inpatient stays. For example, the average postoperative stay, now approximately 5 days, is usually shorter than the incubation period for many infectious diseases.…”

Genetic basis of carbapenem resistance in Acinetobacter clinical isolates in Saudi Arabia

“…The emergence of carbapenem resistance in A. baumannii has been reported worldwide including hospitals in Europe, North America, Argentina, Brazil, China, Taiwan, Hong Kong, Japan and Korea and from areas as remote as Tahiti in the South Pacific (Nishio et al, 2004;Naas et al, 2005;Lee et al, 2006;Liu et al, 2006;Poirel et al, 2007;Qi et al, 2008;. Unfortunately, the emergence of MDR nosocomial A. baumannii has also reported in several hospitals in Saudi Arabia, including King Faisal Specialist Hospital (Riyadh), King Abdulaziz University Hospital (Jeddah), Dhahran Health Center (Dhahran) and King Khalid University Hospital (Riyadh), (Eltahawy and Khalaf, 2001;Hanan et al, 2003;Bukhary et al, 2005;Al-Tawfiq et al, 2007). It has been established that there is difference in the antibiotic resistance rates of A. baumanii in different areas in the world, which is mostly due to factors such as antimicrobial use patterns, infection control practices and climate (Perez et al, 2007;Peleg et al, 2008).…”