Current state of antimicrobial stewardship and organ transplantation in Saudi Arabia

Abstract

Background Antimicrobial resistance constitutes a major public health issue that leads to poor outcomes and increased costs associated with healthcare. Solid organ transplant recipients are more prone due to prolonged exposure to antimicrobials. Methods We reviewed existing programs in the Kingdom of Saudi Arabia and pattern of drug resistance, and the extent of transplant medicine in the kingdom through published articles in databases and official documents from health authorities. Results A national committee for antimicrobial resistance (AMR) was established to set the guidelines required for an antimicrobial stewardship program (ASP), especially when there is a high prevalence of AMR. A survey noted that ASPs are implemented in only 26% of Saudi Ministry of Health hospitals. Factors affecting the implementation of ASPs in Saudi hospitals included a lack of necessary staff resources and specific ASP staff/teams to advocate adopting ASP in the organizations. Specific attention should be given to transplant patients as transplantations are expected to increase in the next few years. No antimicrobial stewardship programs are currently specifically tailored to transplant centers. Conclusion The current healthcare system transformation in Saudi Arabia should take into consideration the urgent need for effective ASP that might help face the increasing trends in the multidrug‐resistant organisms (MDRO) prevalence rate.

Antibacterial Resistance Patterns Among Common Infections in a Tertiary Care Hospital in Saudi Arabia

“…Globally, it is estimated that ABR infections are responsible for approximately 700,000 deaths per year [ 2 , 3 ]. If no preventative actions are taken, it is predicted that infections caused by ABR bacteria will have a mortality rate exceeding that of cancer and become the most common cause of death by the end of 2050 [ 2 , 3 ].…”

“…Globally, it is estimated that ABR infections are responsible for approximately 700,000 deaths per year [ 2 , 3 ]. If no preventative actions are taken, it is predicted that infections caused by ABR bacteria will have a mortality rate exceeding that of cancer and become the most common cause of death by the end of 2050 [ 2 , 3 ]. According to the Centers for Disease Control and Prevention (CDC), approximately 35,900 deaths out of 2,868,700 ABR cases are expected to be reported annually in the United States [ 2 ].…”

“…Within this sample, the most prevalent microorganism was Escherichia coli , followed by Klebsiella pneumoniae , Pseudomonas aeruginosa , methicillin-resistant Staphylococcus aureus (MRSA), Acinetobacter , Clostridium difficile , and Enterococcus [ 4 ]. In addition, a study conducted by the Saudi national surveillance on Gram-positive cocci revealed that 32% of S. aureus belonged to MRSA, 33% of S. pneumoniae were resistant to penicillin G, and 26% of S. pneumoniae were resistant to erythromycin [ 3 ]. In the western region of Saudi Arabia, Alam et al reported bacterial resistance to trimethoprim/sulfamethoxazole (48.6%), ampicillin (49.3%), piperacillin (59.3%), and methicillin (50.3%) [ 5 ].…”