Frequency and antibiotic susceptibility of gram-positive bacteria in Makkah hospitals

Abstract

BACKGROUND AND OBJECTIVE:Gram-positive bacteria are important nosocomial pathogens. The objective of this study was to estimate the frequencies and resistance rates of gram-positive pathogens isolated from hospitals in Makkah, Saudi Arabia.DESIGN AND SETTING:Prospective study at three Makkah hospitals from May 2008 to April 2009.PATIENTS AND METHODS:Clinical isolates were collected and demographic and laboratory data were recorded. Standard microbiological methods were used to identify the organisms and test for antimicrobial susceptibility. The results were interpreted according to the Clinical Laboratory Standards Institute (CLSI) guidelines.RESULTS:Clinical isolates were collected from 1087 patients. Gram-positive pathogens infected all age groups, but had no gender predominance. Staphylococcus aureus was the most common cause of wound infection and accounted for more than half of the clinical isolates (688 cases). Coagulase-negative staphylococcus (CONS) was a common isolate from blood cultures. Wounds were the most common site of infection (37.6%). Enterococcus spp. and Streptococcus agalactiae were the second most common bacteria (26%). The resistance rates of S aureus and CONS isolates were 39.4% and 82.4% for oxacillin, respectively. Among the streptococci, the resistance rates of Streptococcus pneumoniae were 21.1% and 16.7% for ampicillin and erythromycin, respectively.CONCLUSIONS:S aureus infections were found to be very common in the Makkah hospitals. Infection prevention, control measures and continuous monitoring for antibiotic susceptibility are necessary to reduce these and other nosocomial infections.

Surveillance of Australian Hajj pilgrims for carriage of potentially pathogenic bacteria: Data from two pilot studies

“…Transnational dissemination of multi-drug resistant organisms has been reported [28] . This is relevant in the context of pneumococcal disease since about 20% of the pneumococcal isolates at Hajj are penicillin resistant [53] . Circulation of drug resistant pneumococci has been of concern in other mass gatherings, such as the reporting of pathogenic multi-drug resistant strains of S. pneumoniae circulating in Spain at the time of Barcelona Olympic in 1992 (however, the Olympic Organising Committee did not recommend pneumococcal vaccine for visitors) [54,55] .…”

“…Circulation of drug resistant pneumococci has been of concern in other mass gatherings, such as the reporting of pathogenic multi-drug resistant strains of S. pneumoniae circulating in Spain at the time of Barcelona Olympic in 1992 (however, the Olympic Organising Committee did not recommend pneumococcal vaccine for visitors) [54,55] . Today, antibiotic resistance is widespread and, considering the high incidence of pneumonia, the high carriage rate of pneumococci and circulation of multi-drug-resistant pneumococci, vaccination is recommended for all high-risk pilgrims and the conjugate vaccine is preferred [20,37,53] . The effect of facemasks use on pharyngeal bacterial carriage at Hajj has not been established yet, although a large trial is underway to examine the effectiveness of facemasks against viral infections [32] .…”

Antimicrobial resistance pattern of Gram-positive bacteria during three consecutive years at the nephrology ward of a tertiary referral hospital in Shiraz, Southwest Iran

“…[1518] This ranges between 30% and 40% in different regions of the neighboring country, Saudi Arabia. [19] MRSA frequency largely depends on several factors such as infection control activities and antimicrobial selection pressure. Regarding the first issue; for example, it has been demonstrated that rigorous infection control practices set by the government in the United Kingdom have resulted in the sharp fall in MRSA prevalence from 40-45% during 2001–2005 to 36% in 2007.…”

“…Similarly, at three Makkah Hospitals in Saudi Arabia, Asghar reported that 82.4% of CONS were resistant to oxacillin. [19] Isolated CONS from Northern population of Jordan revealed the resistance rate of 98.2% and 97.3% to ampicillin and penicillin, respectively. [28] The resistance rate of Staphylococcus epidermidis to oxacillin at Imam Khomeini hospital in Tehran and Namazi Hospital in Shiraz was 57.1%[16] and 100%,[13] respectively.…”

The Saudi Thoracic Society pneumococcal vaccination guidelines-2016

“…Another study from three hospitals in Mecca city reported that S. pneumoniae was the main isolate from age groups <10 and >40 with an incidence rate of 36.8% and 57.9, respectively. [ 35 ] In a report from a university hospital in Riyadh conducted between 2000 and 2004, 62% of pneumococcal isolates from all age groups and 83% of isolates from children aged <2 years were included in the PCV7. [ 36 ] In a recent large prospective population-based study of CAP in hospitalized adults in the USA, a pathogen was identified in 38% of patients and S. pneumoniae was the responsible pathogen in 5% of them.…”