Pathogenic spectrum of blood stream infections and resistance pattern in Gram-negative bacteria from Aljouf region of Saudi Arabia

Abstract

Background The pathogenic spectrum of bloodstream infections (BSIs) varies across regions. Monitoring the pathogenic profile and antimicrobial resistance is a prerequisite for effective therapy, infection control and for strategies aimed to counter antimicrobial resistance. The pathogenic spectrum of BSIs in blood cultures was analysed, focusing on the resistance patterns of Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae, in Aljouf region. Methods This descriptive cross-sectional study analysed the culture reports of all non-duplicate blood samples collected from January 1 to December 31, 2019. Antibiograms of A. baumannii, E. coli, and K. pneumoniae were analysed for antibiotic resistance. The frequency and percentages of multi-drug, extensively-drug, pan-drug and carbapenem resistance were calculated. Results Of the 222 bloodstream infections, 62.2% and 36.4% were caused by gram-negative and gram-positive bacteria, respectively. Most BSIs occurred in patients aged �60 years (59.5%). Among the 103 isolates of the studied Gram-negative bacteria (GNB), 47.6%, 38.8%, and 2.9% were multi-drug, extensively drug and pan-drug resistant respectively. 46% of K. pneumoniae isolates were carbapenemase producers. Resistance to gentamycin, 1 st-4 th generation cephalosporins, and carbapenems was observed for A. baumannii. More than 70% of E. coli isolates were resistant to 3 rd-and 4 th-generation cephalosporins. Klebsiella pneumoniae presented a resistance rate of >60% to imipenems.

Antimicrobial susceptibility of gram-positive and gram-negative bacteria: a 5-year retrospective analysis at a multi-hospital healthcare system in Saudi Arabia

“…As expected, HAI events were more frequent in the ICUs (37.2%) compared with non-ICU locations [HAI events in wards and outpatients were 32.9% and 29.9%, respectively], a finding which was previously described in local studies [ 10 , 28 ] and may reflect the epicenter role of ICU in both infections and antimicrobial resistance. The predominant isolates to cause HAIs were gram-negative organisms (71.9% vs. 28.1%); this finding was similar with many Saudi studies made in different cities in Saudi Arabia including Riyadh [ 6 , 28 , 29 ], Makkah [ 30 , 31 ], Dhahran [ 32 ], Bisha [ 33 ], and Aljouf [ 10 ]; with the majority being Escherichia coli (38%) accounting approximately for 52.9% of the gram-negative bacterial growth in line with previous national studies [ 7 , 29 , 30 , 32 , 34 ]. The second predominant isolates of the gram-negative organisms were the Klebsiella species (15.1%), this finding was similar to the bacterial isolates prevalence studies from Dhahran [ 7 ], and Riyadh [ 6 ].…”

“…Several local studies have estimated the rates of susceptibility among gram-positive and gram-negative bacteria in Saudi Arabia [ 6 – 10 ], but none was comprehensive, and comparisons are complicated by variable methods and study periods that influence the findings explanation and interpretation.…”

Gram negative organisms isolated from Blood Cultures and their Susceptibility Pattern

“…70% E.coli and 60% Klebsiella pneumoniae were susceptible to this drug. Similar findings were observed in other studies proving Tazobactam -pipercillin to be as good as meropenem for resistant blood stream infections 24,25 .…”

“…As far as Co-Amoxiclav is concerned, 19% E.coli and 13.1% Klebsiella pneumoniae were found susceptible. 24 A second combination drug Tazobactam -piperacillin was also evaluated for its efficacy. 70% E.coli and 60% Klebsiella pneumoniae were susceptible to this drug.…”

“…Poor susceptibility pattern of cephalosporins has also been observed in other studies. 24,26 This owes to wide scale and undue use of these drugs. Salmonella Typhi exhibited 44.4% susceptibility to Ceftriaxone.…”