NDLI: Prevalence of antimicrobial resistance among gram-negative isolates in an adult intensive care unit at a tertiary care center in Saudi Arabia.

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Prevalence of antimicrobial resistance among gram-negative isolates in an adult intensive care unit at a tertiary care center in Saudi Arabia.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Al Johani, Sameera M. Akhter, Javed Balkhy, Hanan El-Saed, Ayman Younan, Mousaad Memish, Ziad
Spatial Coverage	Saudi Arabia
Description	Country affiliation: Saudi Arabia Author Affiliation: Al Johani SM ( King Abdulaziz Medical City, Riyadh, Saudi Arabia. johanis@ngha.med.sa)
Abstract	BACKGROUND AND OBJECTIVES: Patients in the ICU have encountered an increasing emergence and spread of antibiotic-resistant pathogens. We examined patterns of antimicrobial susceptibility in gram-negative isolates to commonly used drugs in an adult ICU at a tertiary care hospital in Riyadh, Saudi Arabia. METHODS: A retrospective study was carried out of gram-negative isolates from the adult ICU of King Fahad National Guard Hospital (KFNGH) between 2004 and 2009. Organisms were identified and tested by an automated identification and susceptibility system, and the antibiotic susceptibility testing was confirmed by the disk diffusion method. RESULTS: The most frequently isolated organism was Acinetobacter baumannii, followed by Pseudomonas aeruginosa, Escherichia coli, Klebsiella pnemoniae, Stenotrophomonas maltophilia, and Enterobacter. Antibiotic susceptibility patterns significantly declined in many organisms, especially A baumannii, E coli, S marcescens, and Enterobacter. A baumannii susceptibility was significantly decreased to imipenem (55% to 10%), meropenem (33% to 10%), ciprofloxacin (22% to 10%), and amikacin (12% to 6%). E coli susceptibility was markedly decreased (from 75% to 50% or less) to cefuroxime, ceftazidime, cefotaxime, and cefepime. S marcescens susceptibility was markedly decreased to cefotaxime (100% to 32%), ceftazidime (100% to 35%), and cefepime (100% to 66%). Enterobacter susceptibility was markedly decreased to ceftazidime (34% to 5%), cefotaxime (34% to 6%), and pipracillin-tazobactam (51% to 35%). Respiratory samples were the most frequently indicative of multidrug-resistant pathogens (63%), followed by urinary samples (57%). CONCLUSION: Antimicrobial resistance is an emerging problem in the KFNGH ICU, justifying new more stringent antibiotic prescription guidelines. Continuous monitoring of antimicrobial susceptibility and strict adherence to infection prevention guidelines are essential to eliminate major outbreaks in the future.
File Format	HTM / HTML
ISSN	02564947
e-ISSN	09754466
DOI	10.4103/0256-4947.67073
Journal	Annals of Saudi Medicine
Issue Number	5
Volume Number	30
Language	English
Publisher	King Faisal Specialist Hospital and Research Centre
Publisher Date	2010-09-01
Publisher Place	Saudi Arabia
Access Restriction	Open
Subject Keyword	Discipline Medicine Anti-bacterial Agents Pharmacology Drug Resistance, Bacterial Gram-negative Bacteria Drug Effects Isolation & Purification Intensive Care Units Acinetobacter Baumannii Amikacin Therapeutic Use Ciprofloxacin Enterobacteriaceae Gentamicins Imipenem Microbial Sensitivity Tests Penicillanic Acid Analogs & Derivatives Piperacillin Pseudomonas Aeruginosa Retrospective Studies Saudi Arabia Epidemiology Trimethoprim-sulfamethoxazole Combination Beta-lactams
Content Type	Text
Resource Type	Article
Subject	Medicine

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