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

Annals of Clinical Microbiology and Antimicrobials

Ahmed M. Alresasi¹  Issa Al-Hadary¹  Ibrahim Bu-Shehab¹  Saad Alhumaid¹  Ahmad J. Alzahrani²  Awad Al-Omari³  Haifa Al-Shammari⁴  Zainab Al Alawi⁵  Mansour Tobaiqy⁶  Ali A. Rabaan⁷  Naif Alhmeed⁸  Mossa Alismail⁹  Ahmed H. Aldera^1,10  Abbas Al Mutair^1,11  Fadhil AlHbabi^1,12 

[1] Administration of Pharmaceutical Care, Alahsa Health Cluster, Ministry of Health, P. O. Box 12944, Rashdiah Street, 31982, Alahsa, Saudi Arabia;College of Medicine, Al-Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia;College of Medicine, Alfaisal University, Riyadh, Saudi Arabia;Research Center, Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia;Department of Histopathology, King Saud Medical City, Riyadh, Saudi Arabia;Department of Pediatrics, College of Medicine, King Faisal University, Alahsa, Saudi Arabia;Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah, Saudi Arabia;Molecular Diagnostics Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia;Naif Alhmeed, Administration of Supply and Shared Services, Ministry of Health, Riyadh, Saudi Arabia;Pharmacy Department, King Faisal General Hospital, Alahsa, Saudi Arabia;Pharmacy Department, Prince Saud Bin Jalawi Hospital, Alahsa, Saudi Arabia;Research Center, Almoosa Specialist Hospital, Alahsa, Saudi Arabia;School of Nursing, Wollongong University, Wollongong, Australia;Virology Department, Regional Laboratory and Blood Bank, Riyadh, Saudi Arabia;

关键词: Antibiotics;    Antimicrobials;    Gram-positive;    Gram-negative;    Healthcare-associated infections;    Rates;    Saudi Arabia;    Sensitivity;    Susceptibility;   

DOI  :  10.1186/s12941-021-00450-x

来源: Springer

【 摘 要 】

BackgroundStudying time-related changes in susceptible pathogens causing healthcare-associated infections (HAIs) is vital in improving local antimicrobial and infection control practices.ObjectivesDescribe susceptibility patterns to several antimicrobials in gram-positive and gram-negative pathogens isolated from patients causing HAIs at three private tertiary care hospitals in Saudi Arabia over a 5-year period.MethodsData on trends of antimicrobial susceptibility among bacteria causing HAIs events in children and adults at three tertiary private hospitals located in Riyadh and Qassim, Saudi Arabia, were collected retrospectively between 2015 and 2019 using the surveillance data datasets.ResultsOver a 5-year period, 38,624 pathogens caused 17,539 HAI events in 17,566 patients. About 9450 (53.8%) of patients who suffered HAIs were females and the average age was 41.7 ± 14.3 years (78.1% were adults and 21.9% were children). Gram-negative pathogens were 2.3-times more likely to cause HAIs compared to gram-positive bacteria (71.9% vs. 28.1%). The ranking of causative pathogens in decreasing order was: Escherichia coli (38%), Klebsiella species (15.1%), and Staphylococcus aureus (12.6%). Gram-positive isolates were mostly susceptible to linezolid (91.8%) whereas they were resistant to ampicillin (52.6%), cefoxitin (54.2%), and doxycycline (55.9%). Gram-negative isolates were mostly sensitive to tigecycline (95%) whereas they were resistant to cefotaxime (49.5%) and cefixime (59.6%). During the 5 years, there were relatively stable susceptibility patterns to all tested antimicrobials, except for cefotaxime which shown a susceptibility reduction by 41.4%, among Escherichia coli and Klebsiella species. An increase in the susceptibility of Acinetobacter and Enterobacter and Citrobacter species to all studied antimicrobials was observed except for colistin that had a slight sensitivity reduction in 2019 by 4.3% against Acinetobacter species. However, we noted reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin.ConclusionThe observed increase in susceptibility of gram-positive and gram-negative bacteria to studied antimicrobials is important; however, reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin is a serious threat and calls for effective antimicrobial stewardship programs.

【 授权许可】

CC BY