Incidence of Antibiotic Resistance Bacteria in Jeddah's Ministry of Health Hospitals, Saudi Arabia

Abstract

This study aimed to determine the emergence and spread of resistant bacteria in Jeddah Ministry of Health hospitals. Sixteen month follow-up (January 2010 to April 2011) study was carried out and clinical isolates of hospitalized patients were collected, identified and their antimicrobial resistance was determined using two automated systems, Phoenix and Vitek 2. Results revealed that 6195 isolates were identified of which 94% (5846/6195) were Gram negatives. In Escherichia coli, the resistance was 40% (681/1703) to ciprofloxacin, 30% (511/1703) to cefepime, 29% (494/1703) to ceftazidime, 8.5% (145/1703) to tazocin and amikacin, 40% (681/1703) to gentamicin and cefuroxime. In Klebsiella pneumonia, the resistance was 48% (550/1147) to ceftazidime, 49% (565/1147) to cefuroxime, 45.5% (522/1147) to cefepime, 38% (436/1147) to gentamicin, 30% (344/1147) to ciprofloxacin, 19% (218/1147) to tazocin, 7.5% (86/1147) to amikacin and 2.4% (27/1147) to imipenem/meropenem. In Acinetobacter bumannii, 79% (850/1076) were resistant to ciprofloxacin, 68.5% (737/1076) to tazocin, 67% (721/1076) to cefepime, 66% (710/1076) to gentamicin and imipenem/meropenem, 65% (699/1076) to ceftazidime, 68% (735/1076) to amikacin and no resistance to colistin was reported. In Pseudomonas aeruginosa, almost 34% (555/1632) were resistant to ceftazidime, 31% (506/1632) to ciprofloxacin, 29% (473/1632) to cefepime, 26.5% (434/1638) to gentamicin, 19% (310/1632) to imipenem/meropenem, 17% (277/1632) to amikacin, and 15.5% (253/1632) were resistant to tazocin. In Gram positive isolates, MRSA counted only for 4.6% (302/6552) and no vancomycin intermediate Staphylococcus aureus (VISA) were detected. In conclusion, the resistance detected in this study is considered high and antibiotic Stewardship Programs is inevitably required.

Share and Cite:

Halwani, M. , Tashkandy, N. , Aly, M. , Masoudi, S. and Dhafar, O. (2015) Incidence of Antibiotic Resistance Bacteria in Jeddah's Ministry of Health Hospitals, Saudi Arabia. Advances in Microbiology, 5, 780-786. doi: 10.4236/aim.2015.512082.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] http://en.wikipedia.org/wiki/Jeddah
[2] Aarestrup, F.M., Wegener, H.C. and Collignon, P. (2008) Resistance in Bacteria of the Food Chain: Epidemiology and Control Strategies. Expert Review of Anti-Infective Therapy, 6, 733-750. http://dx.doi.org/10.1586/14787210.6.5.733
[3] Maragakis, L.L. and Perl, T.M. (2008) Acinetobacter baumannii: Epidemiology, Antimicrobial Resistance, and Treatment Options. Clinical Infectious Diseases, 46, 1254-1263. http://dx.doi.org/10.1086/529198
[4] Walsh, C.T. (2003) Antibiotics: Actions, Origins, Resistance. American Society for Microbiology, Washington DC. http://dx.doi.org/10.1128/9781555817886
[5] Levy, S.B. and Marshall, B. (2004) Antibacterial Resistance Worldwide: Causes, Challenges and Responses. Nature Medicine, S122-S129. http://dx.doi.org/10.1038/nm1145
[6] Atkinson, B.A. and Lorian, V. (1984) Antimicrobial Agent Susceptibility Patterns of Bacteria in Hospitals from 1971 to 1982. Journal of Clinical Microbiology, 20, 791-796.
[7] von Baum, H. and Marre, R. (2005) Antimicrobial Resistance of Escherichia coli and Therapeutic Implications. International Journal of Medical Microbiology, 295, 503-511.
http://dx.doi.org/10.1016/j.ijmm.2005.07.002
[8] Kronvall, G.A. (2010) Antimicrobial Resistance 1979-2009 at Karolinska Hospital, Sweden: Normalized Resistance Interpretation during a 30-Year Follow-Up on Staphylococcus aureus and Escherichia coli Resistance Development. APMIS, 118, 621-639. http://dx.doi.org/10.1111/j.1600-0463.2010.02660.x
[9] Blaettler, L., Mertz, D., Frei, R., Elzi, L., Widmer, A.F., Battegay, M., et al. (2009) Secular Trend and Risk Factors for Antimicrobial Resistance in Escherichia coli Isolates in Switzerland 1997-2007. Infection, 37, 534-539. http://dx.doi.org/10.1007/s15010-009-8457-0
[10] Naas, T., Nordmann, P., Vedel, G. and Poyart, C. (2005) Plasmid-Mediated Carbapenem-Hydrolyzing Beta-Lactamase KPC in a Klebsiella pneumoniae Isolate from France. Antimicrobial Agents and Chemotherapy, 49, 4423-4424. http://dx.doi.org/10.1128/AAC.49.10.4423-4424.2005
[11] Schwaber, M.J. and Carmeli, Y. (2008) Carbapenem-Resistant Enterobacteriaceae: A Potential Threat. JAMA, 300, 2911-2913. http://dx.doi.org/10.1001/jama.2008.896
[12] Won, S.Y., Munoz-Price, L.S., Lolans, K., Hota, B., Weinstein, R.A. and Hayden, M.K. (2011) Emergence and Rapid Regional Spread of Klebsiella pneumonia Carbapenemase-Producing Enterobacteriaceae. Clinical Infectious Diseases, 53, 532-540. http://dx.doi.org/10.1093/cid/cir482
[13] Sanchez, G.V., Master, R.N., Clark, R.B., Fyyaz, M., Duvvuri, P., Ekta, G. and Bordon, J. (2013) Klebsiella pneumoniae Antimicrobial Drug Resistance, United States, 1998-2010. Emerging Infectious Diseases, 19, 133-136. http://dx.doi.org/10.3201/eid1901.120310
[14] Obritsch, M.D., Fish, D.N., MacLaren, R. and Jung, R. (2005) Nosocomial Infections Due to Multidrug-Resistant Pseudomonas aeruginosa: Epidemiology and Treatment Options. Pharmacotherapy, 25, 1353-1364
[15] Go, E.S., Urban, C., Burns, J., Kreiswirth, B., Eisner, W., Mariano, N., et al. (1994) Clinical and Molecular Epidemiology of Acinetobacter Infections Sensitive Only to Polymyxin B and Sulbactam. Lancet, 344, 1329-1332. http://dx.doi.org/10.1016/S0140-6736(94)90694-7
[16] Butler, M.S., Blaskovich, M.A. and Cooper, M.A. (2013) Antibiotics in the Clinical Pipeline in 2013. The Journal of Antibiotics, 66, 571-591. http://dx.doi.org/10.1038/ja.2013.86
[17] Wagenlehner, F.M., Weidner, W. and Naber, K.G. (2007) Pharmacokinetic Characteristics of Antimicrobials and Optimal Treatment of Urosepsis. Clinical Pharmacokinetics, 46, 291-305. http://dx.doi.org/10.2165/00003088-200746040-00003
[18] Livermore, D.M., Nichols, T., Lamagni, T.L., Potz, N., Reynolds, R. and Duckworth, G. (2003) Ciprofloxacin-Resistant Escherichia coli from Bacteraemias in England; Increasingly Prevalent and Mostly from Men. Journal of Antimicrobial Chemotherapy, 52, 1040-1042.
http://dx.doi.org/10.1093/jac/dkg479
[19] Mavroidi, A., Miriagou, V., Liakopoulos, A., Tzelepi, Ε., Stefos, A., Dalekos, G.N. and Petinak, E. (2012) Ciprofloxacin-Resistant Escherichia coli in Central Greece: Mechanisms of Resistance and Molecular Identification. BMC Infectious Diseases, 12, 371. http://www.biomedcentral.com/1471-2334/12/371
[20] Manchanda, V., Sanchaita, S. and Singh, N.P. (2010) Multidrug Resistant Acinetobacter. Journal of Global Infectious Diseases, 2, 291-304. http://dx.doi.org/10.4103/0974-777X.68538
[21] Obritsch, M.D., Fish, D.N., MacLaren, R. and Jung, R. (2004) National Surveillance of Antimicrobial Resistance in Pseudomonas aeruginosa Isolates Obtained from Intensive Care Unit Patients from 1993 to 2002. Antimicrobial Agents and Chemotherapy, 48, 4606-4610.
http://dx.doi.org/10.1128/AAC.48.12.4606-4610.2004
[22] Raja, N.S. and Singh, N.N. (2007) Antimicrobial Susceptibility Pattern of Clinical Isolates of Pseudomonas aeruginosa in a Tertiary Care Hospital. Journal of Microbiology, Immunology and Infection, 40, 45-49.
[23] Manno, G., Cruciani, M., Romano, L., Scapolan, S., Mentasti, M., Lorini, R., et al. (2005) Antimicrobial Use and Pseudomonas aeruginosa Susceptibility Profile in a Cystic Fibrosis Centre. International Journal of Antimicrobial Agents, 25, 193-197. http://dx.doi.org/10.1016/j.ijantimicag.2004.11.009
[24] Panlilio, A.L., Culver, D.H., Gaynes, R.P., Banerjee, S., Henderson, T.S., Tolson, J.S., et al. (1992) Methicillin Resistant Staphylococcus aureus in US Hospitals, 1975-1991. Infection Control and Hospital Epidemiology, 13, 582-586. http://dx.doi.org/10.2307/30148460
[25] Mekviwattanawong, S., Srifuengfung, S., Chokepaibulkit, K., Lohsiriwat, D. and Thamlikitkul, V. (2006) Epidemiology of Staphylococcus aureus Infections and the Prevalence of Infection Caused by Community Acquired Methicillin-Resistant Staphylococcus aureus in Hospitalized Patients at Siriraj Hospital. Journal of the Medical Association of Thailand, 89, S106-S117.
[26] Diekema, D.J., Pfaller, M.A., Schmitz, F.J., Smayevsky, J., Bell, J., Jones, R.N., et al. (2001) Survey of Infections Due to Staphylococcus Species: Frequency of Occurrence and Antimicrobial Susceptibility of Isolates Collected in the United States, Canada, Latin America, Europe, and the Western Pacific Region for the SENTRY Antimicrobial Surveillance Program, 1997-1999. Clinical Infectious Diseases, 32, S114-S132.
[27] Thamlikitkul, V., Jintanothaitavorn, D., Sathitmethakul, R., Vaithayaphichet, S., Trakulsomboon, S. and Danchaivijitr, S. (2001) Bacterial Infections in Hospitalized Patients in Thailand in 1997 and 2000. Journal of the Medical Association of Thailand, 84, 666-673.
[28] Hiramatsu, K., Hanaki, H., Ino, T., Yabuta, K., Oguri, T. and Tenover, F.C. (1997) Methicillin-Resistant Staphylococcus aureus Clinical Strain with Reduced Vancomycin Susceptibility. Journal of Antimicrobial Chemotherapy, 40, 135-136. http://dx.doi.org/10.1093/jac/40.1.135
[29] Ploy, M.C., Grelaud, C., Martin, C., de Lumley, L. and Denis, F. (1998) First Clinical Isolate of Vancomycin-Inter mediate Staphylococcus aureus in a French Hospital. Lancet, 351, 1212. http://dx.doi.org/10.1016/S0140-6736(05)79166-2
[30] Hofmann, J., Cetron, M.S., Farley, M.M., Baughman, W.S., Facklam, R.R., Elliott, J., Deaver, K.A. and Breiman, R.F. (1995) Prevalence of Drug-Resistant Streptococcus pneumoniae in Atlanta. The New England Journal of Medicine, 333, 481-486. http://dx.doi.org/10.1056/NEJM199508243330803

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.