A Multi-Point Surveillance for Antimicrobial Resistance Profiles among Clinical Isolates of Gram-Negative Bacteria Recovered from Major Ha’il Hospitals, Saudi Arabia
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ha’il City and All Its Socio-Economic Strata
2.2. Study Designs, Data Sources, and Statistical Analysis (From September to December 2020)
2.3. Classification as Multi-Resistant, Extremely-Resistant, and Pan-Resistant Types (MDR, XDR, PDR)
3. Results
3.1. Kleb. pneumoniae (MDR)
3.2. E. coli (MDR)
3.3. Pseudomonas aeruginosa (XDR)
3.4. Acinetobacter baumannii (PDR)
3.5. Proteus mirabilis (MDR)
3.6. Other Gram-Negative Bacteria (MDR)
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Ward a | Bacterial Clinical Isolates (n = 621) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
K. pneumoniae (n = 178) | E. coli (n = 151) | P. aeruginosa (n = 84) | A.baumannii (n = 82) | P. mirabilis (n = 46) | Other Gram- Negatives (n = 71) | |||||||
n | % | n | % | n | % | n | % | n | % | n | % | |
Intensive Care Unit ICU (30%) |
42 Urine (16) Sputum (9) Blood (8) Wound/pus (7) AE (2) | 24 |
31 Urine (16), sputum (6) blood (6), wound/pus (3) | 21 |
34 Urine (5), Blood (5) Sputum (15) Wound swab/pus (2) Other (7) | 41 |
40 Sputum (20) Blood (8) Swab/wound/pus (8) Other (4) | 49 |
24 Blood (7) Sputum (6) Urine (5) Wound/pus/swab (6) | 52 |
15 Urine (3) Blood (2) Sputum (4) Wound/swab/pus (3) Other (3) | 21 |
COVID-19 Isolation Zones (ISO) or Ward (COW) 13.5% |
40 Blood (15) Sputum (12) Urine (6) Wound/pus/swab (5) Other (2) | 23 |
7 Blood (1) Sputum (1) Wound (1) Urine (4) | 5 | 0 | 0 |
29 Bloody sp. (12) Urine (2) Sputum (11) Wound (4) | 35 | 0 | 0 |
2 Blood Wound | 3 |
Surgical Ward (SW) 12% |
25 Wound/pus/swab (8) Urine (11) Blood (1) Other (5) | 14 |
19 Wound (7) Urine (8) Blood (1) Other (3) | 13 |
9 Wound (3) Sputum (4) Urine (2) | 11 |
3 Wound (3) | 4 |
3 Swab (2) Sputum (1) | 7 |
13 Sputum (6) Wound (4) Blood (1) Other (2) | 18 |
Male/Female Medical Ward (M/F MW) 17% |
21 Blood (3) Wound (3) Urine (11) Sputum (2) Other (2) | 12 |
44 Urine (26) Swabs (9) Blood (2) Sputum (1) Other (5) | 29 |
6 Wound swab (4) Urine (2) | 7 |
5 Wound (1) Urine (1) Other (3) | 6 |
13 Urine (10) Sputum (2) Blood (1) | 28 |
16 Urine (9) Swabs (3) Blood (2) Stool (2) | 23 |
AKU—AMR 4% |
8 Blood (4) Other (4) | 4.5 |
3 Urine (3) | 2 | 6 | 7 | 0 | 0 | 0 | 0 |
5 Blood (5) | 7 |
Other (25%) | 42 | 24 | 47 | 30 | 29 | 35 | 5 | 6 | 6 | 13 | 24 | 34 |
Total n = 616 | 178 | 100% | 151 | 100% | 84 | 100% | 82 | 100% | 46 | 100% | 75 b | 100% |
Age b | ||||||||||||
Young 1–20 (16%) | 14 | 11 | 34 | 26 | 16 | 23 | 5 | 9 | 0 | 0 | 12 | 20 |
Adults (21–49 y) (30%) | 43 | 33 | 41 | 32 | 27 | 39 | 15 | 27 | 7 | 17 | 14 | 21 |
Seniors (>50 y) (54%) | 74 | 57 | 55 | 42 | 26 | 38 | 35 | 64 | 34 | 83 | 40 | 61 |
Gender c | ||||||||||||
Male (59%) | 72 | 53 | 57 | 43 | 59 | 75 | 43 | 74 | 29 | 66 | 45 | 63 |
Female (41%) | 64 | 47 | 75 | 57 | 20 | 25 | 15 | 26 | 15 | 34 | 26 | 37 |
MDR, XDR, PDR d | MDR | MDR | XDR | PDR | XDR | MDR |
Organisms | Gender | Age a | Specimen | Ward b | AK | CN | ETP | IMI | MRP | KF | CXM | FOX | CAZ | CRO | FEP | ATM | AMP | AUG | TZP | CS | SXT | NIT | CIP | LEV | TGC | Hospital |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
P. stuartii | F | 71 | Swap | FMW | S | S | S | S | S | R | S | S | S | S | S | S | I | R | S | R | S | R | S | S | KKH | |
P. stuartii | F | 74 | Sputum | ICU | R | R | S | R | R | R | R | S | R | R | R | R | R | R | R | R | R | R | R | R | KKH | |
P. stuartii | M | 81 | Blood | AE | I | R | S | S | S | R | R | I | S | S | S | S | R | R | S | R | S | R | R | R | KKH | |
P. stuartii | M | 31 | Sputum2-B | MSW | S | R | S | S | R | R | I | S | S | S | S | S | R | R | S | R | S | R | I | R | KKH | |
P. stuartii | M | 38 | Wound | ICU | S | R | S | S | S | R | S | R | R | R | R | R | R | R | R | R | R | R | R | KKH | ||
P. stuartii | M | 68 | Sputum | MSW | S | R | S | S | R | R | S | R | R | R | R | R | R | S | R | R | R | R | R | KKH | ||
P. stuartii | M | 33 | Urine | EAB | S | R | R | R | S | R | R | R | R | R | R | R | R | R | S | R | R | R | R | R | X | KKH |
P. stuartii | M | 61 | Sputum | ICU | S | R | R | R | R | R | R | S | R | R | R | R | R | R | S | R | R | R | R | R | X | KKH |
P. stuartii | F | 61 | Dialysis | ICU | S | R | S | X | X | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | X | KKH |
P. stuartii | F | 52 | Urine | HND | S | R | S | S | R | S | S | S | S | S | S | R | R | S | R | R | R | R | R | R | X | KKH |
P. stuartii | M | 31 | Sputum | MSW | S | R | S | R | R | I | S | S | S | S | S | R | R | S | R | S | R | I | R | KKH | ||
P. stuartii | F | 71 | Sputum | ICU | S | R | R | S | R | R | R | R | R | S | R | R | R | S | R | R | R | R | R | KKH | ||
P. stuartii | F | 52 | Urine | LAB | R | R | S | S | R | R | S | R | R | R | R | R | R | S | R | R | R | R | R | KKH | ||
P. stuartii | F | 42 | Wound | FMW | S | S | S | X | S | R | S | S | S | S | S | S | S | R | S | R | S | R | I | I | KKH | |
P. stuartii | M | 40 | Wound | S | R | R | X | R | R | R | S | R | S | S | R | R | R | R | R | R | R | R | R | R | KSSH | |
P. stuartii | M | 6 | Sputum | MSW | S | S | S | S | R | S | S | R | R | R | S | R | S | S | R | R | R | R | R | KKH | ||
P. stuartii | M | 40 | Sputum | MSW | S | S | R | S | S | R | S | R | R | S | R | R | R | S | S | R | S | R | S | R | X | KKH |
P. stuartii | M | 51 | Other | LAB | S | S | R | X | S | R | R | S | S | R | R | R | S | R | S | R | S | R | R | S | X | KKH |
P. stuartii | F | 65 | Urine | ICU | S | R | S | R | R | R | R | S | R | S | R | R | S | R | R | R | R | R | S | R | X | KKH |
P. stuartii | F | 52 | Urine | HND | S | R | S | S | R | S | S | S | S | S | S | R | R | S | R | R | R | R | R | R | X | KKH |
P. stuartii | F | 30 | Sputum | MSW | S | R | S | R | S | I | S | R | S | R | S | R | R | S | R | S | S | R | R | KKH | ||
P. stuartii | M | 72 | Wound | S | R | R | X | S | R | R | S | S | S | S | S | R | R | S | R | S | R | S | S | R | KSSH | |
M. morganii | M | 54 | Pus | MSW | S | S | S | S | R | R | S | R | R | S | S | R | R | S | R | R | I | I | I | |||
M. morganii | M | AE–AN | ICU | S | S | S | S | S | R | R | S | S | S | S | S | R | R | S | R | R | R | S | S | R | ||
M. morganii | M | 61 | Blood | ICU | S | R | S | S | S | R | R | S | R | R | R | I | R | R | S | R | R | R | R | R | R | |
M. morganii | S | S | S | S | S | S | S | S | R | S | S | S | S | S | s | MCH | ||||||||||
M. morganii | F | 33 | S | S | S | X | S | R | R | S | S | S | S | S | R | R | S | R | S | R | S | S | S | KKH | ||
M. morganii | F | 54 | Wound | FSW | S | S | S | X | S | R | R | S | S | S | S | S | R | R | S | R | S | R | S | S | R | KKH |
M. morganii | M | 51 | Blood | MSW | S | S | S | X | S | R | R | S | R | R | R | S | R | R | S | R | S | R | S | S | R | KKH |
M. morganii | F | 79 | Urine | S | R | R | R | S | R | R | I | S | R | R | R | R | R | S | R | R | R | R | R | R | KSH | |
S. fonticola | M | 85 | Urine | MMW | S | S | R | I | R | R | R | S | S | R | R | R | R | S | S | S | S | R | S | S | R | |
S. fonticola | M | 88 | Urine | MMW | S | S | R | R | R | R | R | R | S | S | S | R | R | S | R | R | R | S | S | R | ||
Haemophilus sp. | M | 3m | Eyes swap | PICU | R | S | S | S | R | S | S | S | S | S | S | S | R | |||||||||
C. koseri | F | 62 | Blood | AKU | S | S | S | S | S | S | R | S | S | S | S | S | R | S | S | S | S | R | S | S | S | |
C. koseri | F | 28 | FSW | S | S | S | S | S | S | S | S | S | S | S | S | R | S | S | S | S | S | S | S | S | KKH | |
C. koseri | M | 3m | Urine | PW | S | S | R | S | S | R | R | S | R | R | R | R | R | S | S | S | S | R | S | S | R | |
C. koseri | M | 8M | Urine | PICU | R | I | X | I | S | R | R | S | R | R | R | R | R | S | S | R | R | I | S | S | I | KKH |
K. oxytoca | M | 3 | Urine | PW | S | S | R | S | S | R | R | R | R | R | R | S | R | S | S | S | R | S | S | S | S | |
K. oxytoca | M | 6M | Urine | UR | S | S | S | S | S | S | S | S | S | S | S | S | R | S | S | S | S | R | S | S | S | |
K. oxytoca | M | 7M | Urine | UPO | S | S | S | S | S | S | S | S | S | S | S | S | R | S | S | S | S | S | S | S | S | KKH |
K. oxytoca | M | 96 | Urine | LAB | S | S | R | R | R | R | R | S | R | R | R | R | R | R | R | S | S | S | S | S | S | KKH |
K. ozae | M | 64 | Urine | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | S | KSSH | |
S. enterica | Urine | AE/ER | S | S | S | S | S | S | S | S | s | s | S | S | s | MCH | ||||||||||
S. typhi | S | S | S | S | S | S | S | S | S | S | S | S | S | |||||||||||||
Salmonella sp. | M | 4M | Stool | PW | S | S | S | S | S | S | S | S | S | S | S | S | S | S | S | S | S | S | S | S | S | KKH |
P. fluorescens | M | 24 | Blood | MMW | S | I | S | S | S | R | R | R | S | R | S | R | R | R | S | S | S | R | I | S | S | KKH |
P. putida | F | 65 | Urine | FMW | S | S | R | S | S | R | R | R | S | S | I | I | R | R | S | S | R | R | I | R | R | KKH |
S. maltophilia | F | 18 | Wound | FSW | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | S | R | R | S | I | KKH | |
S. maltophilia | M | 70 | Blood | AMR | R | R | R | R | R | R | R | R | R | R | R | R | R | R | S | R | I | S | I | KKH | ||
S. maltophilia | M | 64 | Blood | AMR | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | X | S | R | I | S | I | KKH |
S. maltophilia | M | 64 | Blood | MMW | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | S | R | S | S | S | KKH | |
S. maltophilia | M | 70 | Blood | AMR | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | X | S | R | R | S | S | KKH |
S. maltophilia | M | 45 | Bloody Sputum | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | S | S | KSSH | |
P. rettgeri | F | 61 | Blood | ICU | S | I | I | S | R | S | S | S | S | S | S | R | R | S | R | S | R | S | S | KKH | ||
P. rettgeri | Wound | S | S | S | I | S | R | S | S | S | S | S | S | R | R | S | R | S | S | S | S | R | KSSH | |||
P. rettgeri | M | 70 | Wound | MSW | S | R | S | R | S | R | R | S | R | R | R | R | R | R | S | R | R | R | R | R | R | KKH |
*C. freundii | M | 56 | Blood | COW | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | S | S | S | R | S | S | KKH |
C. freundii | M | 65 | Wound | COW | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | R | S | R | R | S | KKH |
C. freundii | M | 2M | Urine | PW | S | R | S | S | S | R | R | R | R | R | R | R | R | R | S | S | S | S | S | S | S | KKH |
C. freundii | F | 81 | Wound | ICU | S | S | S | S | S | R | R | R | R | R | R | R | R | R | R | S | R | S | R | R | S | KKH |
C. freundii | F | 62 | wound | FMW | S | R | S | S | S | R | R | R | R | R | R | R | R | R | S | S | S | S | S | S | S | KKH |
C. freundii | M | 75 | ICU | S | R | S | R | S | R | R | R | R | R | R | R | R | R | I | S | R | S | R | R | S | KKH | |
C. koseri | F | 62 | Blood | AKU | S | S | S | S | S | S | R | S | S | S | S | S | R | S | S | S | S | R | S | S | S | |
C. koseri | F | 28 | FSW | S | S | S | S | S | S | S | S | S | S | S | S | R | S | S | S | S | S | S | S | S | KKH | |
C. koseri | M | 3m | Urine | PW | S | S | R | S | S | R | R | S | R | R | R | R | R | S | S | S | S | R | S | S | R | |
C. koseri | M | 8M | Urine | PICU | R | I | X | I | S | R | R | S | R | R | R | R | R | S | S | R | R | I | S | S | I | KKH |
B. cepacia | F | 49 | Urine | FMW | R | R | R | R | R | R | R | S | R | R | R | R | S | R | S | R | R | R | S | |||
B. cepacia | M | 63 | Sputum | ICU | S | S | R | I | R | R | R | R | R | R | R | R | R | R | R | R | R | R | S | |||
P. vulgaris | M | 66 | Urine | R | R | I | R | I | R | R | I | R | R | R | R | R | R | I | R | S | R | R | R | R | KHH | |
Shigella sp. | M | Stool | LAB | R | S | S | S | S | S | S | R | S | S | S | S | S | S | MCH | ||||||||
Shigella sp. | M | Stool | LAB | S | S | S | S | S | S | S | I | S | S | S | S | S | S | MCH | ||||||||
Shigella sp. | F | Stool | FMW | R | S | S | S | S | S | S | R | S | S | S | S | S | S | KKH | ||||||||
Shigella sp. | F | Stool | LAB | S | R | S | S | R | S | R | S | I | S | R | S | S | I | S | KKH | |||||||
C. lapagei | M | 58 | Urine | MMW | R | R | R | R | R | R | R | R | R | R | R | R | R | R | S | R | R | R | R | R | S | KKH |
C. werkmanii | F | 61 | Urine | LAB | S | S | S | S | S | R | S | R | S | S | S | S | R | R | S | S | S | S | S | S | S | KKH |
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Said, K.B.; Alsolami, A.; Khalifa, A.M.; Khalil, N.A.; Moursi, S.; Osman, A.; Fahad, D.; Rakha, E.; Rashidi, M.; Moussa, S.; et al. A Multi-Point Surveillance for Antimicrobial Resistance Profiles among Clinical Isolates of Gram-Negative Bacteria Recovered from Major Ha’il Hospitals, Saudi Arabia. Microorganisms 2021, 9, 2024. https://doi.org/10.3390/microorganisms9102024
Said KB, Alsolami A, Khalifa AM, Khalil NA, Moursi S, Osman A, Fahad D, Rakha E, Rashidi M, Moussa S, et al. A Multi-Point Surveillance for Antimicrobial Resistance Profiles among Clinical Isolates of Gram-Negative Bacteria Recovered from Major Ha’il Hospitals, Saudi Arabia. Microorganisms. 2021; 9(10):2024. https://doi.org/10.3390/microorganisms9102024
Chicago/Turabian StyleSaid, Kamaleldin B., Ahmed Alsolami, Amany M. Khalifa, Nuha A. Khalil, Soha Moursi, Abuzar Osman, Dakheel Fahad, Ehab Rakha, Musleh Rashidi, Safia Moussa, and et al. 2021. "A Multi-Point Surveillance for Antimicrobial Resistance Profiles among Clinical Isolates of Gram-Negative Bacteria Recovered from Major Ha’il Hospitals, Saudi Arabia" Microorganisms 9, no. 10: 2024. https://doi.org/10.3390/microorganisms9102024