Objective: To detect the prevalence of carbapenem resistance among Gram negative bacilli at the Al-Noor Specialist Hospital in the western part of Saudi Arabia. Materials and Methods: This study was conducted in the Microbiology department, Al-Noor Specialist Hospital, Makah city, Saudi Arabia. The clinical samples were collected from admitted patients in the wards, Intensive Care Units (ICUs), urology unit and surgery unit, these samples included blood, urine, sputum, pus and wound. The identification and antibiotic susceptibility testing of all bacterial isolates were performed via the Vitek 2 Compact System. Results: Out of 4803 Gram negative bacterial bacilli were isolated, the prevalence rate of carbapenem resistance among these isolates was 2797/4803 (58.23%), and sensitivity rate was 2006/4803 (41.77%) of the total isolates. The rate of resistance to carbapenem was among Acinetobacter baumannii 1710 (99.13%), followed by Pseudomonas aeruginosa 575 (62.4%), Klebsiella pneumoniae 459 (38%) and Escherichia coli 56 (5.59%). The trend of carbapenem resistance among Gram negative bacterial isolates from 2013-2015 was 53.99%, 59.88% and 61.43% respectively. Conclusion: A. baumannii rec-orded, the highest rate of carbapenem resistance through three year, 98.19%, 99.48% and 99.81% respectively and the lowest rate of resistance recorded with E. coli, 4.63%, 5.79% and 6.31% respectively.
References
[1]
Paterson, D.L. and Bonomo, R.A. (2005) Extended-Spectrum β-Lactamases: A Clinical Update. Clinical Microbiology Reviews, 18, 657-686.
https://doi.org/10.1128/CMR.18.4.657-686.2005
[2]
Gaynes, R.P. and Culver, D.H. (1992) Resistance to Imipenem among Selected Gram Negative Bacilli in the United States. Infection Control & Hospital Epidemiology, 13, 10-14. https://doi.org/10.2307/30146962
[3]
Lee, K., Lim, Y.S., Yong, D., et al. (2003) Evaluation of the Hodge Test and the Imipenem-EDTA Double-Disk Synergy Test for Differentiating Metallo-β-Lactamase Producing Isolates of Pseudomonas spp. and Acinetobacter spp. Journal of Clinical Microbiology, 41, 4623-4629. https://doi.org/10.1128/JCM.41.10.4623-4629.2003
[4]
Papp Wallace, K.M., Endimiani, A., Taracila, M.A., et al. (2011) Carbapenems: Past, Present, and Future. Antimicrobial Agents and Chemotherapy, 55, 4943-4960.
https://doi.org/10.1128/AAC.00296-11
[5]
Nordmann, P., Naas, T. and Poirel, L. (2011) Global Spread of Carbapenemase- Producing Enterobacteriaceae. Emerging Infectious Diseases, 17, 1791-1798.
https://doi.org/10.3201/eid1710.110655
[6]
Tiwari, P., Rohit, M. and Pharm, M. (2013) Assessment of Costs Associated with Hospital-Acquired Infections in a Private Tertiary Care Hospital in India. Value in Health Regional Issue, 2, 87-91. https://doi.org/10.1016/j.vhri.2013.03.002
[7]
Agarwal, S., Kakati, B., Khanduri, S., et al. (2017) Emergence of Carbapenem Resistant Non-Fermenting Gram-Negative Bacilli Isolated in an ICU of a Tertiary Care Hospital. Journal of Clinical and Diagnostic Research, 11, DC04-DC07.
https://doi.org/10.7860/JCDR/2017/24023.9317
[8]
Falagas, M.E., Lourida, P., Poulikakos, P., et al. (2014) Antibiotic Treatment of Infections Due to Carbapenem-Resistant Enterobacteriaceae: Systematic Evaluation of the Available Evidence. Antimicrobial Agents and Chemotherapy, 58, 654-663.
https://doi.org/10.1128/AAC.01222-13
[9]
Patel, J.B., Rasheed, J.K. and Kitchel, B. (2009) Carbapenemases in Enterobacteriaceae: Activity, Epidemiology, and Laboratory Detection. Clinical Microbiology Newsletter, 31, 55-62. https://doi.org/10.1016/j.clinmicnews.2009.03.005
[10]
Martin, E.T., Tansek, R., Collins, V., et al. (2013) The Carbapenem Resistant Enterobacteriaceae Score: A Bedside Score to Rule Out Infection with Carbapenem Resistant Enterobacteriaceae among Hospitalized Patients. American Journal of Infection Control, 41, 180-182. https://doi.org/10.1016/j.ajic.2012.02.036
[11]
Nordmann, P., Dortet, L. and Poirel, L. (2012) Carbapenem Resistance in Enterobacteriaceae: Here Is the Storm! Trends in Molecular Medicine, 18, 263-272.
https://doi.org/10.1016/j.molmed.2012.03.003
[12]
Organization, W.H. (2014) Antimicrobial Resistance: Global Report on Surveillance. World Health Organization, Geneva, 257.
[13]
Karaiskos, I. and Giamarellou, H. (2014) Multidrug-Resistant and Extensively Drug-Resistant Gram-Negative Pathogens: Current and Emerging Therapeutic Approaches. Expert Opinion on Pharmacotherapy, 15, 1351-1370.
https://doi.org/10.1517/14656566.2014.914172
[14]
Alsultan, A.A., Evans, B.A., Elsayed, E.A., et al. (2013) High Frequency of Carbapenem Resistant Acinetobacter baumannii in Patients with Diabetes Mellitus in Saudi Arabia. Journal of Medical Microbiology, 62, 885-888.
https://doi.org/10.1099/jmm.0.057216-0
[15]
Ahmed, N.H., Hussain, T. and Biswal, I. (2015) Antimicrobial Resistance of Bacterial Isolates from Respiratory Secretions of Ventilated Patients in a Multi-Speciality Hospital. Avicenna Journal of Medicine, 5, 74-78.
https://doi.org/10.4103/2231-0770.160233
[16]
Fouad, M., Attia, A.S., Tawakkol, W.M. and Hashem, A.M. (2013) Emergence of Carbapenem-Resistant Acinetobacter baumannii Harboring the OXA-23 Carbapenemase in Intensive Care Units of Egyptian Hospitals. International Journal of Infectious Diseases, 17, 1252-1254. https://doi.org/10.1016/j.ijid.2013.07.012
[17]
Dhabaan, G.N., Hamimah, H. and Shorman, M.A. (2011) Emergence of Extensive Drug-Resistant Acinetobacter baumannii in North of Jordan. African Journal of Microbiology Research, 5, 1070-1075.
[18]
Zafer, M.M., Al-Agamy, M.H., E1-Mahallawy, H.A., Amin, M.A.M.Z. and Ashour, M.S.E. (2014) Antimicrobial Resistance Pattern and Their Beta-Lactamase Encoding Genes among Pseudomonas aeruginosa Strains Isolated from Cancer Patients. BioMed Research International, 2014, Article ID: 101635, 8 p.
[19]
Al-Agmy, M.H., Shibl, A.M., Tawfik, A.F., Elkhizzi, N.A. and Livermore, D.M. (2012) Extended Spectrum and Metallo Beta Lactames among Ceftazidime Resistant Pseudomonas aeroginosa in Riyadh, Saudia Arabia. Journal of Chemotherapy, 24, 97-100. https://doi.org/10.1179/1120009X12Z.00000000015
[20]
Bonomo, R.A. and Szabo, D. (2006) Mechanisms of Multidrug Resistance in Acinetobacter Species and Pseudomonas aeruginosa. Clinical Infectious Diseases, 43, S49-S56. https://doi.org/10.1086/504477
[21]
Dijkshoorn, L., Nemec, A. and Seifert, H. (2007) An Increasing Threat in Hospitals: Multidrug-Resistant Acinetobacter baurnannii. Nature Reviews Microbiology, 5, 939-951. https://doi.org/10.1038/nrmicro1789
[22]
Metwally, L., Gomaa, N., Attallah, M. and Kamel, N. (2013) High Prevalence of Klebsiella pneumoniae Carbapenemase-Mediated Resistance in K. pneumoniae Isolates from Egypt. Eastern Mediterranean Health Journal, 19, 947-52.
[23]
Shibl, A., Al-Agamy, M., Memish, Z., Senok, A., Khader, S.A. and Assiri, A. (2013) The Emergence of OXA-48- and NDM-1-Positive Klebsiella pneumoniae in Riyadh, Saudi Arabia. International Journal of Infectious Diseases, 17, e1130-3.
https://doi.org/10.1016/j.ijid.2013.06.016
[24]
Dortet, L., Poirel, L., Al Yaqoubi, F. and Nordmann, P. (2012) NDM-1, OXA-48 and OXA-181 Carbapenemase-Producing Enterobacteriaceae in Sultanate of Oman. Clinical Microbiology and Infection, 18, E144-E148.
https://doi.org/10.1111/j.1469-0691.2012.03796.x
[25]
Poirel, L., Al Maskari, Z., Al Rashdi, F., Bernabeu, S. and Nordmann, P. (2010) NDM1-Producing Klebsiella pneumoniae Isolated in the Sultanate of Oman. Journal of Antimicrobial Chemotherapy, 66, 304-306. https://doi.org/10.1093/jac/dkq428