National Surveillance of Antimicrobial Resistance to Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) in Saudi Arabia in 2022-2023
Introduction: PA and AB are leading Gram-negative pathogens causing healthcare-associated infections. Both are inherently resistant to several antibiotics and easily develop resistance upon exposure. Most surveillance studies from Saudi Arabia were single-centered or didn't utilize the gold sta...
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Elsevier
2025-03-01
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| Series: | International Journal of Infectious Diseases |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1201971224007471 |
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| author | Dr Abrar Thabit Dr. Mahmoud Elfaky Mr. Feras Alharbi Mr. Ammar Alghamdi Mr. Anas Jawah Mr. Musaab Miaji Dr. Fatimah Alturki Dr. Nehal Hosin Mr. Moahmmed Bazuqamah Dr. Masaad Almutairi Mr. Hamad Alhamed Dr. Alaa Elhendawy Dr. Dalya Atallah Mr. Abdulaziz Humadi Mr. Khalid Alfifi Dr. Khadija Alfadel Dr. Khalid Eljaaly |
| author_facet | Dr Abrar Thabit Dr. Mahmoud Elfaky Mr. Feras Alharbi Mr. Ammar Alghamdi Mr. Anas Jawah Mr. Musaab Miaji Dr. Fatimah Alturki Dr. Nehal Hosin Mr. Moahmmed Bazuqamah Dr. Masaad Almutairi Mr. Hamad Alhamed Dr. Alaa Elhendawy Dr. Dalya Atallah Mr. Abdulaziz Humadi Mr. Khalid Alfifi Dr. Khadija Alfadel Dr. Khalid Eljaaly |
| author_sort | Dr Abrar Thabit |
| collection | DOAJ |
| description | Introduction: PA and AB are leading Gram-negative pathogens causing healthcare-associated infections. Both are inherently resistant to several antibiotics and easily develop resistance upon exposure. Most surveillance studies from Saudi Arabia were single-centered or didn't utilize the gold standard broth microdilution (BMD) test. This is the first nationwide study to evaluate the current resistance profiles of PA and AB using BMD to aid decision making regarding antimicrobial stewardship and infection control in the country. Methods: 7 hospitals from 7 regions of Saudi Arabia participated, where PA and AB isolates from different body sites were collected between 2022-2023. The isolates were shipped to an academic microbiology lab, where they were subcultured on blood agar plates (BAPs) then stored in glycerol at -80°C until testing. 24h before testing, the isolates were cultured on BAPs and incubated at 36°C for 24h. On testing days, BMD was done following Clinical Laboratory Standards Institute guidelines using Sensititre GNX3F plates (ThermoFisher Scientific, USA). An inoculum of 0.5 McFarland was prepared and instilled (10µL) with Mueller-Hinton Broth (50µL) in the plates that were incubated at 36°C for 16-24h. %susceptibility to each antibiotic, MIC50, and MIC90 were calculated. Mutlidrug-resistant (MDR) isolate was defined as an isolate that's resistant to ≥3 antibiotics from different classes, whereas pandrug-resistant (PDR) isolate was defined as resistance to all antibiotics (Tamma, et al.2023). Results: 285 isolates (185 PA and 100 AB) were collected, mostly of respiratory origin (34.1% and 43%, respectively). The highest susceptibility by PA was to aminoglycosides (57.8-76.8%) and by AB to tigecycline (39%). Susceptibility rates to remaining antibiotics ranged 15.1-52% and 0-25% by PA and AB, respectively. Notably, the MIC90 of all tested antibiotics against both pathogens were higher than the resistance breakpoint of each antibiotic. All isolates were MDR, but only 5.4% of PA isolates were PDR compared with 42% of AB isolates. Discussion: A recent review examined antibiotic resistance in Saudi Arabia over 10 years (2013-2023) by various bacterial pathogens (Thabit, et al.2023). While it included many studies evaluating PA (n=11) and AB (n=9), none of these studies utilized BMD and they were mostly single-centered. Antibiotic resistance rates reported in our study are alarming compared with the previous studies reported in that review, which could be attributed to the cross-sectional nature of the current study, that it was multi-centered, and perhaps increased overall resistance. Conclusion: There was a surprisingly high national resistance by PA and AB to the antibiotics typically used for therapy. Hospitals nationwide are encouraged to enforce antimicrobial stewardship and infection control policies to improve therapy, limit the spread and emergence of resistant strains, and monitor resistance trends using local antibiograms. Results from this study could be used by other countries in the region for comparison purposes. |
| format | Article |
| id | doaj-art-b84b4ae5207d4122a82dfaa91377546e |
| institution | DOAJ |
| issn | 1201-9712 |
| language | English |
| publishDate | 2025-03-01 |
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| series | International Journal of Infectious Diseases |
| spelling | doaj-art-b84b4ae5207d4122a82dfaa91377546e2025-08-20T02:55:14ZengElsevierInternational Journal of Infectious Diseases1201-97122025-03-0115210767210.1016/j.ijid.2024.107672National Surveillance of Antimicrobial Resistance to Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) in Saudi Arabia in 2022-2023Dr Abrar Thabit0Dr. Mahmoud Elfaky1Mr. Feras Alharbi2Mr. Ammar Alghamdi3Mr. Anas Jawah4Mr. Musaab Miaji5Dr. Fatimah Alturki6Dr. Nehal Hosin7Mr. Moahmmed Bazuqamah8Dr. Masaad Almutairi9Mr. Hamad Alhamed10Dr. Alaa Elhendawy11Dr. Dalya Atallah12Mr. Abdulaziz Humadi13Mr. Khalid Alfifi14Dr. Khadija Alfadel15Dr. Khalid Eljaaly16Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz UniversityDepartment of Natural Products, Faculty of Pharmacy, King Abdulaziz UniversityFaculty of Pharmacy, King Abdulaziz UniversityFaculty of Pharmacy, King Abdulaziz UniversityFaculty of Pharmacy, King Abdulaziz UniversityFaculty of Pharmacy, King Abdulaziz UniversityMicrobiology Department, King Fahad Hospital of the UniversityDepartment of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal UniversityMicrobiology Department, King Khaled HospitalDepartment of Pharmacy Practice, College of Pharmacy, Qassim UniversityLaboratory and Blood Bank Department, King Fahad Specialist HospitalMicrobiology Department, King Fahad HospitalDepartment of Clinical Microbiology, King Abdulaziz University HospitalLaboratory and Blood Bank Department, King Fahad Specialist HospitalMicrobiology Department, King Fahad Specialist HospitalMicrobiology Department, Maternity and Children Hospital, King Salman Medical CityDepartment of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz UniversityIntroduction: PA and AB are leading Gram-negative pathogens causing healthcare-associated infections. Both are inherently resistant to several antibiotics and easily develop resistance upon exposure. Most surveillance studies from Saudi Arabia were single-centered or didn't utilize the gold standard broth microdilution (BMD) test. This is the first nationwide study to evaluate the current resistance profiles of PA and AB using BMD to aid decision making regarding antimicrobial stewardship and infection control in the country. Methods: 7 hospitals from 7 regions of Saudi Arabia participated, where PA and AB isolates from different body sites were collected between 2022-2023. The isolates were shipped to an academic microbiology lab, where they were subcultured on blood agar plates (BAPs) then stored in glycerol at -80°C until testing. 24h before testing, the isolates were cultured on BAPs and incubated at 36°C for 24h. On testing days, BMD was done following Clinical Laboratory Standards Institute guidelines using Sensititre GNX3F plates (ThermoFisher Scientific, USA). An inoculum of 0.5 McFarland was prepared and instilled (10µL) with Mueller-Hinton Broth (50µL) in the plates that were incubated at 36°C for 16-24h. %susceptibility to each antibiotic, MIC50, and MIC90 were calculated. Mutlidrug-resistant (MDR) isolate was defined as an isolate that's resistant to ≥3 antibiotics from different classes, whereas pandrug-resistant (PDR) isolate was defined as resistance to all antibiotics (Tamma, et al.2023). Results: 285 isolates (185 PA and 100 AB) were collected, mostly of respiratory origin (34.1% and 43%, respectively). The highest susceptibility by PA was to aminoglycosides (57.8-76.8%) and by AB to tigecycline (39%). Susceptibility rates to remaining antibiotics ranged 15.1-52% and 0-25% by PA and AB, respectively. Notably, the MIC90 of all tested antibiotics against both pathogens were higher than the resistance breakpoint of each antibiotic. All isolates were MDR, but only 5.4% of PA isolates were PDR compared with 42% of AB isolates. Discussion: A recent review examined antibiotic resistance in Saudi Arabia over 10 years (2013-2023) by various bacterial pathogens (Thabit, et al.2023). While it included many studies evaluating PA (n=11) and AB (n=9), none of these studies utilized BMD and they were mostly single-centered. Antibiotic resistance rates reported in our study are alarming compared with the previous studies reported in that review, which could be attributed to the cross-sectional nature of the current study, that it was multi-centered, and perhaps increased overall resistance. Conclusion: There was a surprisingly high national resistance by PA and AB to the antibiotics typically used for therapy. Hospitals nationwide are encouraged to enforce antimicrobial stewardship and infection control policies to improve therapy, limit the spread and emergence of resistant strains, and monitor resistance trends using local antibiograms. Results from this study could be used by other countries in the region for comparison purposes.http://www.sciencedirect.com/science/article/pii/S1201971224007471 |
| spellingShingle | Dr Abrar Thabit Dr. Mahmoud Elfaky Mr. Feras Alharbi Mr. Ammar Alghamdi Mr. Anas Jawah Mr. Musaab Miaji Dr. Fatimah Alturki Dr. Nehal Hosin Mr. Moahmmed Bazuqamah Dr. Masaad Almutairi Mr. Hamad Alhamed Dr. Alaa Elhendawy Dr. Dalya Atallah Mr. Abdulaziz Humadi Mr. Khalid Alfifi Dr. Khadija Alfadel Dr. Khalid Eljaaly National Surveillance of Antimicrobial Resistance to Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) in Saudi Arabia in 2022-2023 International Journal of Infectious Diseases |
| title | National Surveillance of Antimicrobial Resistance to Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) in Saudi Arabia in 2022-2023 |
| title_full | National Surveillance of Antimicrobial Resistance to Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) in Saudi Arabia in 2022-2023 |
| title_fullStr | National Surveillance of Antimicrobial Resistance to Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) in Saudi Arabia in 2022-2023 |
| title_full_unstemmed | National Surveillance of Antimicrobial Resistance to Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) in Saudi Arabia in 2022-2023 |
| title_short | National Surveillance of Antimicrobial Resistance to Pseudomonas aeruginosa (PA) and Acinetobacter baumannii (AB) in Saudi Arabia in 2022-2023 |
| title_sort | national surveillance of antimicrobial resistance to pseudomonas aeruginosa pa and acinetobacter baumannii ab in saudi arabia in 2022 2023 |
| url | http://www.sciencedirect.com/science/article/pii/S1201971224007471 |
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