Farah Sara M, Alshehri Mohammed A, Alfawaz Tariq S, Alasmeri Faisal A, Alageel Abdulaziz A, Alshahrani Dayel A
Department of Pediatric Infectious Diseases, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. E-mail.
Saudi Med J. 2019 Mar;40(3):252-259. doi: 10.15537/smj.2019.3.23947.
To describe and interpret local antibiograms from a single tertiary care center to monitor the trends of antimicrobial resistance (AMR) patterns and establish baseline data for further surveillance. Methods: We performed a retrospective descriptive review of antibiograms data between January 2010 and December 2015 from King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia. Results: A total of 51,491 isolates were identified, and most were gram-negative (76.2%). Escherichia coli was the most frequently isolated organism (36.8%), followed by Coagulase-negative Staphylococcus (28.4%) and Staphylococcus aureus (27.5%). The detection of antibiotic-resistant organisms, especially extended-spectrum beta-lactamase-producing Escherichia coli (31%-41%), increased over time. The sensitivity of Streptococcus pneumoniae to penicillin improved from 66% to 100% (p less than 0.001). Gram-negative isolates had excellent overall susceptibility to amikacin, variable susceptibility to piperacillin-tazobactam and carbapenems, and declining susceptibility to ceftazidime, ciprofloxacin, and cefepime. Conclusion: Streptococcus pneumoniae susceptibility to penicillin significantly improved over time, which might be because of the introduction of the pneumococcal vaccine. Conversely, the upward trend in resistant gram-negative organisms is worrisome and warrants the implementation of antimicrobial stewardship programs.
描述并解读来自单一三级医疗中心的当地抗菌谱,以监测抗菌药物耐药性(AMR)模式的趋势,并建立基线数据用于进一步监测。方法:我们对沙特阿拉伯王国利雅得法赫德国王医疗城2010年1月至2015年12月期间的抗菌谱数据进行了回顾性描述性分析。结果:共鉴定出51491株分离菌,其中大多数为革兰阴性菌(76.2%)。大肠埃希菌是最常分离出的菌株(36.8%),其次是凝固酶阴性葡萄球菌(28.4%)和金黄色葡萄球菌(27.5%)。随着时间的推移,耐药菌尤其是产超广谱β-内酰胺酶大肠埃希菌的检出率(31%-41%)有所增加。肺炎链球菌对青霉素的敏感性从66%提高到100%(p<0.001)。革兰阴性菌分离株对阿米卡星总体敏感性良好,对哌拉西林-他唑巴坦和碳青霉烯类药物敏感性不一,对头孢他啶、环丙沙星和头孢吡肟的敏感性下降。结论:随着时间的推移,肺炎链球菌对青霉素的敏感性显著提高,这可能是由于肺炎球菌疫苗的引入。相反,革兰阴性耐药菌的上升趋势令人担忧,有必要实施抗菌药物管理计划。