Specialty Internal Medicine, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Indiana University School of Medicine, Indianapolis, Indiana, USA; Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Micobiology Lab, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
J Infect Public Health. 2020 May;13(5):737-745. doi: 10.1016/j.jiph.2020.01.004. Epub 2020 Jan 31.
Increasing prevalence of antimicrobial resistance is a major concern especially in light of lack of new antimicrobial agents. Here, we present antibiotic resistance pattern of gram-negative bacteria (GNB) over six years (2013-2018) in a hospital in Saudi Arabia.
The study included a report of the cumulative antibiogram of GNB. Interpretation of the antibacterial susceptibility tests was based on the Clinical and Laboratory Standards Institute guidelines and VITEK® 2 system.
There was a total of 32,890 GNB isolates and the most common were: Escherichia coli (69.8%), Klebsiella pneumoniae (17.2%) and Pseudomonas aeruginosa (12.8%). Antimicrobial susceptibility of P. aeruginosa and E. coli did not change overtime, however, susceptibility to ceftazidime decreased from 92% to 85% in P. aeuroginosa. Yearly antimicrobial susceptibility did not change significantly overtime for K. pneumoniae. ESBL isolates among K. peumoniae and E. coli was about 26% and 20%, respectively (p=0.0068). For ESBL E. coli, the least effective antibiotics were ciprofloxacin (26%) and trimethoprim-sulfamethoxazole (34%). For ESBL K. pneumoniae, gentamicin, ciprofloxacin, trimethoprim-sulfamethoxazole, and nitrofurantoin had poor activity. For K. pneumoniae, both ciprofloxacin (90%) and trimethoprim-sulfamethoxazole (86%) had better coverage than for E. coli. K. pneumoniae showed less susceptibility to nitrofurantoin than E. coli (20% vs. 92%).
Antibiotic resistance among P. aeruginosa and E. coli did not change overtime (2013-2018) and the rate of ESBL-producing E. coli and K. pneumoniae was high. Thus, continued surveillance is needed.
抗生素耐药性的不断增加是一个主要问题，尤其是在缺乏新的抗生素药物的情况下。在这里，我们呈现了沙特阿拉伯一家医院六年来（2013-2018 年）革兰氏阴性菌（GNB）的抗生素耐药模式。
该研究包括 GNB 累积抗生素耐药谱的报告。根据临床和实验室标准协会的指南和 VITEK® 2 系统对抗菌药敏试验进行解读。
共分离出 32890 株 GNB，最常见的是：大肠埃希菌（69.8%）、肺炎克雷伯菌（17.2%）和铜绿假单胞菌（12.8%）。铜绿假单胞菌和大肠埃希菌的药敏性随时间没有变化，但铜绿假单胞菌对头孢他啶的敏感性从 92%下降到 85%。肺炎克雷伯菌的年抗菌药物敏感性随时间变化不大。肺炎克雷伯菌和大肠埃希菌的产 ESBL 分离株分别约为 26%和 20%（p=0.0068）。对于产 ESBL 的大肠埃希菌，最无效的抗生素是环丙沙星（26%）和复方磺胺甲噁唑（34%）。对于产 ESBL 的肺炎克雷伯菌，庆大霉素、环丙沙星、复方磺胺甲噁唑和呋喃妥因活性较差。对于肺炎克雷伯菌，环丙沙星（90%）和复方磺胺甲噁唑（86%）的覆盖范围均优于大肠埃希菌。肺炎克雷伯菌对呋喃妥因的敏感性低于大肠埃希菌（20% vs. 92%）。
铜绿假单胞菌和大肠埃希菌的抗生素耐药性随时间没有变化（2013-2018 年），产 ESBL 的大肠埃希菌和肺炎克雷伯菌的比例很高。因此，需要持续监测。
