Abstract
Background: In Saudi Arabia, due to its dynamic population and annual hajj pilgrimage, there is influx and efflux of millions of visitors every year, especially to Makkah dan Madinah, providing an international hub for the exchange of microbes. It is rather a common interest to understand the molecular epidemiology and clinical significance of multidrug resistant organisms in this country. Acinetobacter baumannii in particular, is one of the most common Gram negative bacteria isolated in the Kingdom. This organism is responsible for ventilator associated pneumonia, blood stream infections, urinary tract infections and skin infections. Objective: In this manuscript we aim to review the literature available on the antimicrobial resistance, genotypes and clinical significance ofA. baumannii acquisitions in Saudi Arabia. Methodology: The literature was reviewed systematically using PubMed with a combination of the terms ‘Acinetobacter’ AND ‘Saudi Arabia’. Reference lists of relevant articles were searched to identify further material. We only included studies with plausible data. Main observations: In Makkah itself, there are significant increase in carbapenem resistant Acinetobacter from 14% in 2004-2005, 46% in 2005-2006, 63% in 2011 to 90% in 2015. Recent publication from Madinah indicated, beside resistant to carbapenem approaching 90%, an alarming resistant rate to the last resort antibiotic, polymyxin is also observed at 24% of 379 tested strains. In a study in Makkah, the most predominant sequence types being ST 195 and ST557, which in the worldwide clonal complex 2. Conclusion: These resistant rate and sequences type indicated intermingling of the resistant superbugs occurred. With limited treatment option, effective infective control measures and antibiotic stewardship programs are the key element to contain these resistant isolates from spread. Bangladesh Journal of Medical Science Vol. 21 No. 02 April’22 Page : 233-242
Highlights
Acinetobacter baumannii is a Gram negative coccobacilli that is responsible for many nosocomial infections, primarily in immunocompromised patients
It is inherently resistant to several antibiotics and has capability to acquire resistance to other antibiotics via various mechanisms, leaving the clinician with relatively few treatment options.2Among common infections caused by this organism are ventilator associated pneumonia (VAP), catheter associated blood stream infections, surgical site infections and
The studies in Saudi Arabia and the Middle East region on the molecular characterization and antibiotic profile of A. baumannii are scarce.4.5 In this manuscript we aim to review the literature available on the antimicrobial resistance, genotypes and clinical significance of A. baumannii acquisitions in Saudi Arabia
Summary
Acinetobacter baumannii is a Gram negative coccobacilli that is responsible for many nosocomial infections, primarily in immunocompromised patients This organism is intrinsically tolerant to dry surfaces, which contributes to its persistence in hospital environments and transmission.[1] it is inherently resistant to several antibiotics and has capability to acquire resistance to other antibiotics via various mechanisms, leaving the clinician with relatively few treatment options.2Among common infections caused by this organism are ventilator associated pneumonia (VAP), catheter associated blood stream infections, surgical site infections and. Treatment options are becoming limited with the only reliable possibilities seem to be polymyxins in combination with other agents, with a few new agents in the development pipelines.[3] The studies in Saudi Arabia and the Middle East region on the molecular characterization and antibiotic profile of A. baumannii are scarce.4.5 In this manuscript we aim to review the literature available on the antimicrobial resistance, genotypes and clinical significance of A. baumannii acquisitions in Saudi Arabia. (XDR) as organisms non-susceptible to ≥ 1 in all but ≤ 2 categories of antibiotics and pandrug resistance (PDR) is defined as bacteria that are resistant to all current clinically available antibiotics.[6]
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