Antibiotic-Resistant Bacteria in Intensive Care Units in the Kingdom of Saudi Arabia: A Systematic Review

Abstract

Background: The emergence of bacterial pathogens and their associated resistance to antibiotic therapy is one of the most serious public health concerns threatening today’s society, including Saudi Arabia’s intensive care units (ICUs). Aim: This study used a systematic review to explore the antibiotic-resistant bacteria in the intensive care units (ICUs) in Saudi Arabia. Methods: The review adhered to the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 guidelines. The search was limited to studies published within 13 years between 2010 and 2023 through CINAHL, Web of Knowledge, PubMed, Science Direct, and Google Scholar. Results: Fifteen studies were reviewed: 12 were retrospective, 1 was comparative historical, 1 was descriptive epidemiologic and 1 was a surveillance study. Most frequently isolated antibiotic-resistant bacteria were Klebsiella pneumonia, Pseudomonas aeruginosa, Acinetobacter baumannii, Escherichia coli, and Enterobacter. These pathogens were found resistant to various antibiotics including methicillin, tazobactam, cilastatin, meropenem, tigecycline, imipenem, meropenem, piperacillin, colistin, penicillin, ampicillin, oxacillin, vancomycin, carbapenems, amoxicillin, ceftriaxone, amikacin, gentamicin, clindamycin, azithromycin, levofloxacin, nitrofurantoin, trimethoprim, cefuroxime, ciprofloxacin, aztreonam, and cefotaxime. Conclusion: To eradicate future infection outbreaks of K. pneumonia, P. aeruginosa, A. baumannii, and other antibiotic-resistant pathogens in Saudi Arabia’s ICUs, comprehensive surveillance programs, strict infection control and prevention guidelines, and stringent implementation of proactive antimicrobial stewardship program are warranted. Keywords: antibiotic; antibiotic-resistant bacteria; intensive care unit; Saudi Arabia