Abstract
Gram-negative bacilli (GNB) are commonly implicated in clinical diseases. However, with their increasing resistance to antimicrobial agents, treatment becomes a challenge. This study has been conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia over a period of one month from July to August 2011. Identification and antibiotic sensitivity tests of GNB were performed using standard microbiological methods and Vitek2 system. Extended spectrum beta lactamase (ESBLs) strains were detected using double disc synergy test and Vitek 2 system. A total of 176 Gram-negative bacilli were studied. The most frequently isolated organism was E. coli (38.07%) followed by Klebsiella pneumoniae (15.91%), Pseudomonas aeruginosa (11.93%), Proteus mirabilis (9.66%) and Acinetobacter baumannii (6.82%). Other Gram-negative bacilli were less frequent. Isolates were detected most frequently from ICU patients (26.70%). Urinary tract, wound and respiratory tract infections were implicated most often. Extended spectrum beta lactamase strains accounted for 20% of all Enterobacteriacae. The vast majority of the GNB isolates were resistant to many antibiotics. Carbapenems, tigecycline and amikacin were effective against most multi-drug resistant Enterobacteriacae. Pseudomonas aeruginosa was resistant to several antibiotics; most effective agents were ceftazidime (80.95%), aztreonam (76.19%), carbapenem (90.48%), amikacin (90.48%), fluoroquinolones (80.95%) and piperacillin (61.90%). Isolates of Acinetobacter baumannii and Stenotrophomonas maltophilia were mainly multi-drug resistant to most tested antibiotics. In view of high levels of antibiotic resistance encountered, continuous surveillance of antimicrobial susceptibility patterns is warranted. Key words: Gram-negative bacilli, resistance, extended-spectrum beta lactamase, intensive care unit, antibiotics, Enterobacteriaceae, King Abdulaziz University Hospital, multi-drug resistant.
Highlights
MethodsThis prospective study was undertaken in a tertiary care hospital in Jeddah; King Abdulaziz University Hospital (KAUH) with 845 bed capacity, during a period of one month from 15th of July to 15th of August 2011
Gram-negative bacilli (GNB) are a large heterogenous group and amongst them the Enterobacteriacae are one of the most common bacteria isolated in clinical laboratories
This study shows that 20% (28/140) of Enterobacteriaceae were Extended spectrum beta lactamase (ESBLs) producing strains including 20 isolates of E. coli and 8 isolates of K. pneumoniae
Summary
This prospective study was undertaken in a tertiary care hospital in Jeddah; King Abdulaziz University Hospital (KAUH) with 845 bed capacity, during a period of one month from 15th of July to 15th of August 2011. A total of 176 Gram-negative bacilli isolates were identified from 158 patients during the study period. Clinical Gram-negative bacilli strains were obtained from various patient specimens submitted to Clinical Microbiology Laboratory at KAUH. Demographic data (Age, gender, nationality, specimen type and ward of hospital) of patients with Gram-negative bacterial infections (UTIs, skin infections, sepsis, pneumonia, etc.) were recorded on a standardized form. Strains were isolated from a variety of specimens cultured on MacConkey agar and 5% Sheep Blood agar (Saudi Prepared Media Laboratory, SPML). All isolates used in the study were maintained on nutrient agar slants at 4oC
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